Smart investment for better outcomes: Health (dis)investment Working group meeting

Healthcare systems should move away from their traditional focus on facilities such as hospitals and strengthen capabilities in areas such as prevention and data use. This was one of the messages from a Friends of Europe health working group which aims to generate insights and recommendations for the next EU mandate. This first meeting addressed ways of making smart investments and the next meeting on 15 May 2018 will examine the related issue of disinvesting from redundant, obsolete or ineffective health interventions.

The group met as European economies are growing healthily once again after a decade of decline. Health spending was growing faster than GDPs before the crisis, but governments cut back amid pressure on public finances. There is now a chance to reinvest in health systems in a way that addresses new concerns, such as aging populations, and takes advantage of new opportunities.

Instead of just plugging existing spending gaps, governments, private investors or philanthropic foundations could make smarter choices about how and where to inject increased funds. This will involve careful analysis of the financial incentives within healthcare systems, stopping outdated or ineffective practices and embracing modernisation and innovation.

“The health sector is a huge consumer of technologies, and is also being offered digital innovations by various industry sectors,” said one of the participants meeting under Chatham House rules. “The question is: How will these innovations act in the health sector?”

Waste is an important area of focus. Up to a fifth of health spending in the OECD is ineffective or even wasteful, 1 in 10 hospitalisations and half of anti-microbial prescriptions. There is also too much recourse to hospitals’ emergency departments. “We need to rethink what kind of assets we need for patients,” said a participant. “They may not be the assets of primary care as we know them nowadays. Huge hospitals that do everything are prestigious but are not fit for all patient groups. If we are busy with these institutions, we are not busy with other things.” The need to create a new healthcare landscape, with more facilities locally available offered by a greater range of providers and connected by technology.

More should be invested in prevention. And doctors should be given more training in the use of data, a lot of which is sitting in hospital records, unusable and unused. “We have to solve the ownership issues,” said one participant. “The data is the patients’ data and they should be able to access it. We also need to invest in security of data.”