PHSSR European Union Investing in Health 2025

24 Investing in Health for a Competitive, Secure, and Resilient Europe: A Strategic Call to Action The Partnership for Health System Sustainability and ResiliencePoland’). The COVID-19 pandemic demonstrated the well-documented ‘panic and neglect’ cycle of health expenditure, marked by a surge in reactive spending but a failure to invest in long-term preparedness and prevention.109 In 2020, per capita health expenditure increased by over 5% on average across EU countries, and European Semester reports highlighted the need to strengthen health system resilience across each of the 27 Member States.,, Despite the systemic vulnerabilities in health systems exposed by the COVID-19 pandemic, longer-term investment has not been sustained, with resources increasingly redirected towards competing priorities. In the 2024 European Semester cycle, only six Member States110,111,112 received health-focused country-specific recommendations, suggesting a waning emphasis on health policy at both the EU and national levels. Source: World Bank Group (2021) Demographic changes, lagging economic growth, and competing budgetary demands are putting immense strain on public finances, compounding challenges in funding stronger and more resilient health systems for the future.115 Inefficiencies are pervasive in health systems, and the evaluation of pandemic expenditure in several Member States has shown that short-term, emergency funding increases the risk of inefficiencies in spending.116 This underscores the need for a forward-looking and long-term approach to plan and implement fiscally sustainable health system reforms, particularly when combining multiple EU financing instruments with Member State funding. Within the context of an EU strategy on health, the autonomy of health system actors to address country-specific priorities is crucial to ensure impactful EU investments that are complementary to Member State activities. Priority setting should consider stakeholders across the health ecosystem, including national, regional, and local authorities; healthcare providers; patient groups; professional associations; and industry representatives. Flexibility to address country-specific challenges, inclusive multistakeholder consultation, and collaborative governance have been recognised as key factors contributing to the success of the EBCP , for example.117 By contrast, civil society Case study: Primary healthcare reforms in Poland114 From July 2018 to September 2021, the Primary Health Care (PHC) Plus pilot was rolled out in primary care centres across Poland. The pilot tested an integrated care model, introducing multidisciplinary teams and coordinated care pathways to create a patient-centred primary care system. The total cost of the programme was 60 million PLN, co-funded by the National Health Fund (NHF) and supplemented with 15.3 million PLN from the European Social Fund. The World Bank provided support for the development and implementation of the programme’s monitoring and evaluation. The evaluation identified several positive outcomes of the pilot, including reduced fragmentation of care for chronically ill patients and faster access to diagnostic services and specialised consultations. Patients reported statistically and clinically significant improvements in disease severity as well as improved health literacy. However, the evaluation also identified several challenges. Although fragmentation of care was reduced, chronically ill patients reported worse care-seeking experiences than before the pilot. PHC facility managers reported several implementation challenges, including organisational shortcomings and insufficient communication among the key health stakeholders responsible for implementing the integrated care model. The World Bank highlighted the importance of securing adequate financing and strengthening the capacity of PHC providers, the Ministry of Health, and NHF teams to ensure the effective implementation of the new care model.