New Eurohealth on EU cross-border health care collaboration

By 25th October 2013, European Union Member States should have transposed the Directive on the application of patients’ rights in cross-border healthcare into national law, thus promoting a new era of opportunities for patients seeking health care services in an EU country other than their own

Time to focus on benefits beyond the health sector: the example of health literacy

Summary: Many actions to promote and protect health may be funded and delivered outside of the health sector. However, these actions may be seen as activities that may deflect valuable resources away from these sectors’ core goals. Thus, while promoting Health in All Policies as a concept is appealing, in practice implementation can be difficult. The importance of looking beyond health outcomes becomes important when making a case for investment in health literacy actions targeted at children and young people. These outcomes and impacts are still too often neglected when arguments are being made for health in all policies

Regional and national experiences on bridging: a Western European perspective

This presentation reflects on experience across the pre-2004 European Economic Area in making use of formal mechanisms to help collate and consider different sources of information in health and social care policy, with a particular focus on the areas of ageing and disability. The structures, capacity and resource requirements of selected mechanisms will be illustrated. The presentation then assesses how, if at all, different approaches adopted in regions and countries have actually been used to help bridge gaps between different stakeholders, in both establishing policy relevant research priorities and developing evidence informed policy and practice. Challenges for the future strengthening of capacity as well as potential opportunities for pan-national co-operation will also be considered

Health care management autonomy: Evidence from the Catalonian hospital sector in a decentralised Spain

The organisation of inpatient care provision has undergone significant reform in many southern European countries. Overall across Europe, public management is moving towards the introduction of more flexibility and autonomy . In this setting, the promotion of the further decentralisation of health care provision stands out as a key salient policy option in all countries that have hitherto had a traditionally centralised structure. Yet, the success of the underlying incentives that decentralised structures create relies on the institutional design at the organisational level, especially in respect of achieving efficiency and promoting policy innovation without harming the essential principle of ‘equal access for equal need’ that grounds National Health Systems (NHS). This paper explores some of the specific organisational developments of decentralisation structures drawing from the Spanish experience, and particularly those in the Catalonia. This experience provides some evidence of the extent to which organisation decentralisation structures that expand levels of autonomy and flexibility lead to organisational innovation while promoting activity and efficiency. In addition to this pure ‘managerial decentralisation’ process, Spain is of particular interest as a result of the specific regional NHS decentralisation that started in the early 1980’s and was completed in 2002 when all seventeen autonomous communities that make up the country had responsibility for health care services. Already there is some evidence to suggest that this process of decentralisation has been accompanied by a degree of policy innovation and informal regional cooperation. Indeed, the Spanish experience is relevant because both institutional changes took place, namely managerial decentralisation – leading to higher flexibility and autonomy- alongside an increasing political decentralisation at the regional level. The coincidence of both processes could potentially explain why some organisation and policy innovation resulting from policy experimentation at the regional level might be an additional feature to take into account when examining the benefits of decentralisation.Management autonomy, hospital innovation, National Health system, Spain, regional health service, Catalonia

To nudge, or not to nudge, that is the question

The use of techniques from behavioural science to nudge populations in subtle ways to choose behaviours and activities positive to their health and wellbeing is certainly fashionable. One question, yet to be resolved, is whether these nudges will become integral components of public health policy or just passing fads. There should be scope for nudging to play an important role augmenting other elements of health promotion and public health policy. This is likely to depend on whether or not the evidence base on the effectiveness and cost effectiveness of different types of health nudges, targeted at different population groups and in different settings, develops sufficiently