On 9 December the MEP Interest Group on Equitable Access to Healthcare hosted a webinar, organised jointly with the Patient Access Partnership (PACT) and which discussed the monitoring strategy for the implementation of the reforms under the national recovery and resilience plans with a focus on their expected contribution in improving access to healthcare.

Opening the meeting, MEP Andrey Kovatchev welcomed the introduction of the Recovery and Resilience Facility (RRF) for being a cross-sectoral future-proof instrument and expressed hope that at such difficult times, rigid implementation efforts will be put in place to diminish existing inequality in access across the EU. “Inequalities in healthcare funding lead to inequality in the provision of care and treatment, and result in disparities in quality and longevity of life”, MEP Tomislav Sokol added, “but with three funding mechanisms at our disposal – the EU4Health Programme, the Cohesion Policy and the Recovery and Resilience Facility, we can address this staggering inequity”.

The meeting, moderated by Mrs. Nicola Bedlington, Policy Advisory of PACT, tackled a range of issues related to the implementation and expected impact of the RRF, positioning it against the framework of other existing instruments which contribute to improving access to healthcare across the Member States.

Ms. Ingrida Pucinskaite, Country expert at SG RECOVER, set the scene with an overview of the health-related reforms and investments in the RRF based on 22 plans assessed by the European Commission and approved by the Council. Accounting to 29% of the social expenditure, approximately EUR 41 billion is proposed to be spent on health investments and reforms (long-term care included). Although the amount to be spent on health differs widely between Member States, there is a strong commitment to improving health systems by including reforms and investments dedicated to health. Specific examples of access-related reforms include re-organization of health systems to strengthen their capacity, adoption national public health programmes, setting up and rolling out national preventive screening programmes, developing centres of excellence, rebalancing from hospital-centric models to primary care and prevention.

In the context of the round-table discussion, Ms. Geraldine Mahieu, Acting Director of DG ECFIN, emphasized that the RRF is a forward-looking performance-based instrument which ensures that funding is disbursed upon implementation which brings a crucial element of commitment on behalf of Member States. Equally important is that there is an assessment component related to the Country Specific Recommendations which has encouraged significant uptake of the health-related recommendations (expectations are for around 70% of 2019/2020 CSRs to be implemented through the national plans). In practice, the implementation will consist of several instruments, including regular exchange between the EU Commission and the Member States within strict timeframe, tracking and scoreboard assessment, and stakeholder involvement encouragement.

In response to the question whether there is sufficient institutional capacity at national and regional level to absorb these funds, Ms. Sasa Jenko, Head of Sector for Health at DG REFORM, emphasized the importance of the multidisciplinary Technical Support Instrument at disposal to Member States which aims to provide support in identifying the country-specific needs and once there is political ownership, co-create solutions with institutions and stakeholders to allow for the efficient implementation of the RRF reforms. A central component of this task is the capacity assessment and where needed, the provision of support in building the competences needed through peer-to-peer best practice expertise exchange. “This is a paradigm shift towards performance-based funding” Ms. Jenko explained, and added that for optimal results, local engagement is most needed.

Mr. Juan José Fernández Romero, Policy Assistant at the European Patients’ Forum, expressed hope that the RRF will improve healthcare systems across the EU and tackle the deepened health inequalities because of COVID-19 in terms of access to healthcare, out-of-pocket payments, treatment, and medicines availability. He further reiterated the need for systematic and meaningful patient involvement in the discussion of future initiatives, such as the Pharmaceutical Strategy for Europe and the revision of the general pharmaceutical legal framework.

Mr. Giovanni Gorgoni, Chair of EUREGHA, accentuated on the need to build synergies between the RRF funds, other available funding instruments, and innovation and production pathways. He stressed on the need for multi-level governance collaboration at EU and Member State, regional and local levels with regional authorities playing an important role in transforming funds into practical reforms. Another key aspect in this is the collaborative effort to bridge policy and practice with the active involvement of stakeholders. Finally, it is vital that there are clear rules and procedures for traditional and new forms of innovation procurement for ecosystem-level solutions, combined with effective monitoring and implementation mechanisms.

The round-table participants agreed around the concept that significant healthcare improvement can be achieved through the RRF with consistent and coherent application of health-related CSRs, and that this is inherently linked to recovery, resilience, and equity of access moving forward. The transformation of funds into results, it was asserted, can only be achieved through cooperation between governance levels, systematic stakeholder involvement and capacity-building practices.