EU Cohesion Policy supporting health for regional development Andor Urmos Policy Analyst, Thematic Coordination, Innovation DG Regio Venice Stakeholder Event EUREGIO III 25th of February, 2010 European Commission, Regional Policy Directorate General http://ec.europa.eu./comm/regional_policy

OUTLINE Regions, health policy and Cohesion policy Cohesion policy investments in health Health inequalities

PART I - Health and regions Regional / territorial dimension of health policy Relevance of health in Cohesion Policy Health as a prerequisite for socio- economic development Health care “industry” R&D, SMEs Public health care initiatives

EU cohesion policy in a nutshell Disparities in levels of development between EU27 regions are significant and have doubled compared to EU15 (measured in GDP/head). Based on a strategic approach (Community Strategic Guidelines on Cohesion), cohesion policy instruments invest in endogenous growth potential, competitiveness of regional economies and infrastructure. Cohesion policy instruments account for one third of the EU budget or EUR 347 billion over the 2007-2013 period. Based on the policy’s principles of concentration, programming, partnership, additionality and efficiency, the funds’ implementation follows shared management between the Commission, the Member States and the regions.

Regional Disparities in EU27 GDP per head in % in Purchase Power Standard PPS (2004) <50 50 - 75 75 - 90 90 - 100 100 - 125 ³ 125 Index, EUR-27 = 100

EU Cohesion Policy 2007-2013 Eligible Regions Total Budget: EUR 347.4 Mrd. (35,6% of the EU-Budget) Of which 82% for Convergence Regions, 15% for the other.

PART II - Cohesion Policy 2007-2013 STRUCTURAL FUNDS OBJECTIVES HEALTH INVESTMENTS ERDF ‘Convergence’ Investment in health infrastructure to contribute to regional development and quality of life ‘European territorial cooperation’ Development of collaboration and capacity ESF And ‘Regional competitiveness and employment’ Training of health professionals Safety at work to promote more productive forms of work organisation

EU Funding 2007-2013 Between 2007 and 2013: €5.1 billion (1.5% of the total of cohesion policy funding) has been earmarked to support health infrastructure €5 billion have been earmarked for e-services (including e-health) €1 billion has been earmarked for active ageing, etc. 0 % <1% 1-2% 2-3% 3-4% 4-5% >5% Health infrastructure: Percentage of planned investments in health infrastructure in relation to the total amount of Structural Funds allocated to Member States in 2007-13.

Cohesion policy 2007-2013 Health infrastructure is the most visible priority Additional range of actions to eligible for Structural Funding: Population ageing Healthy workforce Health innovation and research Knowledge and information technology Environment

Structural Funds and Cohesion Fund Cohesion Policy: instruments and objectives 2007-2013 3 Objectives Structural Funds and Cohesion Fund Convergence ERDF ESF Cohesion Fund HEALTH HEALTH Regional Competitiveness and Employment ERDF ESF HEALTH HEALTH European territorial Cooperation ERDF HEALTH Infrastructure, Innovation Training Measures Occupational health Member States with a GDP/head below 90% Environment, Transport infrastructure All Member States and regions

Cohesion Policy: instruments and objectives 2007-2013 Direct investments ERDF, ESF – infrastructure, e-health, health promotion, access to services, edication/training, etc. Indirect investments ERDF, ESF - workplace health, inclusive employment, health & safety Investment with potential health gain ERDF, ESF, Cohesion Fund - urban rehabilitation, social cohesion, R&D, transport, environment, etc. By Jonathan Watson (Health and Structural Funds in 2007-2013: Country and regional assessment)

Structural Funds 2007-2013: health investments Member States health priorities in NSRFs and OPs (by area of investment) Health promotion, prevention: BE, CZ, EL, HU, IE, LT, SK 7 Screenings: HU, LT, SK 3 Health promotion, safety at work: BE, CZ, DE, DK, EL, ES, FI, HU, LX, RO, SK 11 eHealth: CY, DK, EL, LT, NL, RO 6 Health infrastructure: BG, CZ, DE, EL, FR, HU, LT, LV, PL, RO, SK Education of health care professionals: CY, CZ, EL, ES, HU, LT, LV, SK 8 Quality (management): CZ, EL, HU, LT, PL, SK Environmental health: CZ, FI, HU, LT, MT, RO Demographic change: AT, FI, FR, RO, SK 5 Access to health care: BE, CZ, EL, ES, FI, FR, HU, LT, LV, SK 10 Emergency care: HU, LT, LV, PL, SK

PART III - Health inequalities in the EU: BETWEEN Countries Life expectancy at birth (years) for males ranges from 65 (Latvia, Lithuania) to 79 (Sweden), a gap of 14 years Life expectancy at birth (years) for females ranges from 76 (Bulgaria, Latvia, Romania) to 84 (France, Italy, Spain), a gap of 8 years

5-fold difference in deaths of babies (under 1 year) Solidarity in Health: Reducing Health Inequalities in the EU Communication, 2009. October Background 5-fold difference in deaths of babies (under 1 year) 14 year gap in life expectancy (men), 8 year gap (women) Regions, rural-urban areas, neighbourhoods, etc.

Lisbon agenda objectives Solidarity in Health: Reducing Health Inequalities in the EU Communication, 2009. October Need for further actions – negative consequence for health, social cohesion, economic development An equitable distribution of health as part of overall social and economic development Lisbon agenda objectives Economic growth Greater social cohesion Healthy life years indicator (to monitor progress) Need for reducing health inequalities

Solidarity in Health: Reducing Health Inequalities in the EU Communication, 2009. October Actions Improving data base (measuring, monitoring, evaluation, reporting) Collection of data and health inequality indicators (age, sex, socio-economic status, geographic dimension) Orientation of EU research - 7th EU Framework Programme for Research Common set of indicators – monitoring health inequalities (Member States, Commission) Building commitment across society Improving the exchange of information, knowledge, across sectors (social care, employment, education, regional development, etc.) Promotion of good practices at EU level Training to address health inequalities

Solidarity in Health: Reducing Health Inequalities in the EU Communication, 2009. October Meeting the needs of vulnerable groups Special attention to be given to needs of people in poverty, migrants, ethnic minority groups, people with disabilities, elderly, child poverty Raise awareness, promotion of actions to improve access to health services, health promotion, preventive care Report on using Community instruments and policies for Roma inclusion (Roma Summit April, 2010, Spain) Report on health inequalities by Fundamental Right Agency (access to adeqaute health care, social and housing assistance, etc.) Developing the contributions of EU policies Half of EU Member States do not place emphasis on reducing health inequalities, lack of comprehensive inter-sectoral strategies. To assist Member States about better use of SF, Cohesion Policy for reducing health inequalities Further use of rural development policy, market policy (school milk, school fruit scheme) – rural poverty Provide funding under PROGRESS, peer reviews, developing relevant strategies

From health infrastructure to health promotion The 'Saude' programme, Portugal Example of a comprehensive health programme, funded by ERDF and ESF since 1986. In the initial phase, construction of hospitals and health centres, training of nurses. Focus now as well on health promotion and disease prevention, access to health services and partnership structures in the health sector Budget 2000-06: EUR 698 million, of which 476 million from Structural Funds

Health, research, innovation and ICT Kuopio Science Park, East of Finland Regional cluster for health, nutrition and environmental sciences reinforced by ICT development, in the second half of the 1990ies. 18,000 people work and study in the science park Funding: ERDF

Interregional networking The “Regions for Economic Change“ initiative Between 2007 and 2013, networks of regions working together on 30 selected themes will be created under the initiative. Three of them will be specific for health related issues: Making healthy communities Meeting the demographic challenge Promoting a healthy workforce in healthy workplaces

Thank you for your attention! Andor Urmos DG Regio Tel: +32-2-229-50679 Email: andor.urmos@ec.europa.eu