Workshop: using Structural Funds in health Professor Jonathan Watson PhD FRSM HCN Executive Director/Board of Trustees Special Professor of Health & Public Policy, University of Nottingham Medical School Governor – Edinburgh Napier University External Partner- Bilbao Consortium (Deusto, Vilnius, Corvinus, Verona) European Masters Degree in Sustainable Regional Health Systems Europe's health economies exchange Financing regional healthcare workshop, AER, Katowice 19 March 2009

items The Structural Fund process How regions have used SF Challenges in using SF for health Achieving added value investments

direct health sector investment (€5 bn -1.5%?)

operating environment for SF and health

Best actions & lessons learned about health investments

…best actions

…lessons learned NO

 Medical technology and telemedicine  The elderly  Prevention & rehabilitation

building regional networks composed of all players common* clinical pathways cross-linked by telemedicine extending telemdicine by telecoaching *trans-sectoral

close to home medicine financed directly with the least bureaucratic detours

Challenges in using SF for health Different metrics in each EU MS Is the new health infrastructure funded by SF increasing the health status of population? Developing indicators and gathering the needed statistical data. Developing cost-benefit analysis for investment projects The process of prioritizing needs and referring them to aims of the Operational programmes Preparing the project according the EU standards Bureaucracy - Complicated and often changed formulas - too many attachments, permissions, opinions, consent.. Too strong tendency to standardize all kinds of projects e.g. indicators that fit to industrial and business projects not fit to health or education ones..

Challenges Separate OP Negotiation with EC Creation of new Managing Authority for separate OPH Content of OP Creation of balanced and realistic OP (Inpatient vs. Outpatient Health Care Infrastructure) State aid Implementation of the Commission Decision 2005/842/EC in the conditions of the Slovak healthcare system MINISTRY OF HEALTH OF THE SLOVAK REPUBLIC

EIII events Workshop A and Master class A (Budapest October 2009) Workshop B (Kaunas, November 2009) Stakeholder Conference (Venice February 2010) Master class B (Stockholm March 2010) Workshop C (Tallinn May 2010) Workshop D and Master class C (Krakow July 2010) Interim challenge workshop (Brussels CoR January 2011) Workshop E (Cluj-Napoca March 2011) Final conference (Brussels October 2011)

non-health sector investment with potential health gain Integrated planning, one-stop shops (rural), health tourism, green spaces, procurement

MAs assessing added value In performance measurement terms there are 3 key challenges that flow from the principle of cost effective investments that maximise health gains at regional and sub-regional level: First - identifying outcome measures that are systemic products and reflect added value for SF and national/regional investments Second - simplifying accountability mechanisms Third - use existing data available across sectors that can be interpreted to inform key indicators (where possible). Added value/health gains: Increasing local employment Increasing the skills base in local labour markets Increasing wealth in the region Promoting business growth (SMEs) competitive in wider markets Healthier lifestyles Enhancing community well being and social cohesion Protecting the environment by decreasing transport miles.

questions… Does your region spend Structural Funds for health? How do you spend the money? What are the challenges you are facing? What help/support do you need?