Building on EUREGIO III: needs and opportunities Brussels 3 February 2011 Professor Jonathan Watson PhD FRSM HCN Executive Director EUREGIO III Project lead Special Professor of Health & Public Policy, University of Nottingham Medical School Lay Court Member – Edinburgh Napier University External Partner to European Masters degree in Sustainable Regional Health Systems (Deusto, Vilnius, Corvinus, Verona)

light and shadow EU policy directions (EU2020, Post-2013 Cohesion Policy, Solidarity in Health) Key messages from EIII SF management and delivery Regional support needs Project lifecycle support Principles, needs & capacity Completing EUREGIO III Summary

EU responses I SMART growth (Innovation Union, Youth on the Move, European Digital Agenda) SUSTAINABLE growth (Resource Efficient Europe, Industrial Policy for a Global Age) INCLUSIVE growth (New Skills and Jobs, Platform Against Poverty)

EU responses II: post 2013 Cohesion Policy Three scenarios: Health continues to feature as an objective for Cohesion Policy Health exists as a sub- priority under a number of other priorities SF are no longer used to invest in health Health system reform mandate given as part of economic governance

social determinants of health Solidarity in Health (2009) WHO/EU Equity Project briefing paper (2010)

EU responses III EU2020 Flagship initiativeIndicative health sector actions Innovation Union (Smart) Regional excellence clusters based on public health systems, universities and health industry collaboration, innovation partnership (healthy ageing), bio-economy, functional foods Youth on the Move (Smart) Inclusive employment, life long learning, transnational and interregional mobility European Digital Agenda (Smart) E-health, ICT-based support for dignified and independent living, telemedicine, tele-coaching, distance learning, patient information services Resource Efficient Europe (Sustainable) Pluralistic health care model (less hospital-centric), cross-border health care, improved local procurement with the health sector supply chain, energy efficient capital investment Industrial Policy (Sustainable) Joint R&D regional platforms for medical device SMEs, regional health sector supply chain SME Networks New Skills & Jobs (Inclusive) Inclusive employment, flexible workforce, active ageing, life long learning, mobile health professionals Platform against Poverty (Inclusive) Inclusive employment, improved social protection (pensions), closer to home health care access

key messages Lessons emerging from case studies of the 2000/6 SF programme differ significantly from those of the 2007/13 programme e-health is ranked above other investments priorities closely followed by infrastructure development, with health promotion and education and training somewhat lower down the scale. There is little evidence of forward planning for the down turn in economic activity and growth Clear demands for better and faster communication with the EC Specific help is needed to improve understanding, confidence and expertise in preparing good Structural Fund applications Specific help is needed to improve understanding, confidence and expertise in managing SF projects There is a need to improve (regional) absorption capacity to manage these changes and plan and implement relevant and effective SF investment;

needs I Management of SF Communication Conditions for pre-assessment Health Equity Impact Assessment Intersectoral governance Incentivise operational flexibility Comparable monitoring and evaluation

needs II Delivery of SF Project development support Peer review Mentoring Real-time knowledge exchange during implementation Good practice clearing house

regional support Knowledge platform Quality support programme Training and development Events and policy dialogue Good Practice Clearing House

project lifecycle support Project development (create the right thing) Project development (create the right thing) Application Process (apply for funding the right way) Application Process (apply for funding the right way) Implementation (do the right thing) Implementation JASPERS+EIII follow-up Conceptualising and connecting EIII follow-up Action research/learning

principles, needs and capacity PrinciplesNeedsCapacity Strategic Disinvest to reinvest Return on investment People focus Sustainability Entrepreneurship Conditionality Project development support Health Equity Impact Assessment Comparable regions Real time knowledge sharing Mentoring & Peer review Organisational Workforce Leadership Partnerships Resources allocation

completing EIII New case material on website from February Liaise with EMPLOY to find more ESF case studies Capacity building audit with selection of regions Training workshops (Budapest in May/June and Brussels in September) Master classes (Lisbon in March and Stockholm in September) Peer-review publications and online thematic papers Final conference in September

summary – preparing for Health systems are an economic investment and not a cost Apply conditionality to funding decisions Work and learn together on issues where regions & organisations share priorities Build capacity and expertise to ensure health systems remain reliable, can adapt, act creatively and manage sustainably.