MEP Konečná: ‘We need a fundamental shift in the way health services are funded, managed and delivered’
MEP Katerina Konečná (GUE/NGL, Czech Republic) is one of the 5 champion MEPs of the EPF Campaign on Access to Healthcare. A member of the Committee on Environment, Public Health and Food Safety at the European Parliament, Mrs Konečná supports the campaign workstream on holistic approach to healthcare.
Why have you decided to become a champion of the EPF campaign?
During my whole political career, I have always worked very closely with many patient organisations because their activities are crucial for citizens both at national and European level. I am focusing on universal access to healthcare in its relation to the social security and justice system and the EPF campaign was an opportunity to take my work to the next level.
Within the campaign, you champion the action area on affordable access to a holistic range of health and related social services, to ensure that all dimensions of care are addressed. In your experience, are there specific gaps in this regard (in Europe and/ or the Czech Republic)?
In my view, the main problem is the non-existing connection not only between individual healthcare systems across all Member States but also between the healthcare system and welfare system within Member States. The Czech Republic is not an exception. This lack of connection causes important economic damages. For example, healthcare system authorities often refuse to reimburse an expensive treatment or medicines for patients with very rare conditions, because the cost is simply too high. However, the public insurance companies do not realise that if this treatment is not delivered on time, the economic burden will only go higher. Most insurance companies prefer to leave the costs associated with the treatment transferred to the welfare system, hence reducing immediate costs for the healthcare budget. It is also very difficult for Member States to properly estimate these costs, as patients could be taken care of by the welfare system for years and in the end costs could be much higher than the costs of the original proper treatment. This is a huge mistake, wasting our limited resources.
In most Member States, the healthcare systems are still organised in “silos” where different parts of the system don’t talk to each other. What can we do to resolve that?
This was one of the topics I tried to push into the INI report of the European Parliament this year on the options to improve access to medicines. Unfortunately, the possibilities to resolve this issue at the European level are very limited. The organisation of healthcare is according to article 168 of the Treaty of the Functioning of the EU (TFEU) still a national responsibility. The healthcare and social systems lie in the exclusive competences of Member States (with some minor exceptions). This issue is also highly connected with the fiscal questions. That is why the EU Institutions have very limited room for manoeuvre. We can make a difference only by soft laws, recommendations and call for deeper cooperation between Member States. The pressure should also come from individual member states and their national civil society organisations, including patient organisations.
Do you think implementing patient-centred integrated care could be a solution? What structural and operational changes would be needed?
Millions of people on the planet lack access to essential healthcare. In many Member States, the organisation of healthcare is fragmented. We need a fundamental shift in the way health services are funded, managed and delivered. We need universal health coverage. It is necessary to shift away from health systems designed around diseases and institutions to health systems designed for people and patients. We need major changes in the health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation and palliative care services, at the different levels of care within the health systems and within the social welfare systems.
How could the “basket of care” that is available to patients be better tailored to their needs, with coverage of appropriate healthcare services and products (e.g., physiotherapy, psychotherapy, dental care)? What is your position on this?
We need to move from disease-centred to patient-centred health systems. This includes not only healthcare services and medicines but also social welfare. It is necessary to move the healthcare system closer to social welfare system and connected them together.
An essential component of integrated care is multi-disciplinary collaboration and team work. What should Member States do to ensure better cooperation between healthcare professionals?
Some basic regulation is necessary. The minimum we can do is to develop and encourage this cooperation. A lot of work has been already made in this area. I think that on the academic level the situation is very good. We have to work on the connection of individual databases and in the field of research and public access to research results.
Could the implementation of digital technology, via eHealth or connected platforms be useful in that regard?
Yes, especially for example in the field of research or rare diseases databases. There are currently more than 30 million people living with a rare disease in Europe. Patients and experts are few, geographically scattered and often isolated. We have very fragmented research, data and expertise of rare diseases. It is also important to study the area of medication where eHealth and connected platforms could play an essential role.
Any final message for our readers?
Just don’t give up. There is plenty of work ahead for all of us. And even that it can sometimes look like the European Parliament is not doing anything in the field of access to healthcare, it is not true. There are plenty of good people working on this issue every day and who need your support.