Shifting the dialogue and giving everyone a voice

Louise Baker-Schuster, Chief Foundation Partners' Officer, reflects on this year's European Health Forum Gastein

With just under 7,000 inhabitants, the Austrian spa town Bad Hofgastein isn't your typical location for an international conference on European health policy. Nestled between some pretty imposing mountains, it has a distinctive feeling of wellbeing and exceptionally clean air. It's also not that easy to get to. After my five-hour train journey and arriving at the idyllic two-platformed train station, I knew that I was in for a unique conference experience. The flip side is, of course, that it's not that easy to leave either.

For four days, this tiny town is taken over by the 900 conference participants of the European Health Forum Gastein (EHFG). Everywhere is within walking distance, and at every turn, you see the all-familiar blue name badges, instantly identifying another member of the very welcoming and ever-growing EHFG Community. And, with the inclusion of the Young Forum Gasteiners, the next generation is not just waiting in the starting blocks but being actively involved in shaping the future health systems that they will be leading.
 
The EHFG offers a platform for dialogue, discussion and debate on international health policy. European, in not only political terms but also focussing on a geographic region and innovation hub. 2023 was dedicated to the theme of "Health systems in crisis - Countering shockwaves and fatigue", a subject that we have also been reflecting on in Sciana.

The plenaries and breakout sessions focussed on resilience, the workforce and digitalisation. No real surprises there. However, it was refreshing to see a broad spectrum of speakers from across the European region and from a wide range of organisations. From health care professionals speaking very openly about their current, personal working situation to patient-led organisations and experts through experience, right through to the high-level political guests from the European Union, the WHO and national ministries, it felt that the EHFG was aiming to give everyone a voice.

With the launch of the Austrian Chapter of Women in Global Health, led by the EHFG Secretary General and Sciana Fellow, Dorli Kahr-Gottlieb, and the unflagging representation of the global organisation through co-founder and former Sciana guest speaker Roopa Dhatt, and Sciana Chair, Ilona Kickbusch, the discussions deliberately included the female voice. Throughout the conference, Roopa and Ilona continued to remind us that women make up the majority of the health and care workforce, yet only a minority of women hold those decision-making positions. Clear statements, evidence-based arguments and a tone of urgency that just could not be ignored. Policy-making and awareness raising at every opportunity, which I personally found absolutely fantastic.
 
Health systems are and have always been complex. The COVID-19 pandemic magnified this complexity, and national health systems are now finding themselves at breaking point while having to cope with constant, complex and multiple challenges. And, not just from within their own system.

Increasingly, health systems across Europe are tackling pressures that have no regard for national borders or financial mechanisms, such as climate change, digitalisation and the effects of migrating populations. These trends are certainly not new but have now grown in such magnitude that they can no longer be ignored. Or solved through national policy alone. New partnerships are needed and are indeed being formed.

In Gastein, I noticed that guest speakers and the direction of the dialogue seems to have shifted since before the pandemic. Industry, pharma, and tech companies are being invited up onto the stage and are now being asked for their opinions, as well as solutions. Non-profit organisations and the private sector rubbing shoulders on a public platform is not something that I have often witnessed.

There appears to be a realisation, that we need to look not just across to other countries but also to other systems and sectors for inspiration, advice, and collaboration. This is very much something that Sciana has always believed in and advocated for through its cohorts of health leaders with very diverse professional backgrounds, so it was good to see this approach getting more of a public platform.
 
Out of the discussions between these sectors, there was often the call for appropriate regulation to ensure meaningful contribution. The lack of streamlined, purposeful regulation has created what one speaker coined as "spaghetti regulation", encouraging unnecessary repetition in investment and innovation. There was strong criticism about how the wheel is constantly being reinvented without a consensus in place about the vehicle we want to take forward or the route we want to take. And this is where European Union (EU) policy can work its magic.

Health may still be a competency of the nation states, but the EU can effectively influence health policy throughout Europe and beyond. Where the EU does have policy-making power is in areas such as agriculture, food safety and trade and it is in areas like these that decision-making at an international level can have a positive impact on national health systems. That the role of the EU on the global health policy stage is changing and growing in importance was voiced on more than one occasion, as was an urgent call to action. We can all actively contribute towards making our health systems more efficient, more patient-centred and more effective.  

The EHFG has decided to take the lead by facilitating the European Health Union Initiative and Manifesto, supported by a number of international organisations, including the Bosch Health Campus. The manifesto, led by renowned politicians and policy-makers sets out a vision of what a European Health Union could look like, including goals, policies, measures and principles. It also calls for each and every one of us to contribute to a health policy that strengthens the EU by demonstrating that by working together, we have the potential to protect everyone and leave no one behind.

The manifesto can be signed by anyone who wishes to, and the initiative is always looking for fellow campaigners. So, join the campaign, sign the manifesto and become a member of the European Health Union initiative!

This article was authored by Louise Baker-Schuster. The views and opinions expressed in this article do not necessarily represent the views of their organisation(s), Sciana: The Health Leaders Network, nor those of the Sciana Network's three funding foundations.