The management of health systems in the EU Member States. The role of local and regional authorities – Study

Health systems across the European Union (EU) are managed and organised in very diverse ways. This study is a re-make of the work carried out in 2011 for the Committee of the Regions (CoR). Like its precursor, it focuses on the role local and regional authorities (LRAs) have within the health management systems of EU Member States (MS).

This role is investigated in terms of power, responsibility and functions with respect to health legislation and policy development as well as healthcare planning, organisation, delivery and funding. Overall, the work aims at contributing the LRAs’ perspective to the current review of the state of health in the EU jointly carried out by the European Commission (EC) and the Organisation for Economic Co-operation and Development (OECD).

It provides updated evidence that in several EU countries LRAs have a significant role with regard to health issues. As a consequence, LRAs and national authorities often share the same concerns on most common challenges faced by health management systems across the Union. These include, for example, the medium-to-long term fiscal sustainability of the systems; increasing expenditure driven, among other factors, by ageing population; health inequalities in access and quality of care; and excessive reliance on costly organisational models such as the hospitalcentric one.