European Structural and Investment Funds (ESIF, earlier called SF, Structural Funds) used in the health sector mostly financed direct health investments in the 2000-2006 and 2007-2013 SF periods. During this time the predominant SF investments focused mainly on capital expenditure for hospital and health facility renewal and eHealth projects. Projects examining innovative use of ESIF therefore needed to anticipate the mood of change in healthcare as it addresses future flashpoints, demography, chronic disease and an uncertain economic outlook.
A further complex issue is the nature of innovation and impact of SF projects. Innovation tends towards the technical element of projects, in particular eHealth, as opposed to achieving innovative and sustainable outcomes. This can be observed in the general weakness in applying lifecycle operational and economic principles to project proposals. Concept planning and decision criteria need particular attention in this respect. However it is also important to note a nucleus of innovative projects emerging within the past years or so that capture both the spirit and letter of Europe 2020, for example active and healthy ageing, and which will provide exemplars of good practice on which to build for the future.
There is one further important issue, if ESIF for health is to become more effective there will be a need for new concepts accompanied by investment in new practical knowledge, competencies and tool kits to manage the more complex changes ahead.
To this end we are involved in this agenda in several ways as a project partner and as a contractor or sub-contractor for commissioned assignments. The first project we led was EUREGIO III (2009-2011). It identified & shared best actions for the effective use of structural funds for innovative health care investments, concentrating on those areas of spending likely to prove critical to ‘improving future healthcare’. The project identified and developed depth case studies for 10 health projects funded using Structural Funds and compare them with comparator non-SF funded projects. EUREGIO III provided good evidence to inform the conclusions of the Hungarian EU Presidency Programme, which in turn generated the EU Council Conclusions Towards modern, responsive and sustainable health systems (6 June 2011). This advocates strongly the need to develop a more integrated and pluralistic model of healthcare in place of the hospital-centred default model common across all EU member states. Subsequently, HCN was commissioned by DG REGIO to produce a Guide to the negotiation of health infrastructure and health service priorities in the post 2013 programming period in convergence regions (Contract No. 2011CE160AT048). A project that built in part on EUREGIO III was HealthEquity-2020 led by the University of Maastricht and for which HCN was a partner and Project Director (look at the Area of Expertise ‘Reducing health inequalities’ for more information). Currently, we are involved in project led by Lilieua Limited and commissioned by CHAFEA – ESI Funds for health (Contract No. 2015 73 01). In this we provide lead expertise for the thematic block ‘Research and innovation’. See http://esifundsforhealth.eu