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Health governance in Europe

The politics, policy and governance of health in the EU

Stakeholder involvement in health – too little, too much or just right?

Stakeholder involvement has been the focus of much discussion and debate in recent months, in relation to both the delivery and the design of EU policy. In the current economic climate, mechanisms such as public-private partnerships (PPPs) can be effective tools for financing innovation and delivering services, but balancing the role of industry with public interest is a challenge, nowhere more so than in health. Meanwhile, efficient delivery of policy is made easier by inclusive policy-making – to this end the European Commission recently launched a public consultation on the EU guidelines and procedures for stakeholder engagement. The challenge here is to encourage all parties to engage in the consultation process and ensure that a broad range of views are heard. This is particularly important in health, since so many policy proposals have potential implications for public health and health systems.

What then is the appropriate balance? Should health policy-making seek to involve all actors – industry, public health authorities, insurers, civil society, health professionals, patients and others – in equal measure or should some be preferred above others? What types of cooperation and partnership are most fruitful and under what conditions do they work best? How should stakeholders be involved in policy-making? Are public consultations accessible, burdensome or representative? What role should evidence play in the creation of policy and how should it be incorporated? Is self-regulation an effective governance tool?

Interesting examples can be drawn from the EU’s activity in nutrition and physical activity. The 2007 Strategy on Nutrition, Overweight and Obesity-related Health Issues established two partnerships for involving member states, civil society and industry, which have produced a range of outcomes. Whilst the inclusion of both industry and public health interests has sometimes been criticised as unconstructive, some of the specific commitments reached represent a considerable step forward. The experiences and lessons from the Strategy are particularly important in light of last week’s dissolution of the proposed Health Intergroup in the European Parliament, which was stalled following the perceived elevation of industry interests in pharmaceutical policy. What can be learned from the mechanisms and tools used in the EU platform for action on diet, physical activity and health, and the High Level Group on Nutrition, and how can their own functioning be improved further?

This important debate is the subject of the ‘Building EU Health Policy’ forum at the upcoming European Health Forum Gastein. In session two of the Forum, expert panellists will present opposing sides of the argument before engaging in an open discussion with audience members. The Forum will begin at 09:00 on Thursday 2 October and can be followed via Twitter using the hashtags #EHFGstakeholder and #EHFG_F2. Join us then for a vibrant discussion on the future of stakeholder involvement in health and cast your vote for or against the motion!

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