by Sherry Merkur, Anna Maresso and David McDaid
Our final Eurohealth issue for 2014 throws the spotlight on migrant health and the importance of ensuring that everyone in Europe, irrespective of country of origin and legal status, has proper access to health services and treatment.
In the Eurohealth Observer section, Williams and Noori explore the often higher infectious disease burden in migrant populations in Europe, including for HIV, TB and chronic hepatitis B. Just as importantly, the authors highlight the real difficulties in monitoring and treatment, given the lack of reliable data on migrant-specific variables within current disease surveillance systems. Delving into more detail, Falla et al. identify the public health threat of viral hepatitis in Europe and emphasise the need for effective screening, particularly for vulnerable population groups such as migrants. The authors showcase the new HEPScreen Toolkit that has been developed specifically for the practical implementation of screening protocols.
Focusing on a particular sub-group of migrants, van Ginneken explores the disparate approaches taken by European Union countries on undocumented migrants’ entitlement to health services and the practical barriers that may also impede access to services. The article highlights the many areas that still need to be addressed, including the lack of legal clarity to entitlements, ensuring confidentiality, removing financial and administrative barriers to access and addressing cultural and language barriers in service provision. Taking a health systems perspective, Keith et al detail two different approaches taken by Sweden and Spain in granting access to health services to undocumented migrants and the impacts this can have on health systems, including challenges for data collection, health monitoring and resource allocation.
De Raeve and colleagues address issues of planning and forecasting the future nursing workforce at EU level in the Eurohealth International section. They propose four categories for re-classifying nurses in accordance with the European Federation of Nurses Associations’ nursing care continuum. In a second article, Connolly details the incremental growth of the European Commission’s competence in health security. He discusses how the 2009 influenza pandemic in the United Kingdom led to the establishment of the EU Health Security Committee and further legislative changes.
In the Eurohealth Systems and Policies section, Sobczak and Sagan present changes in the legal structure of Polish public hospitals and how this relates to financial losses and other challenges, such as access to necessary care. Affordability of care in the Dutch health care system is examined by Brabers and de Jong; they find that almost half of all service users believe that the rising costs of health care may prevent them from using care in the future. They also discuss the implications for access of shifting costs to individuals, through, for example, the introduction of out-of-pocket payments. Moving to the Mediterranean, Petrou first considers the weaknesses in Cyprus’s health care sector prior to the financial crisis, then evaluates the bailout agreement measures implemented in terms of efficiency and expenditure. Finally, for England, where reducing avoidable mortality is a health policy priority, Karanikolos and colleagues identify areas where progress is needed and offer recommendations for improvements in prevention, care and outcomes.
Eurohealth Monitor features two new books: one on trends in health systems in twelve former Soviet countries and one on geographic variations in health care in thirteen countries. News covers national, European and international developments in the health sector. We hope you enjoy this issue and we wish you a happy holiday season and a prosperous new year!
Eurohealth 20.4 has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner).