In this episode of the Reframing Healthy Ageing podcast, IFA’s Dr. Jane Barratt is joined by Ms. Tamsin Rose of Friends of Europe, Mr. Sean Lybrand of Amgen and Mr. Stecy Yghemonos of Eurocarers to discuss the biggest challenges in health and social systems, including in the long-term care sector, adapting to an ageing society and advocating for policy change and system reform.
In November 2022, the Friends of Europe held the Health Innovation Summit – “Reimaging Health Systems: Green, Agile and Citizen-centred” in Brussels, Belgium and featured three key themes: the changing role of citizens in health; health and the green transition; and an ageing Europe..
The themes feel particularly relevant in today’s news cycle. You don’t have to look far to read editorials and op-eds on these subjects, often predicting dire outcomes – societal breakdown due to the increasing ageing of the population, the increasing use (and potential misuse) of data and artificial intelligence in health, and of course, the looming impacts of climate change, which poses particularly existential threats.
With all the doom and gloom, the Friends of Europe offered a more solution-oriented space, bringing together champions, international and local policymakers, civil society, and industry to deliberate current and future health challenges that shape our society.
The Summit provided an opportunity for further dialogue with key guests, Ms. Tamsin Rose of Friends of Europe, Mr. Sean Lybrand of Amgen and Mr. Stecy Yghemonos of Eurocarers. Following the high-level panels of the Summit, the conversations continued with Dr. Jane Barratt and guests.
Calls for fresh thinking and system reform
The podcast conversation and discussions from the Summit highlighted the need for systems to adapt to a population which is not only ageing but has different characteristics, values, and innovations to leverage.
“…our health systems were designed for a world that no longer exists. They were created 50 years ago, and life expectancy was very different. The health profile of the population was very different. And we can’t address the challenges of today, let alone tomorrow, by using the structures and infrastructures of the past,” says Ms. Tamsin Rose.
Global trends such as climate change, shifting political ideologies, ageing populations, the COVID-19 pandemic and the threat of future pandemics have highlighted the need for a change across global systems to better serve all members of society including older people. In addition, there is a need for intergenerational solidarity to support health, social care, environmental health, and economic security across the life course and ensure the quality of life of future generations is protected.
Breaking down siloes in government, and across disciplines
While healthcare system reform is a necessity, implementing change is difficult, in part due to the lack of a join-up approach across governments. The conversation continued around the need to break down siloes within governments, including between ministries responsible for healthcare, aged care, social care, employment, and finances, and between sectors to advocate for policy change.
Mr. Sean Lybrand explains “I think it’s terribly difficult for government to enact healthcare system reform for a number of reasons. One is the general short-termism of government budgets and where the outcome will occur, versus where the investment is required. One that was raised today, which is interesting, is the lack of joined-upness between the healthcare part of government, the economic and treasury, part of care, and also in some cases, social care. So, an example was given today from Ireland which is taking an approach to integrate both health and social care. So that is an excellent opportunity for a government in a ministry to start to consider all of the costs and all of the outcomes that relate to health and social care.”
Breaking down and connecting the siloes is equally important to bring issues to the agenda of policymakers. Two exemplary initiatives were shared in the episode, the European Care Strategy, which aims to ensure quality, affordable and accessible care and improve the situation of care receivers and deliverers, and the National Strategic Action Plan for Osteoporosis (NSAPO) the addressed the burden of osteoporosis in Australia.
The NSAPO recognized the social and economic importance of bone health in the Ministry of Health and aged care in the Ministry of Health and Aged Care in the context of population health and wellbeing.
Likewise, the European Care Strategy is a turning point in bringing long-term care reform to the table and recognizing that such systems are upheld by informal carers. The urgency of reform was highlighted during the COVID-19 pandemic, which saw high mortality rates in long-term care facilities, disruptions to care for residents and poor working conditions for staff. The strategy is based on shared goals for all European Union (EU) Member States to enhance long-term care systems and ensure that formal and informal carers are supported in those systems, supporting the link between government, civil society and patients and their families.
Mr. Stecy Yghemonos explains, “During the pandemic, but before that and since then, civil society organizations are playing a central role, you know, not only to support obviously informal carers, but also patients and the community. And what we’re seeing is that governments also tend to rely more and more heavily on them, but without really increasing the resources at their disposal.”
The strategy and legislation formally acknowledge informal carers as partners in care, through improved access to information in training, skills validation, work life balance solutions and financial support. The joint objectives set at the EU level are powerful examples for other nations and regions in building more sustainable and resilient health infrastructure.
Recognizing carers and addressing policies beyond health
Carers are just one often forgotten group who experience adverse effects due to the lack of supportive policies and social protections. They are deeply affected by the social determinants of health, such as where we are born, grow, work, live, and age, experience negative health outcomes as a result of their caregiving and face daily challenges that prohibit their full participation in society. According to the OECD, caregiving is associated with higher poverty rates, less participation in the labour force, and increased mental health problems. There is a gender imbalance, with the burden often falling on women. Across OECD countries, 60% of carers are women.
Mr. Yghemonos spoke of the need to improve policies outside the realm of care, including through investment in public health and health promotion, for carers but also many other groups deeply affected by social circumstances.
Health at the center of society
It was clear throughout the dialogue the importance of connectivity, shared goals, and collaboration to tackle global challenges. Whether between EU Member States, across generations, or amongst sectors of government and across disciplines, there is value in alignment and unified efforts. Coalition building between civil society, industry and others is essential to advocate for change.
The COVID-19 pandemic has demonstrated how health is interlaced in daily life and its impact on the whole-of-society, therefore a whole-of-society approach is needed to enact reform and meet the greatest global challenges, with health as a central priority.
Mr. Yghemonos says, “we can see also how health is a core driver of well-functioning societies. Every time we discuss as citizens the future of our societies, I think to some extent we also discuss the health of our societies in the way we are going to age together.”
Recommendations from This Episode
- There is a need for healthcare reform to support current and future generations of older people to support adding life to years.
- Health is essential to a well-functioning society and decisions on health should not be isolated from those of social care, finances, and labour markets. Unified action is needed across civil society, government sectors, industries, and disciplines.
- Carers should be seen as partners in the delivery of health and social services, and formally acknowledged through legislation that provides services for financial aid, access to information and training, and recognizing their skills as well as needs.
- Policies that support health promotion and prevention, and those outside of the health sector, are needed to address the social determinants of health.