ESI Funds for health investments Portuguese national workshop Lisbon 5 th November 2014 Page 1
Workshop agenda I. Workshop opening (9:00 - 9:15) II. Introduction of the project and project output (9:15 – 10:00) III. ESIF investment critical success factors (10:00 – 11:00) IV. Specifics of complex project management and implementation (11:15 – 12:00) V. Principles of effective project application assessment and relevant indicators (12:00 – 13:00) VI. Health funding potential in 2014-2020 PP (14:00 – 14:30) VII. Group activity (14:30 – 15:45) VIII. Discussion on effective follow up (15:45 – 16:00) Page 2
I. Introduction of workshop participants Page 3
II. Introduction of the project and outputs (i) Project and its context [Project introduction and disclaimer] Page 4
Project objectives ► The project is aimed at providing assistance in the area of healthcare to EU Member States in the programming and implementation of European Structural and Investment Funds (ESIF) in the new programming period 2014 - 2020, more concretely: ► To support the Member States and their efforts to tap into the potential of ESIF 2014 - 2020 for health investments and to manage ESIF support for health in a better and more effective way ► To promote effectively implemented actions in the health sector which will have a major positive impact on the wider population’s access to quality and sustainable healthcare in EU Member States ► To build knowledge of the implementation of ESIF for health in the new programming period 2014 - 2020 Page 5
Project background ► The project builds on two key documents: ► Toolbox for effective structural funds investments in health 2014-2020 as developed by Subgroup 2 of the Reflection Process on modern, responsive and sustainable health systems that was conducted in the Council of the EU under the auspices of the Working Party on Public Health at Senior Level [Ele ctronic version in various languages available at the website of the Council of the European Union ] ► Policy Guide for Health Investments by European Structural and Investment Funds 2014-2020 , developed by the European Commission (DGs SANCO, REGIO, EMPL) [ Electronic version in English available at the DG REGIO website] Page 6
Workshop objectives 1. Inform the workshop participants about the project and outputs developed Introduce the project and main outputs ► 2. Share lessons learned from implementation of health projects under EU SF from 2007 - 2013 Share examples of good practices and recommendations to various investment life- ► cycle stages Discuss good practice in implementation of complex projects in health ► Share recommendations for effective project application assessment and selection of ► relevant indicators in health projects 3. Identify all possible health investments under Operational Programmes adopted in Portugal Link specific Thematic Objectives with possible health issues/investments ► Discuss specific possibilities to support health under specific Operational Programmes ► developed for 2014-2020 programming period Page 7
Disclaimer ► Please be aware that the workshop (as well as the project itself) are NOT part of the negotiations between the Commission and the Member States EY has been contracted by DG SANCO, not DGs directly involved into negotiations ► EY provides consultations based on its professional judgment, analysis of documents ► and analysis of situation in all Member States Information provided in the project outputs and in this presentation should serve as ► supportive material for discussion and reflection Suggestions presented further do not reflect the Commission's position, but E Y’s ► professional opinion and good practice examples gathered during this project The presentation does not reflect the Commission's position and the way implementation of ESIF will be finally delivered is still being negotiated with the European Commission Page 8
II. Introduction: II. Introduction of the project and outputs (ii) Project outputs (ii) Project outputs [EY outputs introduction] [Project scope] Page 9
Project outputs WP 1: Mapping report WP 2: Guide WP 3: Toolkit Guidance on effective Set of technical and Implementation of SF in health investment from managerial tools to health in all EU Member ESIF accompany the Guide States ► Overview of 2007 - 2013 ► Recommendations for ► ESIF instruments and Ministries of Health and mechanisms in 2014-2020 period managing authorities on ► Calls for proposal ► Planned implementation practices that lead to management of ESIF for funding efficient health investment health priorities in 2014 - ► Set of indicators funded from ESIF 2020 based on ► Sustainable and efficient ► Roles of MoH and MA and Partnership Agreements models & concepts in HC ways of their cooperation and OPs ► Manual on capital to achieve effectiveness investment ► Lessons learned (Do’s and ► Investment appraisal Don’ts) methods WP 4: Roll out to Member States: Website, country visits, regional workshops Page 10
III. ESIF investment critical success factors (i) ESIF investment effective lifecycle [Topic covered by the project outputs] Page 11
WP2 ESIF investment effective lifecycle Critical success factors 07 01 Investment Strategy sustainability development 06 02 Monitoring Partnership Critical & Evaluation building success factors Procurement Capacity management building 05 03 Financial planning 04 Page 12
Critical success factors Discussion topics Q1: Based on introduction of critical areas, where do you think are Hungarian: i. Strong areas, i.e. areas that could be shared with other Member States as a good practice example. ii. Weak areas, i.e. areas where would Portugal appreciate support in a form of a good practice example from other Member States. Q2: Would you name any other critical success factor that has not been mentioned here and is worth mentioning? Page 13
III. ESIF investment critical success factors (ii) Practices and recommendations to various investment life-cycle stages [Topic covered by the project outputs] Page 14
01 . Strategy development Recommendations Problems Lack of real public health strategy ► Develop an overarching public health strategy ► based on evidence and centered around a patient Absence of clearly defined priorities ► oriented approach [Ministry of Health] Investments are not focused on achievement of ► ► Coordinate the strategy-making process with clear objectives (duplicities and overlapping of stakeholders to make the strategy broadly funding) accepted and relevant [Ministry of Health] Investments do not generate any tangible results ► (there are no health gains and no improved cost ► Identify & involve stakeholders efficiency of health sector) ► Know other existing and developing strategies Unsustainability of the investments ► ► Ensure balanced and complementary approach Lack of project progress or project disruption in ► to maximize investment effects [Ministry of Health] case of changes in political environment ► Infrastructure development Lack of coordination in strategy development ► ► Human resources development On various levels of public administration ► For different types of health care ► Prevention and health promotion campaigns ► (outpatient x hospital care; ► Identify financial resources and select priorities primary x specialized care) to be financed from ESIF [Ministry of Health, On cross-regional and cross-border level ► Managing Authorities] Inefficient use of public resources Obstacles to systemic changes Page 15
Example of insufficient strategy development Hungary, programming period 2007 - 2013 Context The implementation of ESIF for health infrastructure in Hungary in PP 2007-2013 was the largest of all ► EU Member States (approx. 1,3 bn. EUR allocated over the 7 years, which represents 5,5 % of whole ESIF allocation) Lack of strategic planning in the field of health and coordinative management of resources ► Political instability contributed to insufficient funding coordination ► Consequences Spending driven approach in preference for project lacking evidence base , rather than a strategic ► one taking into account sustainability considerations Insufficient attention given to health gains when deciding on where to direct the funding ► Lack of coordinative management function caused inefficiencies in a way that projects addressing ► various levels of care provision are not complementary and loose (at least partially) their benefits Potential effects limited by insufficient coordination of Structural Funds projects and other ► development efforts, on regional level no strategy planning : Investments into regional hospitals were not coordinated with investments in outpatient primary ► care Infrastructure investments in specialized oncological centers were not coordinated with ► development of regional hospitals Page 16
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