Each spring, since 2011, the Commission presents country-specific recommendations as part of the economic monitoring of EU countries known as European Semester cycle. This year recommendations highlight investment needs in various policy areas including health and research and innovation.

Health care systems

Although Member States are responsible for their own health policies, in the context of the European Semester the EU can give a recommendation on certain aspects of its health systems (those that relate to general economic, fiscal and social policies). The 2019 Spring Package included a number of recommendations to encourage health reforms in the next 12 – 18 months.

The suggested improvements on health care measures target 16 countries, mainly in eastern and central Europe. The need to ensure sustainability and cost-effectiveness for health care systems was identified in Austria, Cyprus, the Czech Republic, Ireland and Malta. The Greek and Polish health care system need investment from their governments. Latvia, Lithuania, Romania, Bulgaria and Slovenia should improve people’s access to health care. Hungary should improve health outcomes by supporting preventive health measures and strengthening primary health care. Portugal should reduce the late payments made to hospitals.

According to Anne Bucher, the Director-General for Health and Food Safety, in the field of health, Commission specifically mentioned investment needs for a few countries only. For the other countries investment needs were described in the respective country-reports that were issued earlier this year as the analytical basis for recommendations.

The Commission bases its analysis and recommendations on a thorough assessment of the national situation and also takes into account the knowledge provided by the State of Health in the EU initiative. The advice on health systems touches on the delicate balance of competence between the EU and national governments. The Commission acknowledges that many of the challenges for national health systems are longstanding and the recommendations on health show a low implementation rate.

The implementation of recommendations is monitored throughout the year and reported on in the Commission’s country reports in February/March the following year.

Focus on research and innovation investment

This is the first time the commission’s yearly review has made research and innovation investment a recommendation for all member states. The recommendations are rather general, without specific targets, calling on member states to “focus” on research and development investment. Nevertheless, the recommendations highlight the fact that while research spending accounts for a major chunk of the EU’s budget, it is only a tiny fraction of spending Europe as a whole. More is coming out of national research budgets and the majority from the private sector.

The recommendations are accompanied by explanatory notes commenting on the country’s circumstances. These comments come across as quite negative practically in all cases, because the purpose of the report is to highlight areas where member states could improve.

Many governments in the EU and elsewhere have cut national research and development spending in the years following the crash of 2008. Yet, despite cuts to public research budgets, overall investment in this area actually hit a ten-year high in 2017 in the EU, thanks to increased private sector spending.

See all country specific recommendations