HaDEA and the change of narrative: re-prioritising healthcare at the European level

Whilst still a lot is to be done to get the European Union to play a greater role at the regional level on the healthcare front, a narrative change is currently being witnessed, this being a good first step to ultimately achieve a greater integration and cross-country collaboration, which will, of course, take time and commitment at the national level.

Yesterday, the European Health and Digital Executive Agency (HaDEA) became operational, managing from now on European programmes and initiatives on behalf of the European Commission, including EU4Health and some strands of Horizon Europe. Beyond the intrinsic importance of this new agency, which will be key for the delivery of the ambitious plans of the EU in a post-COVID world, it is important to highlight its role in the change of narrative and semantics as health is re-prioritised in the European policy agenda.

It’s not a secret that healthcare was in the process of being taken off the European agenda not very long ago, under the belief that it was the competence of the member states to deal with this. Current treaties make it hard for the European Union to have a major say, and as budget cuts were sought, healthcare was an area that could be justified when reducing the role of the European institutions. If anything positive can be taken from the catastrophic pandemic that we have experienced, it is the fact that it has conveyed the importance of European collaboration to ensure the best quality of and access to healthcare services across the Union.

Healthcare should of course be, at least partly, a national competence. Countries are, needless to say, well-placed to understand the needs of their particular demographics, and how these tie into path-dependent healthcare systems, and the changing social, cultural and economic circumstances. However, this does not mean that member states are the only players who should be in charge of this. This is no longer a zero-sum game, or a mutually exclusive matter, as witnessed through the COVID-19 crisis. At the European level, the wonderful opportunities brought by freedom of movement, for example, also entail a series of “risks”, such as the fact that borders are no longer physical barriers to unexpected challenges such as pandemics. “Cross-border health” has therefore become a hot topic among European politicians and policy-makers, who try to work out how, in a Union where health has traditionally been majorly (if not solely, except certain elements) a national competence, problems at the regional level that affect all countries regardless of the political lines drawn on a map should be tackled in a fair and equal way.

This topic, of course, opens the door to a wide range of major discussions, such as the importance of changing treaties to move to a wholly shared competence, or the potential short-term nature of the prioritisation of healthcare, and what will happen after we start forgetting about the pandemic we are currently living. However, in this post, we’ll be focusing on something particularly interesting: the semantics change that we have experienced in recent months, making the narrative at the European level healthcare-focused, and reinforcing the role that the European institutions will now play moving forward by looking at the establishment of the HaDEA and the EU4Health programme as examples. It is undeniably true that changing the way healthcare is referred to, from a narrative perspective, is only the first step in a long list of changes that need to actually take place to achieve a greater and more efficient management of healthcare systems at the regional level. However, this is a significant change that is needed if the European institutions are to convey their commitment and increasing efforts to position themselves as the next leaders in the healthcare arena.

Changing the semantics: making healthcare a clear priority

Both praised and criticised for its ambitions and its ultimate implementation, EU4Health has been in the spotlight in recent months. This is the fourth and largest of the EU Health Programmes since their inception in 2003, and is the response to the fact that “66% of EU citizens would like to see the EU given more say over health-related matters. The pandemic has shown that the EU needs greater coordination during health crises and health-systems that are more resilient.”

However, beyond its actual dimension, something else captured the attention of professionals working in healthcare communications: the actual title of the programme. By giving it a specific name, beyond “fourth health programme”, the European Commission has highlighted its uniqueness. EU4Health is not simply a programme that takes over the previous one. It is the beginning of a new commitment, a new brand and identity for the Union. This is not just about being the largest programme – it is about marking the beginning a new era where healthcare funding will be one of the Union’s commitments to ensure that healthcare systems are resilient, efficient and work for everyone. In addition to this, the Commission has gone for a very clear and direct title, moving away from the complexities of the past and simply conveying their overarching objective: the EU is standing up for health. Health is now a major priority.

With the establishment of HaDEA, this idea is mirrored. It is important to note that this new agency will cover a wide range of areas that are not limited to health and digital per se (although, of course, they will be linked on many fronts), including space or food. So why are Health and Digital dominating the name of the new organ? It is true that these two concepts englobe a majority of the funds that the agency will cover. However, beyond this, they are also two of the greatest priorities for the Commission right now. Health and Digital point towards the direction of the Commission, and therefore the potential future of the Union. Avoiding grandiose (and confusing) terms, the name of the organ is clear, straight to the point. The end of the Consumers, Health, Agriculture and Food Executive Agency, and its partial integration into the new HaDEA, marks a symbolic change, highlighting the Union’s priorities and moving towards a more simple and user-friendly way of presenting the work of the institutions.

So yes, the reality -for now- might be that the more formal steps towards creating a real healthcare union are still to be seen, and, as we are used to, the process of prioritising healthcare at the regional level is slow. However, in such a complex structure, small changes are necessary to move to bigger and better things – they trigger the process, create political appetite, and act as a signal, showing what the direction is. HaDEA, we hope you’ll have the desired impact.

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