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The European Semester process and health equity Findings from the Recovery and Resilience Plans in eight EU Member States

As Europe deals with the aftermath of the pandemic, climate crisis, global conflict, demographic change and technological revolution, people with the fewest resources are less able to cope and adapt, and wealth and health inequalities are widening.

The EU Recovery and Resilience Facility helps EU Member States to mitigate these multiple crises, facilitate a green and digital transition, and promote wellbeing and equality.

For the 2022 analysis of the European Semester, EuroHealthNet spoke to 24 public health experts in eight EU Member States about the use of the EU Recovery and Resilience Facility and its impact on health equity and wellbeing

Read our full analysis here (.pdf)

Key messages and recommendations

The Recovery and Resilience Facility helps EU Member States to mitigate the multiple crises that we are in, facilitate a green and digital transition, and promote wellbeing and equality through investments and reforms. This report offers insight on how EU Member States are using these funds, and shares many promising initiatives.

However, system reforms take time. The sustainability of these initiatives will largely depend on whether governments keep positioning health and wellbeing strongly as both a means to and an outcome of economic development.

For in-depth recommendations read the full analysis (.pdf)

Based on the findings of the cross-country analyses in this report, we make the following recommendations to EU Institutions and Member States on how they can improve health equity and wellbeing.

  • Recognise the value of public health, as part of wider health system, and recovery and resilience reform strategies. This includes strengthening mental health promotion and care, improving the attractiveness of careers in the health sector, investing in prevention and improving digital health literacy.

  • Facilitate and encourage better and more transparent communication among policy makers, professionals and public about how Recovery and Resilience Facility is being spent.

  • Develop an overarching Strategy for the European Union, that brings together all key policy objectives, and that could serve as a collective vision and guidance for the European Semester process and drive systemic change towards economies that generate wellbeing.

About this report

This year, EuroHealthNet’s analysis of the European Semester looks at the European Semester 2022 cycle and reflects on the first year implementing the Recovery and Resilience Plans (RRP).

Insights gathered from 24 experts in eight Member States (Austria, Belgium, Finland, France, Italy, Lithuania, Spain, Sweden) illustrate programmes and initiatives financed as part of the RRPs, and how they instigated health system reforms while strengthening investments in public health, health promotion and disease prevention.

EuroHealthNet has been analysing the European Semester process from a health equity and wellbeing perspective since its inception in 2011 - determining whether its outcomes are in fact leading to more equitable, resilient, ‘better’ societies, as set out above, and how.

We take a broad ‘health improvement’ oriented approach, one that does not just focus on healthcare, but that understands that health and wellbeing result from a wide range of converging factors. We are therefore interested in understanding how the Semester process and RRPs are instigating a reform of health systems, strengthening investments in public health, health promotion and disease prevention, and making them more effective and sustainable.

We also explore how the Semester process and RRPs are contributing to reforms in other key areas like housing early child development, skill building, the digital transition and climate adaptation and mitigation. We explore whether and how the health sector is involved in such initiatives, to maximise the ‘co-benefits’ for health and wellbeing, and whether distributional impacts are considered at during the design, implementation and assessment phases. 

Have a look at our previous analyses here.

More about our annual analysis of the Semester

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The European Semester

The European Semester is the EU’s annual cycle of economic and social policy coordination. The Semester affects health care, early childhood education, unemployment, as well as social transfer and pension systems.

Similarly, the Semester is also a tool and a mechanism which can assist health agencies in their work to improve public health and act of the determinants of health. Therefore, it is essential they understand what it is and how to work with it.

The Recovery and Resilience Facility

In 2020 the European Semester was adapted to incorporate the Recovery and Resilience Facility (RRF) - a €723.8 billion funding programme put in place by the EU - as a ‘stimulus package’ to help EU Member States recover from the impact of COVID-19.

To receive these funds, EU Member States prepared Recovery and Resilience Plans (RRPs), outlining how they would invest the funds by 2026, addressing the challenges identified by the European Semester process.

About EuroHealthNet

EuroHealthNet is a not-for-profit partnership of organisations, institutes, and authorities working on public health, disease prevention, promoting health and wellbeing, and reducing inequalities. We aim to tackle health inequalities within and between European States through action on the social determinants of health.

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This report was produced by EuroHealthNet, the European partnership of organisations, institutes, and authorities working on public health, disease prevention, promoting health and wellbeing, and reducing inequalities. We aim to tackle health inequalities within and between European States through action on the social determinants of health. Read more about us on our website.

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