Health care, social services and education sector working together to address health inequalities

WHO - Paris 8.12.16

(15 December 2016)

EPSU contributed to one of the sessions of the conference “Promoting intersectoral and interagency action for health and wellbeing in the WHO European Region” organised by the World Health Organisation (WHO) on 7 and 8 December 2016 in Paris. EPSU recalled the need of public investment in adapted qualifications and of a sustainable funding of structures supportive of cross-sectoral cooperation. The event brought together representatives of Member States’ governments, from international organisations and the civil society. Its aim was to strengthen intersectoral cooperation between the health, education and social sectors in Europe for better, more equal health and social outcomes for children and adolescents. It also served to explore innovative ways and policies to ensure 1) universal social protection for better health and well-being, 2) the promotion of health and well-being in schools and preschools; and 3) good governance for the health and well-being of all children and adolescents.

As the organisers write, “there is sufficient evidence to show that providing universal access to quality and affordable education for children in early years is one of the most powerful ways to ensure fair health, social and economic opportunities during the life course.” To further illustrate this the WHO compiled more than 100 examples of improving the health and well-being of children and adolescents through intersectoral action. Prior to the event the WHO had also commissioned a report to showcase financing and budgeting mechanisms to support intersectoral actions between health, education, social welfare and labour sectors. It also worked on a compendium of case studies on the theme “Partnerships for the health and well-being of our young and future generations.”

In conference session 4 entitled "A systems approach - investing in the workforce, enabling change", EPSU focused on the question "What are the priority investments required in our health, education and social workforce to accelerate progress towards universal health coverage and the UN Sustainable Development Goals (SDG), including addressing health inequalities in children and adolescents?" prepared for the six panellists. In EPSU's view public investments into the workforce in the health and social care (and education) sectors are needed to help adapting vocational education and training (VET) and continuing professional development (CPD) to new professional qualifications/skills/knowledge, to new professional profiles and to emerging new models of hospital and social care. If intersectoral actions between health, education, social welfare and labour sectors are to become a reality, the health care and social services workers also need CPD to be better prepared for the multi-disciplinary work in cooperation with professionals from the education sector aiming at the reduction of health inequalities affecting children and adolescents. This CPD is (to be) financed by the employers, done during paid working time and with staffing levels allowing for a replacement of those involved in the work-related training courses. Finally, working across sectors to tackle health inequalities of children and adolescents also requires regulatory frameworks (covering i.a. questions of professional scope, practice and liability) and in particular funding mechanisms that support the cross-sectoral cooperation of workers from the health care, social services and education sectors around commonly defined objectives and targets linked to the prevention or reduction of health inequalities of children and adolescents. The funding mechanisms need to be designed in a way to support the overcoming of work in silos and to roll out models of person-centred care and of integrated services.

To introduce this session participants listened to a presentation by Prof. Heikki Raisanen, Reasearch Director, Ministry of Economic Affairs and Employment, Finland. In the example 1 presented by the expert, the Joint Labour Force Service Centres (LAFOS), for EPSU what constitutes the basis for the successful implementation of the innovative cross-sectoral cooperation is 1) that it is constructed on the basis of a public-public-public partnership, 2) that it brings together multi-professional teams oriented on problem-solving and 3) that it pools and newly arranges competences of the Public Employment Service, of the local authorities and of the Social Insurance Institution. The satisfaction of the users with the improved quality and effectiveness of the service provided has clearly increased. What is important to highlight for EPSU in view of example 2 presented, the Youth Guarantee, is that it the intersectoral and multi-disciplinary service 1) is organised as a one-stop-shop, 2) that it succeeds in crossing administrative borders and 3) that it led to increased cooperation between health care, social services and education services, implying more effective services for the beneficiaries of the Youth Guarantee.

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