XVI European Patients’ Rights Day: from the Conference on the future of Europe and NRRPs still little participation of citizens in defining health priorities (21st APRIL 2022)

Focus on Italy: little openness of the institutions both in the definition of priorities and in the implementation of the NRRPs.

Civic organizations and social partners not sufficiently involved in the definition of priorities and the implementation procedures of the National Recovery and Resilience Plans (NRRPs): this is generally valid as denounced for some time by the European Economic and Social Committee, and in particular in terms of health public, as emerged from the survey conducted by the European branch of Cittadinanzattiva, Active Citizenship Network, and presented on the occasion of the 16th Edition of the European Patients' Rights Day, which took place online on 20 and 21 April 2022.

Specifically, by questioning 38 patient and rights protection associations from 18 countries, it emerged that in most cases they have not been involved by institutions in the definition of public health priorities. The majority replied that they were not involved at all (35%) or had not been informed of these processes (22%), while 35% responded positively. However, of the latter, only 13% were involved in the consultation processes from the outset, while 11% were very limited.

Regardless of any formal involvement by the authorities, more than half of the respondents (55%) confirmed that their association has provided civic recommendations to institutions in setting priorities in the public health sector.

Even worse seems to be going on in the implementation phase of the NRRPs: a large majority of respondents (79%) stated that their organization was not formally involved by the institutions in the implementation of the Plan in their country, while only 10% have confirmed its involvement through participation in debates, public consultations and the promotion of new health models.

"The importance that the PNRR assumes for Italy is under everyone's eyes: we are the country that has received the most funds and that, more than the others, has decided to allocate them to different and transversal policies, from the digital transition to the environmental one, from social to health; moreover, the Italian Plan combines investments and reforms, some of which have been expected for years ”, declares Anna Lisa Mandorino, secretary general of Cittadinanzattiva. “But, in the face of this, the level of participation of citizens and communities in the same is lacking. As a Civic Observatory on NRRPs - of which Cittadinanzattiva is one of the promoting organizations - we have demanded greater spaces and forms of participation, as well as greater transparency of data and information, also obtaining important openings in this sense. But that's not enough: just to give an example, about the reform of territorial assistance, envisaged at Mission 6, up to now no public consultation has been launched by the central government and many Regions have decided where to place the Community Houses without having field paths of public debate with the communities, sometimes foreseeing the houses next to the hospitals while the logic from which they arise is to foresee a capillary diffusion on the territory ".

Opening with a message from the European Commissioner for Food Safety and Public Health, Stella Kyriakides, the annual European Patients’ Rights Day saw the participation of representatives of the European Commission, the OECD, the Ministries of Health of Italy and France, MEPs, leaders of patient organizations, healthcare professionals, industry experts and businesses, and was built with the unconditional contribution of Boehringer Ingelheim, Illumina, MSD, Teva, and Viatris.

At the centre of the debate was the work of the Conference on the Future of Europe and the need to pay more attention to some issues, including: the full implementation of the European directive on cross-border care; the recognition of health expenditure as an investment, and the importance of the role of health professionals, as well as the need for an industrial policy of the Member States that takes greater account of the health needs of their population, including through a better drug supply system.

"It is paradoxical - comments Mariano Votta, head of European affairs of Cittadinanzattiva and Director of Active Citizenship Network - that, despite the more than two years of the pandemic, the issue of health was one of the last to be discussed at the Conference on the future of Europe, but we can consider it as a starting point for stronger collaboration among the Member States to reduce health inequalities”.

The EPRD2022 also dedicated attention, with two testimonies, to the humanitarian and health crisis in Ukraine.

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