Improving the health of the population depends on leadership not only in health and care

Many countries have seen exacerbated health inequalities and population health outcomes deteriorate since the start of the pandemic. Tackling the structural causes of these problems will require new leadership not only in health and care, but also in business and politics. It is promising that good examples in these areas are emerging.

Last month, health leaders from across Europe gathered for the 2021 Gastein European Health Forum (EHFG) to discuss how best European states can recover from the Covid-19 pandemic.

What quickly became evident was that countries, not only in Europe, but also around the world, face many of the same obstacles and enablers in ensuring strong and efficient health and care systems.

Many of them will come as no surprise. The workforce, for example, is expected to be a critical barrier globally, with a projected shortfall of 18 million healthcare workers by 2030. In England, the Health Foundation estimates that it would take nearly half a million additional health workers to meet demand pressures and recover. pandemic over the next 10 years.

However, when it comes to facilitators, there is one defining factor considered essential in both contexts and geographies: leadership. Fostering and rewarding collaborative leadership will be a prerequisite for addressing the multiple challenges facing countries around the world as they seek to recover from Covid-19, improve access to care and tackle the determinants broader health.

While it can often be difficult to quantify where and how leadership is lacking as we seek to overcome such challenges, it is clear that we need to nurture certain styles and traits of leadership in several areas of civic life. Three examples can be identified.

Department of Health and Care

First, the emphasis has rightly been placed on the need for health and care leaders to think in systems, as integration replaces competition as the driving force for service improvement. In England this should involve organizations working together with local partners to solve common problems.

A key test for these main integrated systems of care will be whether they can develop, with partners, a convincing account of the specific and concrete value they believe the functioning of the system can bring.

Commercial management

Second, however, we will need to look beyond the health and care sectors if we are to make real progress in improving population health outcomes. Specifically, it will be essential to inspire business leaders to consider their own role in improving and maintaining the health and well-being of employees.

One company moving in the right direction in the UK, for example, is John Lewis, who recognizes that looking after the health and well-being of its employees is good for people and good for business. It supports its employees through a wide range of internal health and wellness services such as physiotherapy and counseling, on demand when they need it.

The benefits of such initiatives for the entire health and care system are clear. The more employers can be made to take greater responsibility for the health and well-being of their staff, the more we can address health issues earlier and alleviate significant pressures on stretched local services.

Likewise, in-house health and wellness services could prove to be a powerful weapon in addressing health inequalities, if the services – like the physiotherapy offered by John Lewis – offer support for health issues that disproportionately affect people from low-income backgrounds.

Political leadership

Finally, political leadership both nationally and internationally will be a key determinant in determining whether and how the health of the population will improve in the years to come. Nationally, the NHS Confederation and other health and care organizations have long called on political leaders to take a ‘health in all policies’ approach. This would encourage all ministries to take seriously their role in carrying out intersectoral actions aimed at addressing the broader determinants of health.

At the international level, the European Union will have to learn the lessons of the pandemic. Speaking at the EHFG, Professor Agnes Binagwaho, senior lecturer at Harvard Medical School, argued that the global health system will continue to remain vulnerable to crises until structural barriers are removed.

The developing world cannot remain dependent, for example, on vaccine distributions from rich states that have stocks. On the contrary, coordinated international action must be taken to improve health infrastructure and create a more level playing field in the international life sciences market, with better production opportunities in the poorest countries.

Create incentives

While it is recognized that these types of leadership are essential, the difficult question is how we can encourage them.

There is a strong argument that governments – through incentive mechanisms such as tax breaks, loans or grants – must do more to encourage the private sector to invest in health and wellness programs. at work.

Part of the answer, however, will also lie in how we assess the performance of leaders. A key challenge will be to ensure that we have means to assess the impact of short-term leaders while judging overall organizational performance, and in particular the performance of integrated care systems, on improving health. of the population in the long term.

Encouraging leadership changes ultimately requires the right support and takes time. In England, as the Secretary of State for Health and Social Affairs recently launched an NHS leadership review, it will be particularly important that this message is heard.


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