Abstract

What are “public health services”? Countries across Europe understand what they are, or what they should include, differently. This study describes the experiences of nine countries, detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England, France, Germany, Italy, the Netherlands, Slovenia, Sweden, Poland and the Republic of Moldova, and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services.

Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications.

This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe, Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity, alcohol and antimicrobial resistance (both forthcoming).

Contents

• Acknowledgements
• List of figures, tables and boxes
• List of abbreviations
• Contributors
• 1. Introduction
  Bernd Rechel, Anna Maresso, Anna Sagan, Cristina Hernández-Quevedo, Gemma Williams, Erica Richardson, Elke Jakubowski, and Ellen Nolte.
  • Public health services
  • Methods and country selection
  • Structure of country reports
  • References
• 2. England
  John Middleton and John Williams.
  • Historical background and context
  • Organizational structures
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References
• 3. France
  Laurent Chambaud and Cristina Hernández-Quevedo.
  • Historical background and context
  • Organizational structures
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References
• 4. Germany
  Klaus D. Plümer.
  • Introduction
  • Organizational structures
  • Financing
  • The public health workforce
  • Quality assurance and performance measurement
  • Accreditation and certification
  • Conclusion
  • References
• 5. Italy
  Andrea Poscia, Andrea Silenzi, and Walter Ricciardi.
  • Historical background and context
  • Organizational structures
  • Planning public health services
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References
  • Legislation
• 6. Republic of Moldova
  Angela Ciobanu, Jarno Habicht, Aliona Serbulenco, and Stela Gheorghita.
  • Historical background and context
  • Organizational structures
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • References
• 7. The Netherlands
  Hans Maarse, Maria Jansen, Mariëlle Jambroes, and Dirk Ruwaard.
  • Introduction
  • Organization and structure
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References
  • Web sites
• 8. Poland
  Roman Topór-Mądry, Łukasz Balwicki, Iwona Kowalska-Bobko, and Cezary W. Włodarczyk.
  • Historical background and context
  • Organizational structures
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References
• 9. Slovenia
  Vesna-Kerstin Petrič and Anna Maresso.
  • Historical background and context
  • Organizational structures
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References
• 10. Sweden
  Bo Burström and Anna Sagan.
  • Historical background and context
  • Organizational structures
  • Formal administrative structure of public health services at the various tiers of administration
  • Public health services within curative health care services
  • Enforcement of public health policies and regulations
  • Intersectoral collaborations and partnerships
  • The financing of public health services
  • The public health workforce
  • Quality assurance and performance measurement
  • Conclusion and outlook
  • References

The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of health systems in Europe. It brings together a wide range of policy-makers, academics and practitioners to analyse trends in health reform, drawing on experience from across Europe to illuminate policy issues.

The Observatory is a partnership hosted by the WHO Regional Office for Europe, which includes the governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, Switzerland, the United Kingdom and the Veneto Region of Italy; the European Commission; the World Bank; UNCAM (French National Union of Health Insurance Funds); the London School of Economics and Political Science; and the London School of Hygiene & Tropical Medicine. The Observatory has a secretariat in Brussels and it has hubs in London (at LSE and LSHTM) and at the Technical University of Berlin.

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The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the European Observatory on Health Systems and Policies concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

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