WHO conference: "Attention needed for local governance"

On May 02 and 03 2016 in Copenhagen, the World Health Organization (WHO) organized a last round of consultations on a European framework for more coherent care. Mirella Minkman, distinguished professor at TIAS, was invited by the WHO to reflect on this framework. During her lecture, she urged the member states to translate the framework into local policy and local actions.

The "European Framework for Action on Integrated Health Services Delivery" has been developed with a view to implementing more coherent care in Europe and to creating policy on an integral interplay of care and welfare for the future.

The framework has four pillars: "systems", "services", "people" and "change". The member states themselves decide how to set up their care system. They may use the WHO framework as an umbrella concept for their own situation.

An enormous challenge

"The framework is very well organized, there is a wealth of knowledge behind it", according to Minkman. "You can also see that it appeals to most countries. But the challenge is enormous." There are large differences between countries, she explains. Some countries especially need strengthening of general practitioner care and first line treatment close to home. Other countries are making preparations for an aging population. But for all countries it holds that the coherence and integrality of care and welfare can be done even better. 

"Nearly all countries are far better able to cross-link social services and care around peoples' networks. That demands collaboration at a local level. Innovative governance approaches apply here. We have a long way to go in this respect."

Local players

It is a good thing that the WHO is setting this guiding principle, according to Minkman. "In many countries, governance has been focused too little on collaboration or on the reduction of 'production or income raising' incentives. She advocates management that facilitates the local players in care and welfare and makes them jointly accountable. "Local, close to the clients: that is where it has to happen and where ultimately value is created." 

In September 2016 a last feedback round will follow, then the WHO will define the final framework. Download the current version of the framework.

Dr. Mirella Minkman is distinguished professor of Organization and Management of Long-Term Integral Care within the TIAS Governance Lab.

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