Dr. Vytenis Andriukaitis:

Frankly, if one looks at the money being dedicated to dealing with public health issues and addressing social determinants, one will see a strange picture. During times of austerity there are cuts, especially in public instruments, because the approach of accountants is to cut. Only approximately 3% of public spending in all 27 member states is dedicated to addressing social determinants. At a glance that shows that the difference in the level of access of low income and higher income groups to health care has been growing in the past five years. The same applies when encouraging counties to use Structural Funds to invest in the public sphere to address social determinants. Countries are mainly investing in road provision.

It is an excellent example of countries using Structural Funds on big buildings and big roads, and the reason is very simple. One needs to understand how difficult it is to join small actors, especially to build social industry, which are capable of addressing social determinants. One needs experts and the political will to build some clusters or platforms which invite small actors to stay and to apply for Structural Funds and to use those funds in a more effective way to solve problems related to social determinants. Such social determinants are in real territories, in rural communities and smaller cities and regions which are depressed because of austerity and the destruction of industry in those countries. One sees a strange picture. It is much easier to invest in road infrastructure than solve social problems. It is more difficult to achieve progress, but we have social instruments at EU level. Translating it into real action is very difficult, however. Social determinants are a major and painful issue for all of us.

The Michael Marmot report is an excellent report. Every member has a chance to read it and I ask the Parliament and the Government to consider what action is needed on the ground on how to use the Social Funds and Structural Funds to address social determinants. Otherwise one has no chance because there is not enough national public money.