The management of health systems in the EU Member States : The role of local and regional authorities

Health systems across the European Union (EU) are managed in very different ways. This report focuses on the role of local and regional authorities (LRAs) within these systems in terms of power and responsibility, from the issuing of legislation to policy development, implementation and funding. LRAs play a significant role with regard to health issues. This role often reflects the constitutional structure of the country in question. However, there are several factors which complicate this simple relationship, such as the prevailing type of hospital governance or the LRA’s competence for raising the financial resources to be invested in health locally. The study has three aims: (i) compiling an inventory outlining the type of prevailing management within health systems across the EU; (ii) proposing a typology of health management systems on the basis of some key competences held by LRAs within the systems; and (iii) highlighting, on the grounds of the evidence gathered, those health-related policy areas where local and regional inputs may potentially add value to EU policy development processes