From healthcare financing in 2027 and hospital modernisation to access to medicines and crisis preparedness, the transformation of the healthcare system highlights the need for predictable resources, more effective services and better coordination between institutions. For patients, the stakes are tangible: more accessible care, timely access to treatment and continuity of healthcare services when they need them most.
These topics were discussed at the National Public Health Conference #UndeDoare, organized by BUCHAREST CENTER FOR ECONOMY & SOCIETY (CES Bucharest). The event brought together representatives of national and European authorities, doctors, experts, industry representatives and patient organizations to discuss sustainable financing, the role of technology in improving system performance, the balance between innovation and the availability of medicines, and the capacity to deliver an integrated emergency response.
At least EUR 20 billion for healthcare proposed for the next EU budget
Victor Negrescu, Vice-President of the European Parliament, presented his proposals to include healthcare among the priorities of the European Union's next budget for 2028 to 2034.
"In my capacity as rapporteur in the European Parliament's Committee on Public Health, I have proposed a dedicated healthcare chapter in the future national and regional partnership plans and called for a minimum allocation of EUR 20 billion for investment in healthcare." said Victor Negrescu.
The MEP also advocated retaining the EU4Health programme and a dedicated European instrument for healthcare, as the European Commission's proposal no longer includes the programme as a standalone instrument. He also called for medical research, innovation and the development of new treatments and technologies to be funded through the future European Competitiveness Fund.
Healthcare system resilience: institutional cooperation and secure digital infrastructure
Lucian Fatu, State Secretary, President of the Euro-Atlantic Resilience Centre (E-ARC), Ministry of Foreign Affairs (MAE), highlighted the role of interinstitutional and civil-military cooperation in ensuring continuity of healthcare services during crises.
"Representatives involved in the supply of blood, plasma and derived medicines identified, first and foremost, the need for national planning that can simultaneously provide care for those injured in a kinetic conflict and ensure continuity of care for transfusion-dependent patients, with resources prioritized according to clear medical criteria. Civil-military planning, long-term blood storage and a steady blood supply are also needed." said Lucian Fatu.
He referred to the exercise scheduled for 18 and 19 November at the Dr. Constantin Papilian Military Emergency Clinical Hospital in Cluj, designed to test medical evacuation and the management of mass-casualty incidents amid hybrid attacks and disruptions to critical infrastructure.
Continuity of healthcare services also depends on reliable digital infrastructure and secure communications, emphasized Major General Eng. Gabriel David, First Deputy Director, Special Telecommunications Service (STS).
"The Special Telecommunications Service provides the public healthcare sector with everything from applications and hosting to infrastructure, communications and networks that interconnect medical institutions. Every service must be available 24 hours a day, seven days a week, because any interruption can have consequences, sometimes serious ones. Security is equally important, because the exposure of patient data would be extremely serious. This year, we completed the construction of four new data centres, which can also be made available to the healthcare sector." said Major General Eng. Gabriel David, First Deputy Director, Special Telecommunications Service.
Hospital investment must support healthcare services that remain operational over the long term
Vlad Mixich, Health Policy Expert and Team Leader, European Investment Bank (EIB), highlighted the need for a long-term approach to investment in healthcare infrastructure that considers both the financing required to build or modernize hospitals and the resources needed to operate them.
"Any major investment in Romania's healthcare system must demonstrate the sustainability of human resources over the medium and long term. There is little point in building new hospitals or renovating existing ones if we do not have the doctors and nurses, with the required specialisations and in sufficient numbers, to operate a hospital according to the standards of 21st-century medicine." said Vlad Mixich, Health Policy Expert and Team Leader at the European Investment Bank.
From treating disease to prevention and assessing patient outcomes
Representatives of the healthcare professions also highlighted the importance of prevention and a patient-centred approach to care.
Prof. Valeriu Gheorghita, MD, PhD, Director General, Prof. Dr. Agrippa Ionescu Emergency Clinical Hospital, and Member of the Infectious Diseases Commission of the Romanian College of Physicians, advocated a shift from financing healthcare services based on their volume to models that take patient outcomes into account.
"I believe that improving the efficiency of the healthcare system will only be possible when outcomes are linked to financing. In other words, when we move from what is known as fee-for-service, meaning payment based on the number of services provided regardless of their results, to what is known as value-based care, where the outcomes achieved through the services we provide also matter. We do not need to invent something that works here in Romania; we simply need to look at what others have done and try to adapt it to our country's circumstances." said Valeriu Gheorghita.
Assoc. Prof. Adrian Pana, MD, PhD, Director, National Centre for Public Health Statistics, National Institute of Public Health (INSP), drew attention to the importance of primary healthcare and investment in public health.
"Hospital care and medicines account for 80% of our current spending. Changing this balance requires a shared understanding; the National Health Insurance House cannot do it alone. Better data, a stronger focus on public health and properly delivered basic services free up funding for more efficient hospitals." said Adrian Pana.
Access to patient data would also enable pharmacists to contribute more to treatment safety. Anca Crupariu, Pharmacist and Spokesperson for the Romanian College of Pharmacists, explained:
"Digitalisation would be a breath of fresh air for pharmacies in Romania. If the electronic health record were integrated into the platform, pharmacists could access patients' medical histories." said Anca Crupariu.
The need for greater investment in prevention is also reflected in children's oral health: according to data presented by Dr. Florin Dan Cezar Lazarescu, President of the Romanian Dental Council, 66% of children have dental caries, and only one in two brushes their teeth twice a day.
"Given budgetary constraints, we consider investment in prevention a priority. A gradual shift from reimbursing curative treatments towards preventive treatments could bring us long-term benefits." said Florin Dan Cezar Lazarescu.
The National Public Health Conference #UndeDoare was organized by BUCHAREST CENTER FOR ECONOMY & SOCIETY (CES Bucharest), in partnership with the Carol I Central University Library, with the support of MSD, Medtronic, Reteaua de Sanatate REGINA MARIA and Uniunea Nationala a Societatilor de Asigurare si Reasigurare din Romania (UNSAR).