Principle 16


"Everyone has the right to timely access to affordable, preventive and curative health care of good quality."

- Principle 16 of the European Pillar of Social Rights

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Access to healthcare as a determinant of health

Our understanding of factors contributing to the spread and development of illnesses has grown considerably: some communicable diseases can be prevented through vaccinations, and early measures can be taken to slow down or avoid various noncommunicable diseases, mental health and obesity, and age-related conditions.

However, both curative and preventive healthcare can only be delivered if it is available, citizens know where to find it, and feel confident to seek healthcare free of judgement or repercussions, including financial and social. Equity in access in relation to primary and community-based health and long-term care are of concern as well.

What does the EPSR Action Plan say?

The EPSR Action Plan sets out several overarching goals for EU Member States in the field of social rights more generally:

  • At least 60% of adults should participate in annual training with at least 80% of those aged 16-74 having basic digital skills: This will be key to ensure digital health literacy.

  • Member States should develop comprehensive policies to provide access to quality education for all and provide targeted support to disadvantaged learners.

  • At least 78% of the population aged 20 to 64 should be in employment by 2030, contributing to stable income provision, preventing poverty and social exclusion.

  • The number of people at risk of poverty or social exclusion should be reduced by at least 15 million by 2030, out of which at least 5 million should be children.

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Where are we now?

The Social Scoreboard measures progress on the principles of the EPSR. Linked to Principle 16 the Scoreboard outlines that in the EU:

  • In 2022, 2.2% of EU citizens reported they were not able to get a medical diagnosis or treatment due to financial reasons, a too long waiting list, or healthcare provider too far.

  • While most healthcare in the EU is covered or (partially) reimbursed by insurances, people may also have direct “out-of-pocket” expenses.

  • Healthy life years across the EU have improved slightly from 9.3 years in 2015 to 9.9 years in 2021 for women, and from 9.2 to 9.5 years for men.

  • Most recent data from 2022 estimates that 21.6% of EU citizens were at risk of poverty or social exclusion, compared to 24% in 2015.


What are public health actors doing?

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The following actions taken by public health actors at (sub)national level can support the implementation of EPSR principle 16.

Click on a country to learn about initiatives taking place.

EU tools that help to implement Principle 16

There are EU policies and instruments that can help relevant actors in the field, including public health, to work together to achieve EPSR Principle 16.

More information about the EU institutions and programmes is available on EuroHealthNet's Health Inequalities Portal.

The European Child Guarantee

Adopted in 2021, the European Child Guarantee aims to prevent social exclusion and guarantee children access to a number of services, including free healthcare. This includes the facilitation of early detection and treatment of disorders, both physical and mental. It also aims to ensure access to regular medical examinations, screening programmes, and follow-up interventions.

In addition, Member States are required to provide at least one healthy meal each school day and access to healthy nutrition, as well as education and early childhood education and care. Children with disabilities should receive rehabilitation services.

The EU4Health Programme
The European Care Strategy
WHO Surgical Safety Checklist
The Pharmaceutical Stategy for EU
The new EU Mental Health Approach

Available resources

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Have your say

Would you like to share promising policies or practices carried out by your public health institute, which support the implementation of this EPSR principle?

Feel free to reach out to our EuroHealthNet colleague Vania Putatti.

About EuroHealthNet

Building a healthier future for all by addressing the determinants of health and reducing inequalities.

EuroHealthNet is the Partnership of public health agencies and organisations building a healthier future for all by addressing the determinants of health and reducing inequalities. Our focus is on preventing disease and promoting good health by looking within and beyond the health system.

Structuring our work over a policy, a practice, and a research platform, we focus on exploring and strengthening the links between these areas.

Our approach focuses on integrated concepts to health, reducing health inequality gaps and gradients, working on determinants across the life course, whilst contributing to the sustainability and wellbeing of people and the planet.

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EuroHealthNet is co-funded by the European Union. However, the information and views set out on this website are those of the author and do not necessarily reflect the official opinion of the European Commission. The Commission does not guarantee the accuracy of the data included on this website. Neither the Commission nor any person acting on the Commission's behalf may be held responsible for the use which may be made of the information contained therein.

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