In general, fund managers, policy-makers and other stakeholders appear to be well aware of the linkages between public health issues and economic development in general, and the need to address public health and some of its determinants in order to tackle employment issues. This stems from a number of Welsh policies and strategies[1] that target poor health as a main cause of socio-economic problems, based on socio-economic analyses and studies. Moreover, there are a number of relevant good practices in Wales with regard to extending the benefits of Structural Fund programmes to the disabled and other vulnerable groups, as well as targeting public health-related issues through economic development-oriented programmes.

There are two Convergence programmes in the West Wales and the Valleys sub-region: one for ERDF and one for ESF. Both were developed through consultation with stakeholders, which included a number of organisations responsible for or working for health, social policy and well-being in Wales. There was, however, limited input from statutory health authorities due to the fact that the programmes do not directly fund health care or other investments directly targeting health-related objectives.

In the OP for ERDF, indirect benefits to population health and general well-being are considered from a community development perspective. Some investment priorities target the regeneration of contaminated land areas, including brownfield sites and green public spaces; and community development. These are expected to improve opportunities for recreation and more active lifestyles, as well as improve social inclusion.

The ESF OP looks more directly at health, as it identifies work-limited health conditions as a major cause of economic inactivity. The programme therefore targets activities that will assist individuals with work-limited health conditions (e.g. chronic pain or illness, mental health problems) to better manage their conditions to the point where they may seek employment. It will also work to improve the health of those already in work to prevent the flow into unemployment and economic inactivity.

Public health issues are also integrated into the Structural Fund programmes in Wales through the two cross-cutting themes, which address environmental sustainability and equality of opportunity, as required in the EU General Regulation on the Structural Funds for 2007-2013. In Wales, a dedicated team within the Managing Authority is responsible for the integration and monitoring of the cross-cutting themes into programme implementation; detailed and individualised guidance is available from the MA on this. The equality of opportunity theme in particular targets vulnerable groups including the disabled, to ensure that programme benefits effectively reach these parts of society.

Officials and stakeholders in Wales are aware of the limitations of Structural Fund programmes, particularly limits on direct spending on health/health care, but also limits on directly targeting health and well-being issues with the funds. As a result, health gains from Structural Fund programmes in Wales are not directly targeted or measured as part of the formal programme processes. Officials and stakeholders agree that it could be useful to better capture these health gains, but that doing so within the formal constraints of Structural Fund programmes could prove cumbersome, particularly if it would add more complexity to the programming and implementation process.

The guide to health gains from Structural Fund programmes currently under development could improve this situation, particularly if it can clearly and simply highlight the impacts that non-health investments have on health. The guide should also have a strong awareness-raising function, to improve overall understanding of how public health relates to economic and social objectives and vice-versa. As well-being is high on the Welsh agenda for future social and economic development, this issue will increase in importance in the coming years and may therefore have strong relevance for the 2014-2020 programming period.

The impact of the guide could be more powerful if it is endorsed at the European level, by not only DG Sanco, but also DG Regio and DG Employment, who have significant roles in working with Managing Authorities on programme specifics. Reference to public health in the EU regulations and/or guidance documents would also improve the likelihood that health gains from Structural Fund programmes are targeted and captured in the future.

    

 

Background information

With its cross-cutting themes targeting environment and non-discrimination, as well as its indirect use of ESF funds to target work-limiting health conditions, Wales presents an interesting and useful case for understanding how Structural Fund programmes integrate public health concerns into their contents and delivery arrangements. 

Wales is a country within the United Kingdom, bordered by England to its east and the Atlantic Ocean and the Irish Sea to its west. Wales is divided into two NUTS 2 regions – West Wales and the Valleys and East Wales (referred to as “sub-regions”). A single authority, the Welsh European Funding Office (WEFO) serves as the Managing Authority for all Structural Fund programmes in Wales. This case study covers West Wales and the Valleys (WWV), which is one of two remaining Convergence[2] regions in the UK. West Wales and the Valleys consists of fifteen local authorities and covers the western half of Wales.                                                                                                     

Figure 1: Map of the West Wales and the Valleys region within Wales

Description: convergence map

Source: Welsh European Funding Office website

 

Table 1: West Wales and the Valleys: the region at-a-glance

Population (inh., 2007)

1.89m

Surface area (km2)

13,129

GDP per capita in EUR (PPS, 2008)

17,900 

GDP per capita as % of EU 27 (PPS, 2008)

71%

Cohesion Policy status

Convergence

Life expectancy at birth, male (2008)

76.6

Life expectancy at birth, female (2008)

81.1

Sources: Eurostat and Fifth report on economic, social and territorial cohesion

Economic output per head has historically been lower in Wales than in other parts of the United Kingdom. This is explained by two main factors, according to the region’s ERDF Operational Programme: lower-value-added per worker (productivity) and a lower employment rate. Lower value-added per worker is mainly attributed to the sub-region’s economic structure, which is dominated by a manufacturing jobs and service sector consisting of jobs in public administration, health and education. Sparse population, distance from major centres, and inadequacies in traditional infrastructure are other contributing factors, as well as relatively low expenditure on research and development and low uptake of ICT in businesses.

 

Figure 2: GDP per capita in PPS (EU27 average = 100)

Source: Eurostat; GDP per capita in PPS is Gross Domestic Product in purchasing power standards.

In 2008, life expectancy at birth in West Wales and the Valleys was 76.6 years for men and 81.1 years for women, which is close to the EU 27 average of 75.8 (men) and 82 (women). In terms of overall development, however, West Wales and the Valleys scored above the EU average on the EU version of the UN’s Human Development Index (HDI).[3] This index includes healthy life expectancy, household income, and educational attainment levels. West Wales and the Valleys scored 68.6 out of 100 compared to an average value of 62 for EU regions.

 

 

Policy and institutional overview

Cohesion Policy

West Wales and the Valleys is one of two Convergence regions in the UK (along with Cornwall and the Isles of Scilly). It has been allocated a total of €2.083 billion in Cohesion Policy funding for the 2007-2013 period, comprising funding from both the European Regional Development Fund (ERDF) and the European Social Fund (ESF). Spending of these funds is governed by two Operational Programmes (OPs), one for the ERDF funds and one for the ESF funds. The OPs outline the priorities for each programme, based on social, economic and environmental analyses of the needs and opportunities of the region. They stem from the National Strategic Reference Framework (NSRF) prepared for the entire UK, which aims to “increase the rate of sustainable growth, improve prosperity and achieve a better quality of life, with economic and employment opportunities for all.”[4]

The ERDF programme will cover investments in the knowledge economy, and supporting the growth of new and existing businesses. It will also address transport linkages, regeneration of the most deprived communities, and tackling climate change. The ESF programme will focus on economic inactivity, and increasing skills and employment overall.

Managing institutions

The Managing Authority is the Welsh European Funding Office, a governmental institution created specifically for the management of EU-funded programmes throughout Wales. WEFO manages the two Convergence programmes in West Wales and The Valleys, and two Regional Competitiveness and Employment programmes in the East Wales region. It also participates in four territorial cooperation programmes, which work to strengthen the economic, environmental and social links between member states, as well as encourage cross-border neighbours to work together to develop innovative projects.

WEFO operates the programmes through an open call for project proposals from the public, private and third sectors (non-profits). Detailed advice and guidance to project applicants is provided on the WEFO website (http://wefo.wales.gov.uk).

The All-Wales Programme Monitoring Committee (PMC) is responsible for monitoring the implementation of the 2007-2013 programmes in Wales. The PMC is chaired by the Managing Authority, and consists of a panel of ten publicly appointed expert members and 14 members nominated on a representative basis from partners and statutory bodies. These include local government, higher and further education, the public, private and voluntary sectors, trade unions, social partners and those with statutory responsibilities for the cross-cutting themes of environment and equality. There is no representative with representing the health care or public health sectors. Representatives of DG Regio and DG Employment serve as advisors to the PMC.

Health sector

Overview of institutions

Health care and public health policy in Wales are among the executive and legislative powers that have been constitutionally delegated to the National Assembly for Wales (NAW) and the Welsh Assembly Government, under the Government of Wales Acts of 1998 and 2006. The statutory authority for health policy in Wales is the Health and Social Services Directorate of the WAG; within this a department of public health and health professions leads on public health strategy and programmes, with the aim of protecting and improving health and reducing health inequalities.

The priorities for this department are:

  • to address the socio-economic and cultural determinants of ill health and reduce inequalities in health
  • to strengthen public health services to support the improvement of health in local communities and commission health and social care
  • to further improve the health of children and young people to give them the best start in life
  • to tackle obesity by encouraging healthy eating and fitness
  • to address health-related behaviours and risk (including smoking, alcohol, drugs, sexual health)
  • to better manage long-term health conditions and reduce their impacts on health and well being
  • to improve the delivery of mental health services[5]

The publicly funded National Health Service of Wales (NHS Wales) provides healthcare services, and is the responsibility of the WAG.

The third sector also has a key role in health care and public health, including a range of organisations operating between the state and the private sector, such as small local community and voluntary groups, registered charities and a growing number of social enterprises. The organisations provide services such as advocacy, volunteering, information and advice provision, needs identification and fundraising. They also frequently develop and carry out Structural Funds projects in relevant fields.

Overview of public health policies and objectives

The WAG ten-year strategy for the future of health and social services, Designed for Life,[6] sets out the government’s objectives for health care services, focusing on lifelong health and world class care. A large number of strategy and policy documents address public health, well-being, social services and the health care system in Wales. Some of the most relevant for socio-economic determinants of health and health inequalities are:

  • Our Healthy Future (2007)is a strategic framework for public health in Wales, which sets the overall context and direction for action to protect and improve health in Wales by 2020. It aims to achieve improved quality and length of life; and fairer outcomes for all.
  • Health Challenge Wales (2004)is a commitment to health improvement by supporting individuals to focus on their own health and for opportunities to be for all, through a coordinated and informed approach. The umbrella policy also gives local governments responsibilities for delivering key initiatives.
  • Well-being in Wales (2002)is a consultation document that focuses on improving health and reducing health inequalities
  • Better health, better Wales (1998)is an earlier consultation document aimed at engaging the population in the debate about the best ways to improve people’s health.

The last three documents are specifically referenced in the Welsh Structural Funds programming documents for 2007-2013.

Most local authorities – through well-being partnerships and local health boards –have also developed strategies and actions plans addressing health, social care and well-being issues. An example is the Carmarthenshire Strategy, which prioritises preventing ill-health in the first place, through tackling the root causes of ill-health; improving access to primary and secondary health care services, and improving the availability and quality of housing and support services. The strategy targets those in need, particularly children, older people and people with specific health and well-being needs.[7] In this sense, some aspects of the local strategy are compatible with those of the Structural Fund programmes and can benefit from funding.


 

Health in the Structural Fund programmes

Wider public health is contained within the “vision” for both of the Convergence OPs for West Wales and the Valleys: “...with its people living in a prosperous, strong, healthy, safe...communities within and ever improving natural environment.”

While neither public health nor health care systems is identified as a direct objective or funding priority for the West Wales and the Valleys programmes, the objectives, analysis and some of the investment priorities in both programmes do address the social, economic and environmental determinants of health. The ESF programme goes further, addressing ill health as a major cause of economic inactivity in the region, and therefore envisions projects directly aimed at improving the health of specific social groups.

OP for the European Regional Development Fund (ERDF)

The ERDF Convergence OP aims at strengthening the regional economy through stimulating enterprise and business developments, growth and opportunities; promoting a knowledge-based economy; and supporting this with the necessary physical infrastructure and integrated regeneration solutions. The programme states up front that is was prepared in the context of a number of EU, UK and Welsh policies and strategies for economic and sustainable development, including an environmental strategy for Wales. It also references the extensive consultation carried out with a “wide range” of partners and stakeholders during its preparation.

While health is not directly targeted, poor health is identified in the analysis that underpins the programme strategy as a barrier to labour participation, which contributes to the low employment rate across the region.

Within the investment priorities, there is some focus on the benefits to population health and well-being from regeneration of contaminated land areas and the resulting economic reinvigoration. This is stated under Priority 4“Creating an attractive business environment”; the contribution of leisure and recreation activities to healthier lifestyles as envisioned by the Healthy Challenge Wales strategy are also referenced in this priority.

Priority 5, “Building sustainable communities,” funds regeneration of the physical landscape, including brownfield sites and green public spaces. It also envisions community economic development through small-scale lending, support to NGOs and organisational development and reach-out. While health is not directly referenced in the rationale or description of the investment priority, the social inclusion and other community development results will substantially impact important social, economic and environmental health determinants.

OP for the European Social Fund (ESF)

Health is more directly targeted in the ESF Convergence OP. Work-limiting health conditions are identified as a major cause of economic inactivity (defined as those neither employed nor seeking work), which is nearly five percentage points higher in West Wales and the Valleys than in the UK as a whole. In a 2004 labour force survey cited in the ESF OP, the factor most commonly identified by respondents, particularly men, was a long-standing, self-reported, work-limiting health condition. Commonly cited conditions include high blood pressure, respiratory illness/asthma, back pain, and limiting long-term illness. Long-term illness particularly affects people in the over 49 age bracket.

Thus, tackling economic inactivity by addressing work-limiting health conditions is identified as a key part of the programme strategy.

At the same time, the analysis recognises other factors that lie at the heart of high economic inactivity in Wales. These include an unskilled labour force and a falling demand for unskilled workers, lack of transport and other infrastructure links to employment centres, and a lack of public services that would facilitate employment. Tackling all of these issues, the programme maintains, will raise levels of employment and thereby address the wider social consequences of worklessness and poverty which impact on health and social inclusion.

The ESF programme refers to the broad strategic policy agenda for Wales, Wales: a Better Country,[8] which maintains that action to promote economic development must occur alongside other elements of the strategic agenda, including health. It also notes its contribution to the EU Community strategic guidelines for cohesion[9] section 1.3.5 on helping to maintain a healthy labour force.

 All of the four investment priority axes in the ESF programme refer to ways in which they will target or impact on health and its wider determinants (see Table 3 for a summary). It is priority 2, “Increasing employment and tackling economic inactivity” that considers health most directly. Building on the strategic analysis for the overall programme, the rationale for this investment priority recognises that the links between ill health, low skills and unemployment and economic inactivity are now well established. Moreover, improving health at work and preventing people becoming ill at work are key to preventing the flow into long-term unemployment and economic inactivity. With regard to targeting ill health, the priority envisions the following types of activities:

  • Activities to support more collaborative work between employment and health sectors, including work with GPs and other primary care providers;
  • Provision of advice and guidance on managing work-limiting health conditions in employment;
  • Development and delivery of workplace health programmes supporting people to manage work-limiting problems at work, especially when returning to work following an absence due to illness, to help avoid work-related ill-health, and improve the general state of their health
  • Provision of guidance and advice on managing health conditions for employers and individuals

A variety of other activities will target disadvantaged groups and help them to address their specific barriers to employment. A key feature of this priority is that proposed projects must aim at getting participants into employment; health and well-being improvements alone are not directly eligible for funding.

Tables 2 and 3 below summarise the key priorities and intervention areas of both OPs, as well as their correlation with the proposed briefing sheet topics. Whenever applicable, the tables also show how health is considered within each priority.

 

Tables 2 and 3: Overview of West Wales and the Valleys’ OPs

 

Operational Programme for the European Regional Development Fund

MA: Welsh European Funding Office

Total EU allocation: €1.25 billion

Priority axis

Funds (€)

Percent of total

Content of priority

Briefing Sheets topic(s)

Health considerations in the priority

1. Building the knowledge based economy

313,878,019

25.10%

Research, technology and innovation capacity

ICT

RTD; ICT

 

2. Improving Business Competitiveness

192,778,000

15.42%

Support entrepreneurship and businesses

Improve access to business finance

RTD

 

3. Developing strategic Infrastructure for a modern economy

330,823,802

26.46%

Transport solutions for agglomerations

Educational and other strategic infrastructure

Transport; RTD;

Education & training

 

4. Creating an attractive business environment

229,898,349

18.39%

Renewable energy and energy efficiency

Environmental risk prevention

Enhancement and protection of environment and its economic potential

Energy;

Climate change; Culture & heritage

Rationale: Economic reinvigoration from regeneration of contaminated land areas will improve health and well being of the population.

The contribution of leisure and recreation activities to healthier lifestyles and the “Healthy Challenge Wales” initiative are referenced.

Linkages to the environment strategy for Wales and its plan for healthy environment that contributes to health of the population.

5. Building Sustainable Communities

158,000,019

12.64%

Physical regeneration, brownfield sites, public spaces

Community economic development

Urban and rural regeneration; Culture & heritage

Rationale: priority includes social justice actions that tackle poor health.

6. Technical assistance

25,000,000

2.00%

 

N/A

 

 

 

ESF 1: Su

MA: Welsh European Funding Office

Total EU allocation: €833,585,460 million

Priority axis

Funds (€)

Percent of total

Content of priority

Briefing Sheets topic(s)

Health considerations in the priority

1. Supplying young people with the skills needed for learning and future employment

123,929,806

14.87%

Tackling underachievement in education

Raising skills and aspirations

Education and training

Link between literacy/numeracy, economic activity and health, deprivation, social exclusion in rationale

2. Increasing employment and tackling economic inactivity

327,810,932

39.33%

Helping people into sustainable employment

Helping people to remain in work

Employment

Work-limiting ill health and disability is seen as a major cause of economic inactivity. Therefore specific measures (and targets) are directed at this group to manage their health, prevent work-related ill health, and to improve linkages between employers and the health sector

3. Improving skill levels and adaptability of the workforce

331,858,760

39.81%

Raising basic employment skills

Higher level skills for knowledge economy

Promoting gender equality in employments

Education and training

Employment

ICT

Participants with work-limiting health conditions or disability are targeted (13%) for training

Gender equality direct target

4. Improving public services – Making the Connections

32,985,962

3.96%

Customer service and engagement

Integrated government functions and efficiency of public sector

Workforce development

(None directly)

Institutional capacity, ICT

Health service providers are a target group and improving standards of health via more collaboration between public sector organisations  is an outcome

5. Technical assistance

17,000,000

2.04%

     

 

 

Integrating health in the programmes

 

Overall, Welsh officials are satisfied that health – in this case wider public health and health determinants – is effectively integrated in the Structural Fund programmes, and that stakeholders are taking advantage of this to develop and implement projects that address health issues.

Programme preparation and content

The process of integrating health into the programmes occurred more through socio-economic analysis than through direct involvement of health authorities or stakeholders. Both the socio-economic analysis carried out for all of the Welsh programmes, as well as the ex-ante analysis required by the European regulations, highlighted health inequalities and the economic impact of those as a major issue to be addressed. Many of these links had already been made in WAG policies and strategies, which the Structural Funds programmes reflect.

 The fact that health care or health infrastructure is not considered eligible for funding in Wales per the European regulations has diminished the direct interest and involvement of the health policy-makers and national health services in the Structural Fund programmes. Nevertheless, a wide range of other institutions and organisations with an interest health, social care and well-being do participate in the programmes as consultation partners and beneficiaries. Programmes in Wales undergo a wide consultation process that includes engagement with the appropriate WAG departments from an early stage, as well as a full public consultation.

The WEFO officials interviewed for this case study stressed the cases where the programmes have notably integrated health concerns. These are the focus on ill health as a cause for economic inactivity in the ESF programme and the themes “Promoting the environment as a driver for economic growth”, “Community economic development” and “Sustainable transport”.

Programme delivery

As mentioned, programmes in Wales are implemented through an open call for projects that meet the eligibility requirements and addressing the programme priorities. Applicants and awarded project beneficiaries receive considerable guidance and assistance in project development and delivery; much of this is available online at the WEFO site. Detailed guidance documents address applying for funding, developing your project and delivering your project. Furthermore, specific guidance to individuals is available both online and in person from WEFO staff. The guidance places particular emphasis on integration of the programme’s cross-cutting themes into project development and delivery, as described below. According to WEFO officials, the cross-cutting themes and the project guidance play an important role in the integration of public health issues into projects and results.

Cross-Cutting Themes

Articles 16 and 17 of the General Regulation on Structural Funds for 2007-2013[10] require that Structural Fund programmes consider “Equality between men and women and non-discrimination” and “sustainable development”; the EU Community strategic guidelines on cohesion[11] consider these essential for the achievement of well balanced, sustainable and innovative economy. For the 2007-2013 programmes in Wales these issues are identified as two cross-cutting themes:

  • Environmental Sustainability: in view of the statutory duty to promote sustainable development,aims to ensure that economic development will not adversely impact on the environment, and to promote the potential of the environment as an economic driver.

 

  • Equal Opportunities: aims to promote equal access to all to the education, training and employment opportunitiesoffered by the programmes, regardless of gender, disability, ethnic original, religion or belief, age, sexual orientation and with regard to the bilingual nature of many of the communities in the region.

As explained by the Head of the Cross Cutting Themes team at WEFO, both of the themes are linked to health determinants. Environmental sustainability is closely tied to the well-being agenda in Wales, based on the assumption that a healthy environment is a pre-requisite for healthy lifestyles, and that physical improvements to public spaces will encourage recreational activities and more active lifestyles that contribute to good health. This is also seen in projects funded by the ESF which use environmental improvement projects to create jobs. The equal opportunities theme was cited by both WEFO officials interviewed for this case study as having great importance for health, as it seeks to ensure the participation of the disabled and those facing work-limiting health conditions in all projects funded by the programmes.

In Wales the cross-cutting themes are an important aspect of programme implementation. A specific team within the Managing Authority is assigned to develop, implement and monitor the cross-cutting themes, including providing assistance to project applicants to consider concrete ways in which the themes can be integrated into projects. Detailed written guidance is available on the WEFO website for each of the programme investment priorities; the guidance includes checklists which applicants must complete to ensure that projects have adequately considered the relevant aspects of each theme in their projects.

All projects that seek Structural Funds funding are assessed in line with the published guidance on both themes, to ensure they not only meet specific criteria, but have taken advantage of opportunities to enhance outcomes related to the themes.

Project Examples

A number of projects with noticeable health gains have already been co-funded under these priorities and are starting to show results. These include:

Remploy – Wellbeing through Work (ESF):  gives employees access to support from advisors on reducing stress, debt management and relationship problems which may impact on an individual’s ability to remain at work. It also provides help for people who have experienced mental illness to get back to work.

COASTAL (Creating Opportunities and Skills Team Alliance) (ESF): provides vocational guidance, employment, skills training and lifelong learning opportunities for individuals who are economically inactive as a result of illness, disability, substance misuse problems or other social disadvantage.

Family Employment Initiative (ESF): supports pathways for individuals and families who have been unemployed for a significant period, many of whom have health related issues, by using green spaces and environmentally focused activity.

Valleys Regional Park (ERDF): aims to encourage access to and use of green space; develop and promote a network of walking and cycling routes for recreation; and develop a range of projects which improve activity tourism opportunities through environmental actions, thereby encouraging healthier lifestyles through recreation.

Challenges and the future programming period

While officials in Wales are largely satisfied with the extent and content of integration of health determinants (and to some extent direct health issues) in the programme content and delivery arrangements, there remain some challenges and issues to consider in the future programming period.

One issue cited by all the officials interviewed for the case study is that since health itself is not an eligible objective (and they agree Structural Funds should not be used for health care in Wales), there are no targets or other efforts made to quantitatively measure or even qualitatively capture the health gains from the ongoing programmes and projects. In fact, one of the officials mentioned that preparation for participation in this case study marked the first time they had consciously tried to put together a list of the health gains expected from the ongoing programmes and projects, and that they were positively surprised by the extent of health-related benefits they were able to identify.

A number of things were identified which might strengthen the capacity to capture health gains. These include: specific indicators and targets for health and/or health determinants integrated in the programme monitoring and evaluation arrangements; putting a representative from a health and well-being organisation on the programme monitoring committee; and strong focus on capturing the specialist knowledge and experience of the 3rd sector organisations working in these fields. However, the importance of health and health determinants for Structural Fund programmes would have to be clearly captured and presented in order to justify the placement of these stakeholders in the relevant organisations, as there is a very broad range of policies that needs to be represented.

A related issue was cited by the representative of a local health, social care and well-being partnership, an advisory body tasked with implementing one ESF-funded project. This official noted that the county council (local authority) is clear that there should be health gains from all infrastructure and economic development investments (from all funding sources), and that there is political expectation for these gains to be realised. This is not always so explicit, however, in the regulations and guidelines that govern the EU funds; these often identify spending priorities and eligibilities in very narrow terms attached to the (mainly economic) EU priorities. The result is that programmes cannot effectively meet real local needs.

As an example of this, he mentioned the fact that the funding programmes in Wales target employment directly (rather than overall well-being) means that they cannot address the wider needs of those who require support, but cannot aspire to permanent employment. Another example given was a project aiming to create “social enterprises” that could create employment opportunities for people with health-related disabilities based on their skills. The project has been difficult to develop because part of the objective is covered by the ERDF programme and the other part by the ESF programme, but the funds cannot be easily and flexibly combined to address a single objective.

While limited consideration has been given to plans for the 2014-2020 programming period in Wales, officials did note that well-being is high on the WAG agenda for the future, and that this should be reflected in future Structural Funds programmes. As health is a strong determinant of well-being, this could mean that further indirect focus on health may be expected from these programmes. A great deal will be determined by the content and wording of the EU regulations for Cohesion Policy 2014-2020, due out in draft form in summer 2011.

 

 

References

Health policy and other documents

Better Health – Better Wales, Public Health Division Welsh Office, 1998

http://www.wales.nhs.uk/publications/greenpaper98_e.pdf

Designed to Add Value – a third dimension for One Wales, A Strategic Direction for the Third Sector in Supporting Health & Social Care, Welsh Assembly Government/NHS Wales, November 2008

http://wefo.wales.gov.uk/developing/crosscutting/equalopportunities/?lang=en

Feeling fine – A Health, Social Care & Well-Being Strategy for Carmarthenshire 2008-2011, http://www.carmarthenshire.gov.uk/english/health/pages/health,socialcarewell-beingstrategy.aspx

Health and Structural funds in 2007-2013: country and regional assessment, Country assessment United Kingdom, EUREGIO III project for DG Sanco, 2009

http://ec.europa.eu/health/health_structural_funds/used_for_health/index...

Health Policy, Members Research Service: Topic Brief, National Assembly for Wales, September 2008, http://www.assemblywales.org/tb-08-003.pdf

Well Being in Wales, Public Health Strategy Division, Welsh Assembly Government, 2002

http://wales.gov.uk/docs/healthchallenge/publications/welbeing/090126wellbeingen.pdf

Our Healthy Future – the Strategic Framework for Public Health in Wales, Welsh Assembly Government, 2007

http://wales.gov.uk/topics/health/ocmo/healthy/;jsessionid=k1XcKLrC4JyYsGGGDWn4m1rFGqDs8JypZVyY1n7qK2R18tMSth!1298896870?lang=en

 

Structural Funds programme documents

Equal Opportunities Guidance, Key Document: West Wales and the Valleys Convergence Programme and East Wales Regional Competitiveness and Employment Programme 2007-2013, Welsh European Funding Office, Version 6 – May 2010

http://wefo.wales.gov.uk/developing/crosscutting/equalopportunities/?lan...

Increasing Employment and Tackling Economic Inactivity – A Practical Guide to Promoting Equal Opportunities,Welsh European Funding Office, Version 6 – May 2010

http://wefo.wales.gov.uk/developing/crosscutting/equalopportunities/?lang=en

Operational Programme for the European Regional Development Fund 2007-2013,Welsh European Funding Office, June 2009 (latest version)

http://wefo.wales.gov.uk/programmes/convergence/?lang=en

Operational Programme for the European Social Fund 2007-2013,Welsh European Funding Office, June 2009

http://wefo.wales.gov.uk/programmes/convergence/?lang=en

Interviews

Damien O’Brien, Director, Welsh European Funding Office, interviewed on 20 April 2011

Chriss O’Connell, Head of Cross-Cutting Themes team, Welsh European Funding Office, interviewed on 20 April 2011

Matt Downton,Head of Settings Branch, Health Improvement Division, Health and Social Services Department, Welsh Assembly Government, interviewed on 27 April 2011

Brickchand Ramruttan, Partnership Manager, Health, Social Care & Well-being Partnership, Carmarthenshire County Council & Local Health Board, interviewed on 28 April 2011


[1]See References for a list of relevant Welsh strategy documents.

[2]Convergence regions have GDP less than 75% of the EU-27 average and receive greater Structural Fund allocations to enable them to catch up through targeting economic development.

[3]Investing in Europe’s future – Fifth report on economic, social and territorial cohesion, DG Regional Policy, November 2010

[4]http://ec.europa.eu/regional_policy/atlas2007/fiche/uk_en.pdf

[5]http://new.wales.gov.uk/about/civilservice/directorates/hssdirectorate/phhp/?lang=en

[6]http://www.wales.nhs.uk/documents/designed-for-life-e.pdf

[7]Feeling fine – A Health, Social Care & Well-Being Strategy for Carmarthenshire 2008-2011, http://www.carmarthenshire.gov.uk/english/health/pages/health,socialcarewell-beingstrategy.aspx

[8]http://www.elwa.org.uk/doc_bin/SkillsObservatory/Learning%20Country.pdf

[9]Council Decision of 6 October 2006 (2006/702/EC) on Community strategic guidelines on cohesionhttp://ec.europa.eu/regional_policy/sources/docoffic/2007/osc/index_en.htm

[10]Council Regulation No 1083/2006 of 11 July 2006 laying down general provisions on the European Regional Development Fund, the European Social Fund and the Cohesion Fund

http://ec.europa.eu/regional_policy/information/legislation/index_en.cfm

[11]Council Decision of 6 October 2006 (2006/702/EC) on Community strategic guidelines on cohesion

http://ec.europa.eu/regional_policy/sources/docoffic/2007/osc/index_en.htm