Healthcare systems in the European Union (EU) are in urgent need of "shock-proofing" if they are to meet the challenges posed by severe pressure on budgets, a leading expert has warned.

"Innovation is crucial to European health policy - people derive more direct benefit from innovation in healthcare than in any other area, but EU-wide austerity policies are having an especially harsh impact in many countries," Professor Helmut Brand, who recently took over as president of the European Health Forum Gastein (EHFG), has said in Brussels. 

He warned: "making cuts and innovation do not really fit together. So where is the line? At what point do cuts become critical for health systems and endanger social safety nets?"

The challenge of how to shock-proof the EU's healthcare systems will be the central theme of this year's annual European Health Forum Gastein (EHFG) Congress, to be held in Bad Hofgastein, Austria from October 2-4. The EHFG is the most important annual health policy event in the EU, providing a forum for nongovernmental organisations, patient groups, academics, healthcare providers and industry to discuss issues with policymakers and for the European Commission to present its health strategies for discussion.

One very topical development, the planned Transatlantic Trade and Investment Partnership (TTIP) between the EU and US, will also be the subject of detailed debate, said Prof Brand, who is professor of European public health and head of the department of international health at Maastricht University, The Netherlands.

The Agreement will "have a major impact on the health sector in many fields,” he noted.

Officials hope that the EU trade ministers will agree a negotiating mandate for the TTIP shortly, so that talks can commence in June or July for a deal that could boost the EU economy by at least 0.5%. The US/EU economic partnership is already the world's largest, worth $4.9 trillion in 2011 and accounting for around a third of global trade and almost half of the world's economic output.

European Trade Commissioner Karel de Gucht has stressed that the EU and US negotiators must have "the courage to talk about everything,” a point also emphasised by UK Prime Minister David Cameron, who said there needs to be "everything on the table, even the difficult issues, no exceptions."

Officials are keen for the deal to tackle expensive "behind the border" non-tariff barriers that impede the flow of goods and services and to significantly cut the costs of differences in regulation and standards by promoting greater compatibility, transparency and cooperation. A study conducted by the Dutch Ecorys consultancy for the European Commission suggests that these and other measures could reduce trade and investment costs for US pharmaceutical companies by15.3% and by 9.5% for EU drugmakers.

However, a hearing on the TTIP organised last week by the US Obama Administration's Trade Policy Staff Committee heard calls for intellectual property (IP) to be excluded from the deal, as originally proposed by the US/EU High-Level Working Group when it presented the case for the TTIP.

A declaration signed by 45 US and EU civil society groups read out at the hearing said that IP "could impede our rights to health, culture and free expression and otherwise affect our daily lives.”

"Past trade agreements negotiated by the EU and US have significantly increased the privileges of multinational corporations at the expense of society in general," said the groups, adding: "provisions in these agreements can, among many concerns…raise healthcare costs and contribute to preventable suffering and death."

Meantime, Prof Brand also told his audience in Brussels that he hopes future EHFG annual conferences will include representatives of the next three EU presidencies. "This should ensure that issues which come up in Gastein directly affect social, concrete policy. Following the treaty of Maastricht, health is an EU policy area, and political decisions in social and health policies affect the lives of individual people very directly," he said.

An EHFG conference held in late May discussed progress with the public health mandate introduced by the Maastricht Treaty, which entered into force in 1993 and gave the EU a new mandate to use its powers for health. The actions which have been formally authorised as a result are in fact less important than the message it sends, which is that "health is a legitimate, and now obligatory, objective of EU policy," Prof Scott Greer of the University of Michigan School of Public Health told the conference.

Prof Brand said the subject of health is receiving much too little attention in the discussions around Europe's financial and economic crisis, but in fact the situation could offer “a window of opportunity” at EU and national levels to implement reforms that would otherwise not be possible, including a reform of the EU health mandate.

Crucial changes should include a further strengthening of the European Parliament's role in public health issues, positioning the EU even more strongly in global health issues and building up an EU health information system, he proposed.