Archives of Hellenic Medicine

Last update:

09-May-2025

Arch Hellen Med, 42(Supplement 1), 2025, 30-37

SPECIAL ARTICLE

Restructuring and strengthening the public health system at the central, regional and local levels

A.D. Tsouros,¹ J. Kyriopoulos[†],² Ε. Thireos,³ Μ. Tsantidou,⁴ Α. Philalithis[†],⁵ V. Diamantopoulos⁶
¹Former Director of Policy and Governance for Health and Wellbeing, World Health Organization (WHO) Europe and Adjunct Professor, Department of Global Health, Boston University School of Public Health, Boston, United States of America,
²President of The Institute of Health Economics – Died in 2022,
³General Practitioner/ Family Physician, Director of National Health System, Head of General Directorate, National Agency for Quality Assurance in Health SA, President of Athens Medical Society, Athens,
⁴Vice President of the Panhellenic Union of Public Health Physicians of National Health System,
⁵Emeritus Professor of Social Medicine – Health Planning, Medical School, University of Crete – Died in 2024,
⁶Assistant Professor of Management and Policies, Public and One Health, Department of Public and One Health, School of Health Sciences, University of Thessaly, Karditsa

The article proposes a modern upgrade of the public health (PH) system in Greece at the central, regional, and local levels. The analysis revealed significant shortcomings, including weak coordination between different structures, overlapping responsibilities, lack of cooperation mechanisms, limited implementation of PH programs, and insufficient integration with healthcare and social care services. At the central level, it is proposed to reorganize the Ministry of Health to focus exclusively on stewardship and strategic functions, re-establish the National Board of Public Health as an independent or autonomous body, expand the remit and responsibilities of the National Public Health Organization, and create a permanent Interministerial Health Committee. At the regional and local levels, it is recommended to strengthen the role of regions and municipalities by restructuring PH councils, establishing local PH councils, and creating PH services in each municipality. Additionally, enhancing collaboration between health regions and local authorities, developing primary health care (PHC) networks, implementing national prevention programs, and utilizing digital tools are proposed. In conclusion, a comprehensive reorganization of the system is necessary, with strategic upgrading, strengthening of technical and scientific capabilities, and ensuring sustainable funding.

Key words: Governance, Public health, Services, System.