Impact of the Covid19 pandemic on municipal public health services; improving local response in future health crises



Policy areas

Organisation name Diputació de Barcelona. Area of Equality and Social Sustainability

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Contact person: Lluïsa Moret Sabidó

The Covid-19 pandemic highlighted the local administrations’ lack of preparedness when it comes to health emergencies. When the Spanish government declared the state of emergency, the risk of contagious diseases was not covered by the local administrations’ and civil protection’s emergency plans, nor did local health plans include provisions for dealing with health crises.

During the first wave of the pandemic, in the province of Barcelona only one-third of local councils managed to implement a response to the health emergency with a good level of coordination despite being unprepared. The rest stated that they encountered bureaucratic obstacles, lack of resources or lack of institutional support.

Local administrations in Catalonia have legal obligations in terms of protecting people’s health against environmental and food risks, and promoting healthier lifestyles among the population.

As a supra-municipal body, Barcelona Provincial Council provides technical, economic, legal and technological support to local councils to carry out these responsibilities and contribute to making towns and cities healthier and more resilient. With this objective, after the first wave of the pandemic in May 2020, Barcelona Provincial Council carried out an assessment of the impact of the pandemic on local public health structures. The conclusions of the analysis underlined the need to:

  • promote the creation of contingency plans for municipal public health services to tackle Covid-19;
  • adapt local health plans to address health crises.

The work carried out is aligned with the spirit of overcoming the social and economic effects caused by the pandemic, improving the quality of public services, and boosting inclusive and sustainable economic growth, in accordance with the principles set out by the European Commission’s Directorate-General for Structural Reform Support and the Technical Support Instrument (TSI).

The project was supported by the Barcelona Provincial Council’s contingency budget and, as of 2021, the Barcelona Provincial Council is offering financial support to all the town councils in the province to adopt contingency plans and incorporate health emergencies into their local health plans. The financial support has been incorporated into the pre-established cooperation mechanism between the Barcelona Provincial Council and the municipalities of the province, through which they annually receive technical and financial support to carry out their public health obligations.

As a result of the work completed and the huge impact of the Covid-19 pandemic, it is to be expected that local public health services will be obliged to set up contingency plans. Once the plan has been adopted, it should be updated by the responsible team as a routine task – something that is not expected to generate unsustainable costs for local administrations.

The Barcelona Provincial Council monitors the development of municipalities’ contingency plans and will undertake future actions according to the needs detected in the region to ensure resilient public health structures. To do this, the Provincial Council has a stable network for working with the municipalities of the province to exchange knowledge and experiences in the field of public health (more information here).

The contingency plans are directly applicable and adaptable to municipalities in Spain, since they share the same framework of public health responsibilities and public health governance, distributed between the 17 autonomous communities (regions) and the state. Therefore, indications have been provided to adapt the contingency plans to the specific needs of each municipality, whether it is a large city or a few hundred inhabitants in a town.

In addition, an implementation manual has been created with details on the more theoretical and conceptual aspects, to assist practical application of the plans. This is a concise operational guide for the application of contingency strategies to guarantee the efficient functioning of municipal public health services when it comes to emergencies such as Covid-19 or other, similar situations that may arise in the future.

Regarding other EU Member States, the contingency plan developed by the Barcelona Provincial Council is applicable to those administrations that have responsibilities over the type of activities envisaged by the model. In some countries, it may apply to both local administrations and other levels of government, and in all countries it may offer inspiration for more preparedness in time of crisis.

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