Across Europe, healthcare systems are being pushed to their limits as they grapple with mounting pressures from geopolitical tensions, funding shortfalls, and seasonal health crises. On December 12, 2025, leaders and experts from the Baltic states and Northern Ireland voiced urgent concerns about the resilience and preparedness of their respective health sectors, highlighting the critical role healthcare plays not just in public well-being, but in national security and societal stability.
At the Saeima in Riga, Latvia, the Baltic Assembly conference titled “Health as an Investment in Baltic Security and the Future” set the stage for a frank discussion about the vulnerabilities and opportunities facing the region’s health systems. Speaker of the Saeima, Daiga Mieriņa, opened the conference with a stark warning: Latvia’s healthcare system must be ready to operate fully during “X Hour” – a term used to describe a moment of acute crisis – and in the face of geopolitical shocks. Drawing on the ongoing conflict in Ukraine and the rise of hybrid attacks across the European Union, Mieriņa stressed, according to the Saeima Press Service, that “war is still ongoing in Europe and that hybrid attacks are now a daily reality across all European Union member states, making it essential for healthcare systems and hospitals to be ready for geopolitical disruptions.”
Mieriņa didn’t sugarcoat the challenges. Latvia’s healthcare sector continues to struggle with insufficient funding, limited access to and quality of services, a shortage of young doctors in rural regions, and low public trust. “We spend only around 60% of the EU average on healthcare, but there are also visible improvements that will significantly affect service availability in the future,” she said, signaling both the scale of the problem and a glimmer of hope for reform.
The conference’s message resonated beyond Latvia’s borders. Baltic Assembly President Jānis Vucāns underscored that health is the backbone of societal resilience, referencing the pandemic, demographic challenges, and the growing mental health crisis. “A state is only as strong as the health of its population,” Vucāns noted, highlighting the interconnectedness of public health and national security. He called for deeper regional cooperation, especially in health research, data sharing, and the adoption of digital innovations. The risks of weak healthcare preparedness, he warned, are not abstract: “Investments in healthcare are investments in long-term security.”
Among the concrete steps discussed was the joint procurement of medicines by the Baltic states, a move that has already helped reduce drug shortages and lower costs for patients. Parliamentarians also highlighted plans to establish a joint particle therapy centre for oncology patients, which would not only improve cancer treatment outcomes but also strengthen the region’s participation in the wider European research ecosystem.
The conference’s keynote presentation, delivered by Malina Müller, Head of the Health Economics Department at the WifOR Institute, offered a compelling economic argument for investment in preventive care. Müller cited research showing that a €20 million investment in cardiovascular disease prevention in Estonia could generate €127 million in social value over 15 years – nearly an eightfold return – and save 315 lives. “Targeted investments in prevention can significantly reduce the burden on healthcare systems and strengthen long-term national resilience,” she emphasized.
But the conversation wasn’t just about economics. Ombudsperson Karina Palkova reminded attendees that access to healthcare is fundamentally a human rights issue, not merely an economic calculation. “The state has an obligation to ensure equal and accessible healthcare as a basic right for every resident,” Palkova stated, reinforcing the ethical imperative behind health sector reforms.
The Baltic Assembly conference, intended as a platform for cooperation among parliamentarians, governments, and experts, aims to promote evidence-based policymaking and formulate concrete policy recommendations for the future, especially as Latvia concludes its presidency. Discussions ranged from financing models and demographic health issues to maternal health as a strategic investment in national security, and the physical and psychological health of conscripts as a foundation of national defense.
Meanwhile, on the other side of Europe, Northern Ireland’s healthcare system is facing its own winter of discontent. Rita Devlin, executive director of the Royal College of Nursing (RCN) in Northern Ireland, described the system as “so fragile” that “it would only take one thing to knock it over.” Her remarks, reported by BBC News NI, come amid a surge in flu cases that is straining hospitals and front-line staff. Several care homes have advised families not to visit loved ones in an effort to protect vulnerable residents from the current flu outbreak, and staff are feeling the pressure. “It’s a huge toll on the wellbeing of the staff who are trying to deliver that care in the most awful of circumstances and environments,” Devlin said.
The numbers paint a sobering picture. In the first week of December 2025 alone, 1,184 new flu cases were identified in Northern Ireland. While nearly 80% of care home residents have been vaccinated, the uptake among staff remains lower, raising concerns about the ability to maintain safe and sustainable care if staff sickness continues. The Department of Health has issued guidance on mask-wearing in care homes, and the impact on home care services remains unclear as many social care staff are also affected by the flu.
Hospitals in Belfast, including Royal Victoria and Mater, are experiencing “very challenging” conditions, according to Dr. Eoghan Ferrie, a paediatric emergency medicine consultant and senior medical officer at the Department of Health. He described the 2025 flu season as “the most severe influenza outbreak” he has experienced. “We face challenges of demand outstripping capacity on a week-by-week basis throughout the year,” Ferrie told BBC News NI, adding that the surge in flu cases only exacerbates the pressures.
The Public Health Agency (PHA) has urged everyone eligible to get vaccinated, with director Dr. Joanne McClean calling the vaccine “the best defence against seasonal flu.” Vaccination programs are ongoing across various health trusts and schools, with some set to complete by the end of next week and additional Saturday clinics scheduled for December 13 and 20, 2025. Community pharmacist Sheelin McKeagney reported a “massive surge in demand” for vaccines, with some pharmacies waiting for further supply. “There’s absolutely no problem getting vaccines” for vulnerable people, he said, “but lots of those have now been used up.”
Looking ahead, John Compton, former chief executive of the Health and Social Care Board, predicted that flu cases would peak in a few weeks, with the busiest time for hospitals traditionally coming just after Christmas. “Already things are pretty busy and pretty difficult,” he remarked, forecasting “a very difficult winter for our health system and for patients and families who are using it.”
From the Baltic states to Northern Ireland, the message is clear: resilient healthcare systems are not a luxury, but a necessity for security, stability, and the well-being of society. As leaders and frontline workers alike confront these challenges, the stakes could hardly be higher.
