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[Correspondence] Health-care improvements in a financially constrained environment

Although the European Council agreed on common values such as good quality, universally accessible care in 1996,1 those values are now under threat. Health expenditure in all European Union (EU) countries between 1996 and 2013 increased from 7·9% to 9·5% of gross domestic product.2 There is a need to adapt to a financially constrained environment.