11

EuropeEurope

AndrAndréé Meijer Meijer Universiteit Maastricht Universiteit Maastricht

Programme director European Public HealthProgramme director European Public Health

22

European Community role European Community role on healthon health

(main source: Lecture dr. Merkel, dg sanco, in Maastricht)

33

44

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Europe 1957-2007Europe 1957-2007

The Treaty of Rome (25 March 1957) The Treaty of Rome (25 March 1957)

created our European familycreated our European family The Maastricht Treaty (1992) created a The Maastricht Treaty (1992) created a

specific public health role, still developingspecific public health role, still developing But health has always been an important But health has always been an important

part of the Community policiespart of the Community policies

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Health in Community policiesHealth in Community policies- but in which ones?- but in which ones?

Free movement of goodsFree movement of goods AgricultureAgriculture Free movement of persons, Free movement of persons,

services and capitalservices and capital Visas, asylum and Visas, asylum and

immigrationimmigration TransportTransport Competition and taxationCompetition and taxation Economic and monetary Economic and monetary

policypolicy EmploymentEmployment Commercial policyCommercial policy CustomsCustoms

Social policySocial policy CultureCulture Public healthPublic health Consumer protectionConsumer protection Trans-European networksTrans-European networks IndustryIndustry Economic and social Economic and social

cohesioncohesion Research and technological Research and technological

developmentdevelopment EnvironmentEnvironment Development cooperationDevelopment cooperation International cooperationInternational cooperation

(source: lecture dr. Merkel, dg sanco, in Maastricht)

77

Health in Community policiesHealth in Community policies- all of them!- all of them!

Free movement of goodsFree movement of goods AgricultureAgriculture Free movement of persons, Free movement of persons,

services and capitalservices and capital Visas, asylum and Visas, asylum and

immigrationimmigration TransportTransport Competition and taxationCompetition and taxation Economic and monetary Economic and monetary

policypolicy EmploymentEmployment Commercial policyCommercial policy CustomsCustoms

Social policySocial policy CultureCulture Public healthPublic health Consumer protectionConsumer protection Trans-European networksTrans-European networks IndustryIndustry Economic and social Economic and social

cohesioncohesion Research and Research and

technological developmenttechnological development EnvironmentEnvironment Development cooperationDevelopment cooperation International cooperationInternational cooperation

(source: lecture dr. Merkel, dg sanco, in Maastricht)

88

Public health actionsPublic health actions

Legislation to set European rules and Legislation to set European rules and standards standards

Open coordinationOpen coordination

Policy actions (of Commission and Sanco)Policy actions (of Commission and Sanco)

Support to Member States and society Support to Member States and society (through networks and projects)(through networks and projects)

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Policy actionsPolicy actions

In 2005 Commission introduced a processIn 2005 Commission introduced a process

which includes policy development on :which includes policy development on :

‘‘health’ and health’ and ‘‘health systems’ health systems’

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Future Health StrategyFuture Health Strategy

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Health Strategy: Consultation Health Strategy: Consultation 2004 2004

Results:Results: MainstreamingMainstreaming cross-policy cross-policy

approachapproach Focus (further) on Focus (further) on promotionpromotion Bridge Bridge health inequalitieshealth inequalities Tackle Tackle global health issuesglobal health issues Address other key issues: Address other key issues: ageing, ageing,

technology, cross border issuestechnology, cross border issues

(source: lecture dr. Merkel, dg sanco, in Maastricht)

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Expanding EU:growing health gaps

Ageing Population

Safety, Pandemic and

Bioterrorism Threats

New Technology and

Innovation Migration &

Cross Border Healthcare

Lifestyle Related Diseases

Globalisation

Citizens’ Agenda

Pharmaceutical ForumEU In Tech

E-HealthHTA

Healthy Life YearsHealth information

Health Portal

European Centre of Disease prevention

He S ec Com

Health services InitiativePatient Safety - Health Profs

Health investments in Structural FundsRegions for Econ Change

White paper on Nutrition

Communication on Alcohol

Tobacco control strategy

WHO, ENPThird

Countries

Current and Future ChallengesCurrent and Future Challenges

(source: lecture dr. Merkel, dg sanco, in Maastricht)

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The EU Health StrategyThe EU Health Strategy

Why an EU Health Strategy now?Why an EU Health Strategy now?

No No coherent strategic approachcoherent strategic approach to current and future challenges, no to current and future challenges, no overarching aims and objectivesoverarching aims and objectives

There is a need to:There is a need to:

Set out a strategic overall framework (10 years with a mid term Set out a strategic overall framework (10 years with a mid term review), including cross-sectoral work and partnership with Member review), including cross-sectoral work and partnership with Member States States

Set out aims and objectivesSet out aims and objectives

Trigger change - deliver concrete results through an effective Trigger change - deliver concrete results through an effective implementation processimplementation process

(source: lecture dr. Merkel, dg sanco, in Maastricht)

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Framing the Strategy 2008-17Framing the Strategy 2008-17

1. Core Issues 1. Core Issues to improve the health of to improve the health of EU citizens - promotion and EU citizens - promotion and prevention, inequalities, ageing, prevention, inequalities, ageing, cross-border issues; health cross-border issues; health services…services…

2. Health in all Policies 2. Health in all Policies - Regional - Regional development, structural funds, development, structural funds, environment, economic policy, social environment, economic policy, social policy, policy, research etc.research etc.

3. Global Health 3. Global Health - EU work at the global - EU work at the global level communicable diseases, level communicable diseases, pandemics, trade, health and pandemics, trade, health and development aiddevelopment aid

Core Issues

Health in all Policies

Global Issues

(source: lecture dr. Merkel, dg sanco, in Maastricht)

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Consultation process 2006-2007Consultation process 2006-2007

Sanco started with noteSanco started with note ASPHER participated and reacted formally (among 150 others)ASPHER participated and reacted formally (among 150 others) Impact Assessment includes data on administrative burden and Impact Assessment includes data on administrative burden and

administrative costs for the MSadministrative costs for the MS

White Paper on EU Health Strategy in mid/end 2007

See Commission website:See Commission website: http://ec.europa.eu/health/ph_overview/strategy/healthhttp://ec.europa.eu/health/ph_overview/strategy/health_strategy_en.htm_strategy_en.htm

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Health services initiativeHealth services initiative

1717

Free movement but…Free movement but…

Basic principle: Court has ruled that health services are Basic principle: Court has ruled that health services are provided for remuneration thus fall within scope of the provided for remuneration thus fall within scope of the TreatyTreaty

But barriers to free movement may still be justified, in But barriers to free movement may still be justified, in particular:particular: to protect public health;to protect public health; to ensure financial sustainability of health systems.to ensure financial sustainability of health systems.

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Health Services InitiativeHealth Services Initiative

Bring legal clarification and certaintyBring legal clarification and certainty

Help national health systems to better address Help national health systems to better address common challengescommon challenges

Reduce inequalities between Member States and Reduce inequalities between Member States and regionsregions

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Health Services Initiative:Health Services Initiative:the Consultationthe Consultation

Consultation closed 31/01/2007Consultation closed 31/01/2007 Over 270 replies receivedOver 270 replies received Individual replies already available in the InternetIndividual replies already available in the Internet Report of the consultation will be presented to the Report of the consultation will be presented to the

Informal Council in Aachen 19-20 April 2007Informal Council in Aachen 19-20 April 2007 After the Council, report will be available in the InternetAfter the Council, report will be available in the Internet Based on the consultation, the Impact Assessment will Based on the consultation, the Impact Assessment will

be launchedbe launched Proposal expected November 2007Proposal expected November 2007 http://ec.europa.eu/health/ph_overview/http://ec.europa.eu/health/ph_overview/

co_operation/mobility/co_operation/mobility/community_framework_en.htmcommunity_framework_en.htm

2020

EU 2008 and future plansEU 2008 and future plans

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Main topicsMain topics

Free movementFree movement Patient safetyPatient safety Sufficient and good health workforceSufficient and good health workforce

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Patient safetyPatient safety

Key concern of citizens – 78% of EU Key concern of citizens – 78% of EU citizens see patient safety as an important citizens see patient safety as an important problemproblem

Estimate of 10% of adverse eventsEstimate of 10% of adverse events Mainly Member State responsibility, but Mainly Member State responsibility, but

enormous potential for added valueenormous potential for added value

2323

Patient safetyPatient safety

Main objectivesMain objectives Reduce avoidable harmReduce avoidable harm Ensure citizens have confidence in healthcare Ensure citizens have confidence in healthcare

throughout the EUthroughout the EU Blame-free culture for professionalsBlame-free culture for professionals When mistakes happen, have mechanisms for When mistakes happen, have mechanisms for

learning from them and providing redresslearning from them and providing redress Sharing best practice to ensure high standards for all Sharing best practice to ensure high standards for all

EU health servicesEU health services Proposals in 2008Proposals in 2008

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Health workforce for EuropeHealth workforce for Europe

Shortages of health professionals for some Shortages of health professionals for some regions and specialismsregions and specialisms MigrationMigration Ageing of the health workforceAgeing of the health workforce Impact in developing countries as wellImpact in developing countries as well

Variations between countriesVariations between countries Initial training content, recognition of specialisms, Initial training content, recognition of specialisms,

continuing professional developmentcontinuing professional development Need collective action to addressNeed collective action to address

2525

Health workforce for EuropeHealth workforce for Europe

Establish a European Health Workforce Establish a European Health Workforce ForumForum Building on the work of the High Level Building on the work of the High Level

GroupGroup Bringing together all relevant stakeholdersBringing together all relevant stakeholders Develop shared ideas for next stepsDevelop shared ideas for next steps

Opportunity to rethink the health Opportunity to rethink the health workforce we need in Europeworkforce we need in Europe

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So what ?So what ?

2727

Draft proposalsDraft proposals

More focus in curricula for cross border, More focus in curricula for cross border, European and global developments in PHEuropean and global developments in PH

Cooperation and alliances with other European Cooperation and alliances with other European PH associationsPH associations

Common projectsCommon projects Support by members through Support by members through

Pool of expertsPool of experts Thematic committeesThematic committees

An office in Brussels with an active and An office in Brussels with an active and supportive staffsupportive staff

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2007 and further2007 and further

There is definitely a big role for

ASPHER to play in

• Brussels, • elsewhere in Europe

• and the world