Health First Europe

NEWS: Health First Europe 10th Anniversary Reception, European Parliament

On 12 November, HFE celebrated its 10 year Anniversary by launching a new European Parliamentary Interest Group on Innovation in Health and Social Care. Hosted by Co-Chair of the Interest Group, Marian Harkin (ALDE, IE), the reception brought together a variety of EU officials and health stakeholders to discuss the achievements of Health First Europe, the future aims of the organisation, and the priorities for the Interest Group which will hold its first meeting in 2015.

Speaking about the origins of Health First Europe, Honorary John Bowis shared that “Health First Europe was originally formed around the issue of patient safety and needlestick injuries to healthcare professionals.” He discussed how he first became involved with HFE as a Member of the European Parliament, as he was given a tour of a healthcare organisation in which he met with healthcare professionals impacted by preventable injuries. Mr. Bowis emphasised how Health First Europe “comes to policymakers with solutions, not problems, which makes it unique in its work at European level.”

With regards to the future work of HFE, Mr. Bowis expressed that the organisation looks forward to working with EU stakeholders to bring forward policy solutions to issues of organisation of care, access to health and social care, patient involvement and researching the value of innovation in health. HFE will utilise the new Interest Group as a vehicle to bring forward such solutions.

MEP Harkin also shared with invited guests her successful experiences working with Interest Groups and the impact such groups can have on policies in the European Parliament. She discussed her ambitions for the Interest Group in the next term including focusing on research, health promotion and public health, particularly around the role of carers and healthcare professionals across the health and safety spectrum given her work on the Employment and Social Affairs Committee.

The first meeting of the European Parliament Interest Group on Innovation and Health and Social Care will take place in 2015 and Health First Europe looks forward to working with our friends and colleagues across the EU to ensure public health is a key priority in the next term.

NEWS: EP Interest Group on Rheumatic and Musculoskeletal Diseases

On 18 March, HFE attended the 13th meeting of the European Parliament Interest Group on Rheumatic and Musculoskeletal Diseases (RMDs). Chaired by MEP Edite Estrela (S&D, Portugal) the meeting reflected on the contribution of the group to public health at EU level and the main challenges for the next Parliament and Commission.

Given that rheumatic diseases elicit the highest cost to European health care and socioeconomic systems (more than 200 billion euros per year), EULAR has been working to reduce the burner of rheumatic diseases on individuals and the society and to improve the treatment, the prevention and rehabilitation of people affected by RMDs. Since 2009, EULAR is running the Secretariat of the EP Interest Group on RMDs. This EP Interest Group involves 25 MEPs and several stakeholders and it aims at gathering information, raising awareness, promoting discussion and EP initiatives on RMDs.

At the final meeting of the group before the European elections, various stakeholders provided their views regarding the progress achieved and the remaining challenges for people with rheumatic diseases. Sylvain Giraud, Head of the Unit for Health Strategy and International issues at DG SANCO, gave a broad overview of the European Commission’s work in public health, reiterating the need to see health as value and an engine for growth. He reminded participants that, “Health is connected strongly with social cohesion, it a key figure on public spending and it is an economic sector with enormous growing possibilities”. He also remarked that European Health systems are facing several challenges, among the others the economic crisis, the increasing of inequalities, cross border threats, the free movement of products and people. Despite health policies are a national responsibility, the EU has worked in direction of proving a legal framework to coordinate health national policies such as through the Europe 2020 Strategy, the EU Health Strategy, and the Investing in Health Paper launched in 2013. The Commission aims to support Member States to guarantee the highest possible level of public health to European citizens by improving health service, fostering prevention and facilitating cross border healthcare. Mr. Giraud underlined the value of “working together in the health sector”, in his opinion health should be targeted through all the EU policies.

Building upon the work of the European Commission, Kai Michelsen, Assistant Professor at Maastricht University’s Faculty of International Health, provided a critical overview of EU action on health from an academic perspective. He did not deny the central role of the EU institutions in tackling with common health challenges, polling resources, but he pointed out the difficulties the European Commission must face when it comes to balancing priorities and economic resources.

Finally, Leonardo Palumbo, Policy Coordinator for EU Affairs at the European Public Health Alliance (EPHA), presented EPHA’s Manifesto for the European Parliament elections. EPHA calls on political parties and individual Members of the European Parliament candidates to ensure that health and well-being in Europe are ranked as high as they are valued. Mr. Palumbo summarized the 4 priorities of EPHA’s Manifesto which include: Refocus Europe’s Business Plan on the well-being of people; Create a people-centric economy: quality work for all; Create an inclusive, sustainable society; and to encourage strong public-interest based health policy.

In her closing remarks, MEP Estrela thanked the participants of the EP Interest Group on Rheumatic and Musculoskeletal Diseases (RMDs) for their hard work during the past 5 years and emphasised that it is necessary to do more to keep improving the lives of people affected by RMDs.

NEWS: HFE attends European Commission Conference “Health in Europe – Making it fairer”

On 18 March, the European Commission hosted an event to tackle the issues of health inequalities across Europe. Given the economic crisis and the reduction in expenditure by European health systems, the event was timely and was a reminder of the fact that health is a right for everybody and the most vulnerable must be protected. The full day conference brought together policymakers and civil society from a variety of disciplines to debate, discuss, and drive the next steps at EU level towards fairness in health.

The leaders of the European Commission opened the conference focusing on the fundamental rights of European citizens to quality healthcare. European Commission Vice-President and Commissioner for Justice and Home Affairs, Viviane Reding, highlighted the fact that “the right to healthcare transcends many policy areas including gender equality, data protection and anti-discrimination.” Commissioner for Health, Tonio Borg, agreed and noted that while there are positive signs such as gaps narrowing amongst Member States in infant mortality and life expectancy, “Europe is still not a union in health and the divergences are still too great.” Commissioner Borg noted that “no health system in Europe is sustainable without reform” and suggested that the Member States still need to be convinced to change health structures for long-term sustainability and fairness.

Representatives from diverse constituencies presented keynote speeches looking at how inequalities in a variety of disease areas impact on the overall health of society. Michel Roland from Doctors of the World, suggested that patient needs must be respected regardless of immigration status, sexual orientation, ethnicity or health status. He declared that, “Medical ethics must come first.” Robert Johnston from the European Patients’ Forum also echoed this sentiment and called for EU equal treatment legislation to protect patients based on health status and chronic conditions to prevent discrimination which is strongly linked to health inequalities.

The panel sessions of the conference focused on three priority areas from a European Commission perspective – equity in addressing chronic diseases, HIV/AIDS, and health of people in vulnerable situations. The objectives of these sessions were to look at how to improve health in each of these areas, improve access to healthcare and to combat discrimination, with the aim of producing conference conclusions from the debates to inform on the next steps at EU level. From a chronic diseases perspective, it was clear that equity remains a challenge especially given that the European region of is the most affected by chronic diseases of the six WHO regions and the trend is on the increase. Michael Hubel, Head of Unit for Programme Management and Diseases at DG SANCO, remarked that “the way patients interact with the health and social system is incredibly important for how diseases develop.” Discussing health inequalities in cancer, coronary heart diseases and mental health, the panelists agreed that there are still great stigmas attached to certain populations and more links between primary and social care are needed to protect vulnerable people.

The conference clearly highlighted that there is still a significant problem in Europe in providing access to healthcare for all. Whether due to discrimination (at individual or systemic levels) or because of poor implementation of laws to protect the vulnerable, promotion of best practices and greater research and data need to be supported to encourage truly equitable access to care.

NEWS: Health First Europe attends the Equity Action final conference

On 23 January, HFE attended the Equity Action final conference on “Addressing health inequalities 2014 and beyond: Building Cohesion and Strengthening Health for Growth”. The event showcased the tools and expertise developed by Equity Action during its three years of activity. The project assessed the progress on addressing health inequality in the EU and considered opportunities and challenges for future actions.

Equity Action is a joint action programme that was launched in 2011 which aimed to support EU Member States and Institutions to develop effective policies to reduce health inequalities. The project brought together 15 Member States and Norway, non – governmental bodies and the European Commission (EC). According to scientific evidence, social determinants play a crucial role in health. For example, the lower a person’s social position, the worse his/her health is likely to be. The effect of this social gradient on health can be seen across social groups by age, gender and ethnicity.

Commissioner for Health Mr. Tonio Borg provided a general overview of Equity Action, underlining the decline of infant mortality and the reduction of the life expectancy gap across EU regions. However, he acknowledged that the gap in healthy life expectancy is wider and that people with lower income can expect to spend many years living with a limiting disability compared to people with higher incomes. Commissioner Borg suggested that in order to reduce health inequalities the EU needs to invest in cost-effective spending, structural reforms and sound innovation to bring efficiency gains and secure better health outcomes.

Highlighting the massive progress which has been achieved towards reducing inequality in the health sector, Mr. Michel Marmot, Director of the Institute of Health Equality at the University College London (UCL), said “this topic was a dirty secret until three years ago and today reducing health inequalities is on the agenda of the EC”. Despite this improvement, however, Mr Marmot noted that inequalities are increasing in several Member States due to the economic crisis. He asserted that this negative trend should push EU Member States and Institutions to adopt a clear, multi-sector, multi-level strategy to tackle health inequalities.

Several EU Health Ministries participated in the event including Ireland, Spain, UK, and Belgium. These countries shared their own national experiences tackling combatting inequalities which were characterised by two common elements: 1) a multi-stakeholder approach to reduce health inequalities; 2) having the economic support from the European Union. On this last point, Mr. Ralph, Adviser to the Director General for Regional and Urban Policy (DG REGIO), suggested that the ongoing negotiations for EU Cohesion Policy and Structural and Investment Funds should define priorities and programmes that consider the issue of health inequalities.

Mr. Georgiadis Adonis, Greek Minister of Health, called for a European vision to improve people’s lives. He underlined, “Europeans life expectancy is increasing but the economic crisis is enhancing inequalities between people with low and high incomes”. Furthermore, he noted that poor people have a higher possibility to be affected by chronic diseases, mental disorders and cancer and declared that Europe needs to invest in health and growth. Mr. Adonis also reiterated that the reduction of social inequalities has been listed among the Greek Presidency’s health priorities.

Mr. John Ryan, Acting Director for Public Health at DG SANCO, concluded by calling for the creation of an alliance among practitioners, civil society and governments to reduce health inequalities. He underlined the European Commission’s objective of enhancing collaboration with Member States on actions to reduce health inequalities across all 28 Member States in the follow on actions from the Equity Action project.

NEWS: Health First Europe attends the World IBD Campaign Final Conference

On 17 October, HFE attended the final conference of the World IBD Campaign at the European Parliament. The event, organised by HFE member the European Federation of Crohn’s and Ulcerative Colitis Associations (EFCCA), with the support of MEP Cofferati (S&D, Italy) and MEP Panayotova (EPP, Bulgaria), discussed the priorities and needs of people living with inflammatory bowel diseases (IBD) from 3 perspectives: employment and labour market, healthcare and research, youth and education.

Inflammatory bowel diseases (IBD) affect over 2.2 million people in Europe, men and women alike. In most cases the illness can be kept under control with medication, but despite extensive research there is currently no known cause or cure for IBD. As emphasized by MEP Cofferati, “there is a lack of awareness of these chronic diseases. There is a need for societal mobilization especially in a moment of economic crisis that could affect research and health for IBD patients.”

The first panel on “Employment and Labour market” focused on the current labour legislation for people affect by IBDs. Mr. Alvaro Oliveira from the Directorate General for Justice at the European Commission, clarified that people with chronic diseases can be protected under European legislation against discrimination. The directive 2000/78 prohibits discrimination in recruitment, working conditions, training and career progression. The panel highlighted that despite the fact that both European and international legislation have became more and more protective towards people affected by chronic diseases, these people are still victims of discrimination in the work place. Ms. Bjornsdottir, an EFCCA member, explained that small changes in the working place, for instance flexible hours, working from home and work stations with easy access to a toilet, could improve the lives of people suffering from IBDs.

The second Panel on “healthcare and research” pointed out the necessity to guarantee safe access and rights to treatment for all people affected by long-life diseases. EFCCA called for the identification of European guidelines for IBD carers and treatments, which would be applied in all the EU Member States. EFCCA highlighted that IBD patients` quality and length of life depends on quality care. IBD care covers all components of individual and social life, not only medical diagnosis. EFCCA Chairman, Marco Greco stated that “To reduce the impact of IBDs in society, it needs to improve the access to specialised medical care for IBD patients and support them through multidisciplinary teams. Moreover, it is necessary to create new healthcare services which do not oblige the patient to go to the hospital.”

The last panel on “Youth and education” focused and young IBD patients. Prof. Vecchi defined these diseases as a “challenge”. The diagnosis is difficult, and a late diagnosis can have a negative impact on patient health, due to succession of periods of sickness and remittance. Maintaining treatment is essential even in periods of remittance; otherwise IBD patients can face severe complications. These diseases often hit young adults and data has shown a growing percentage of teenagers are being affected by IBD. It means that these pathologies often have a terrible impact on the educational and professional lives of young patients.

Prof.Simon Travis closed the conference by presenting the next goals for IBD patients including increasing awareness of IBD diseases and improving quality of life for people affected by these pathologies. To achieve these aims, patients have to be involved in national strategies on IBDs. However. Mr. Travis suggested that the EU has a role to play and should support scientific research on the causes of IBDs, and should include inflammatory diseases in the list of chronic pathologies to provide wider protection of patient rights.

NEWS: Health First Europe attends 3rd Coordination Meeting of EU network on patient safety and quality of care

17/18 October 2013 – Continuing its work as a collaborating partner, Health First Europe attended the 3^rdCoordination Meeting of the EU network on patient safety and quality of care in Paris, France. The meeting brought together partners of the project to update members on each of the seven work packages and discuss upcoming tasks and deliverables for 2013.

The network aims to help Member States implement the Council Recommendations on patient safety including the prevention and control of healthcare associated infections 2009, by bringing together representatives of all Member States as well as EU organisations. The work packages aim to create a patient safety exchange mechanism, implement patient safety clinical practices, develop quality management systems and institute a sustainable EU network for patient safety.

Health First Europe has supported on the work packages dedicated to exchanging safe clinical practices and implementing safe clinical practices in 17 Member States. The network has already set up a wiki mechanism on the website to share events and webinars on a variety of safe clinical practices to encourage broader adoption in the EU. Additionally, more than 140 healthcare organisations throughout Europe have been recruited to implement one or more safe clinical practices. The practices include the WHO surgical safety checklist, medication reconciliation, hand hygiene, and pediatric early warning scores. As part of the project, the implementation process will be monitored and reported on so that information exists for healthcare organisations to share knowledge on best practices for implementation long after the completion of the project.

The next coordination meeting will take place in January 2014 with the project running until 2015. For continuous information on dedicated events related to patient safety, and well as updates on each work package, please visit the PaSQ website at: http://pasq.eu/

NEWS: Health First Europe attends European MedTech Forum 2013

10/11 October 2013 – Health First Europe attended the annual European MedTech Forum which focused on the implications of new regulatory proposals for patients, clinicians and industry. Bringing together a variety of stakeholders, the event highlighted the need for long-term thinking to ensure the continuation of rapid innovative solutions for patients in Europe.

The two-day event began with an informal discussion amongst leaders of Eucomed, the European Diagnostics Manufacturers Association (EDMA) and MedTech Europe. The exchange mainly focused on the current regulatory proposals for medical devices, with leaders of the organisations explaining how various aspects of the proposals are problematic because they believe it will hinder the ability of the industry to innovate.

Paola Testorri Coggi, Directorate General for Health and Consumers, followed the exchange of leaders with a video message and declared that the balance between safety and swift access to market of new technologies is a difficult balance which the European Commission believes it has achieved. She expressed, “We all have a collective responsibility to ensure the sustainability of health systems” and suggested that we “cannot ignore” the recent events which have “compromised the trust of patients in medical technologies.” She also reiterated the call from patients for additional transparency of clinical information on medical technologies so that trust with patients can be built and maintained.

“It’s not just about safety, but also the need for medical technologies to provide a real benefit to patients and demonstrate efficiency” said Wolfgang Ecker from the Austrian Ministry of Health. Lutz Heinemann from the Profil Institute for Clinical Research agreed, and called for more information on the clinical benefit of a technology for a patient. He said that clinicians want to know, “What is the benefit of a medical device in clinical reality?”

In a seminar dedicated to developments on health technology assessment, Jerome Boehm, Team Leader and Policy Coordinator at the European Commission Directorate General for Health and Consumers, discussed the upcoming launch of the permanent network for HTA collaboration in Europe. He explained that the network will provide “a strategic vision for cooperation” in order that Member States can use HTA for evidence-based decision-making. Finn Borlum Kirstensen, Director of the EUnetHTA Secretariat, highlighted the need for all stakeholders to participate in HTA in order to strengthen the practical application of HTA in Europe.

Bringing the patients’ view to the discussion, Dr. Ian Banks, President of the European Men’s Health Forum, and Joao Manuel Valente Nabis, President-Elect of the International Diabetes Federation Europe, gave their perspectives on the meaning of patient-centricity in healthcare. Dr. Banks advised that if “you put the patient first, the profits will follow” and called for a “true partnership” and greater communication with patients which will benefit all health stakeholders.

The conference concluded with the keynote of EU Commissioner for Consumer Policy, Neven Mimica, who emphasised the contribution of medical technologies to healthcare systems. He stressed the changing landscape of healthcare and suggested that systems will need to adapt to the patient and provide more integrated care. He reiterated the need to protect the safety of patients in health systems without compromising innovation or access and declared that he believed a regulatory framework will be established for medical devices that achieves benefits for all health stakeholders.

For more information on HFE’s position on HTA, click here.

For more information on HFE’s statement on the proposed medical devices regulation, click here.

For more information on HFE’s recommendations for patient safety, click here.

Health First Europe attends the launch of the Irish Longitudinal Study on Ageing (TILDA)

On 2 October, HFE attended the launch of the ‘Irish Longitudinal study on ageing” at the European Parliament organised by ISC Intelligence in Science. The study, which is a large-scale, nationally representative study of people aged 50 and over in Ireland, aimed to identify the older citizen and explore the ageing process in order to plan appropriate health, medical, social and economic policies.

Europe’s ageing demographics are a key challenge for the European society, as people aged 65 years or over will account for 29.5% of the population by 2060. As a consequence, there will be an enormous increase in the prevalence of chronic diseases such as Alzheimer’s, dementia and heart disease. According to the draft version of the TILDA study if Europe does not face this challenge, the public finances of the EU Member States may be sunk by the cost of funding public healthcare. The study concludes that to face this challenge, scientific research is essential to provide factual evidence to policy makers. In particular, it requires gathering necessary data involving repeated observations over long periods of time (sometimes even decades) to study development trends across the life of citizen. In this specific case, the focus was on understanding the ageing process and exploring early identifiers of ageing.

TILDA was established by Trinity College Dublin in 2006 and it is one of the most comprehensive longitudinal studies on physical, psychological and socio-economic determinants of healthy and active ageing at European and International levels. TILDA charts all aspect of health, economic and social circumstances of over 8,500 people aged 50 years and over living in Ireland over a period of 10 years and collects data once every two years.

MEP Emer Costello (S&D, Ireland), opened the meeting by describing the engagement of the EU on this topic, specifically highlighting that Horizon 2020 (the EU next financial framework programme for research and innovation), includes a pillar on “societal challenges”. Healthy ageing, demographics and well-being constitute the key societal challenges identified in the framework programme. Moreover, she noted that 2012 was declared “European Year for Active Ageing and Solidarity between Generations” to raise awareness on the contribution that older people make to society. Mrs. Costello also referenced the EU Summit on Active and Health Ageing in June 2013, which was held in association with the Irish Council Presidency, and saw the signing of the Dublin Declaration on Age-Friendly Cities and Communities in Europe.

Professor Rose Anne Kenny, of Trinity College Dublin, described the project as “the most ambitious study on ageing ever carried out in Ireland” and suggested that it represents a step-change in terms of data, knowledge and understanding of ageing. Its aim is to characterise the older citizen and explore factors which determine successful ageing and thereby support the development of an environment for ageing well. She added that “TILDA will provide a very valuable input to policymakers in EU in helping formulate evidence base policies. As the EU prepares to launch Horizon 2020 it will be important to have long-term perspectives contributing to the policy debate around future health care.”

This study has revealed several myths of ageing, such as:

‘Life gets better as we age!” – Quality of life continues to improve after age 50 and peaks between the ages of 65 and 75. At the age 83, quality of life is equivalent to aged to aged 50 years.
“Older people are a resource for family and society” – Older people support adult children and grandchildren. It is not only an economic aid, but they help in the house and they take care of kids and other older people as friends and relatives. Older people are often engaged in social activity and voluntary service for the society, and their help is invaluable for the well-being of the community
“Working is good for your brain” – Working, education and social engagement enhances cognitive function and protects against dementia and Alzheimer’s disease.

TILDA’s results pointed out that increasing life expectancy does not correspond to an improvement of healthy life years. The results suggested that the number of older people who are living poorly is high in the European Union causing unnecessary increases in diseases related to ageing such as depression, atria fibrillation and dementia.

The seminar demonstrated the enormous health and economic challenges for the European Union as its’ population ages. Research has a key role to play in meetings these challenges, not only in addressing health issues, but in providing evidence for the best policies to meet these challenges. Participants therefore stressed that it is essential for the EU to take steps to support the future of longitudinal research.

NEWS: ENVI Committee exchange of views with Dr. Marc Sprenger (ECDC)

On 26September 2013, the ENVI Committee hosted an exchange of views with the European Commission and Dr. Marc Sprenger, Director of the European Center for Disease prevention and Control (ECDC). He discussed ECDC developments in enhancing health protection of European citizens and highlighted the role of the agency for reducing healthcare associated infections (HAIs) across Europe.

Established in 2005, the ECDC aims at strengthening Europe’s defenses against infectious diseases by identifying, assessing and communicating current and emerging threats to human health posed by infectious diseases.

Dr. Sprenger explained that in order to achieve this mission, ECDC works in partnership with national health protection bodies across Europe to strengthen and develop continent-wide disease surveillance and early warning systems. By working with experts throughout Europe, ECDC pools Europe’s health knowledge to develop authoritative scientific opinions about the risks posed by current and emerging infectious diseases.

In particular, the ECDC invests in tackling HAIs which still impact 1 out of every 18 patients in Europe (3.2 million people annually). In July 2013, the ECDC published its most recent report on prevalence of HAIs, “Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals 2011-2012” whichgives the most complete picture available of HAIs in 29 EU/EEA Member States and Croatia in 2011–2012. Data coming from a total of 273 753 patients in 1149 hospitals were submitted to ECDC in order to estimate the prevalence of healthcare-associated infections in European hospitals.

Dr. Sprenger defined the situation as “alarming,” and suggested that the number of patients affected by HAI can be significantly reduced with the adoption of simple hygienic rules such as hand washing. In order to encourage better hand hygiene, the ECDC is providing training to healthcare professionals at national and European level to facilitate cultural changes in health systems.

Moreover, the ECDC is engaged in a dialogue with the European Commission and the ENVI Committee to ensure coordination among agencies to guarantee the safety of citizens in the case of a disease outbreak. For instance, in Germany in 2011, the rapid risk assessment conducted by the ECDC after an outbreak of Escherichia coli (E. coli) and the coordinated action with DG SANCO ensured isolation of the disease and minimized the consequences for the population.

This exchange of views occurred the day after the vote of the ENVI Committee on MEP Oreste Rossi’s Own-Initiative report on patient safety including the prevention and control of healthcare associated infections. The report provides the European Parliament’s view on the next steps for patient safety at EU level, and calls for:

Training of healthcare professionals in the area of patient and healthcare worker safety
Setting national targets for the reduction of HAIs
Encouraging Member States to collect comparable, up-to-date reference data on general patient safety and HAIs and to publish this data on an annual basis (with the support of the ECDC)

NEWS: Health First Europe attended a debate on ‘Equity of Access to Quality Healthcare’

On 26 June Health First Europe attended a debate on ‘Equity of Access to Quality Healthcare’ at the European Parliament.

Following the First Conference on Health Inequalities in the New EU Member States held in Sofia in September, MEP Andrey Kovatchev (EPP, BG) sponsored a follow-up event to discuss the outcome of the initiative. The European Patients’ Forum (EPF) – as Ms. Nicola Bedlington, the EPF Executive Director, explained – was actively involved in the organisation of the Conference.

Firstly, Ms. Emily Peasgood illustrated the results of a survey carried out amongst patients’ organizations in the new EU Member States and candidate countries. The results show that patients are worried about the impact of the economic crisis on their lives. Patients surveyed also feel that improving healthcare infrastructure and the quality of services are issues that need to be urgently addressed.

After hearing the overall patients’ perspective on access to care, Ms. Nicola Bedlington invited Mr. Achim Kautzfrom the European Liver Patients’ Association (ELPA) and Mr. Erik Briers from the European Prostate Cancer Coalition to talk about two case studies: hepatitis and oncology patients.

Mr. Kautz presented the audience with data related to hepatitis patients and underlined that good medication is available but access to it is still problematic. He talked about pricing problems and called for a voluntary scheme for industry and Member States as a possible solution. “Patients need to be informed,” said Mr. Briers, and the situation varies very much among Member States. The same is true for sophisticated diagnostic tools or equipment for treatment that are not available to the same extent in all European countries.

Ms. Dessislava Dimitrova, Chair of the Standing Committee for the WHO Regional Committee, was invited by MEP Kovatchev to talk about collaboration between EU Member States. She presented Health 2020, a policy framework agreed upon by 53 countries of the WHO European region and said that improving health equity is at the core of what this strategy aims to achieve.

Ms. Nathalie Chaze, Head of Unit at the Directorate General for Health & Consumers, contributed to the discussion by giving an overview of what actions the EU has taken to reduce inequalities in the new Member States. She cited the ‘Conclusions on Equity and Health in All Policies’ adopted by the Council in 2006 and the country-specific Recommendations that the Commission elaborates for each Member State. Finally, she expressed her concern about the lack of transparency in pricing of medicines, a topic touched upon also by Mr. Johan De Cock of the Belgian Institute of Health & Disability Insurance (RIZIV).

MEP Alojz Peterle (EPP, SI) and MEP Antonyia Parvanova (ALDE, BG) joined the discussion panel moderated by Mr. Nikos Dedes of Positive Voice, an organisation representing HIV patients in Greece, who reminded everyone that health inequalities not only affect new EU members as the situation in his home country shows. MEP Peterle, who experienced cancer himself, said that patients do not like to be punished just because they were born in the wrong place and stressed the need for better coordination at the European level. MEP Parvanova called for full EU competence in health and said that having a single parliamentary Committee covering both environment and public health does not put health as high on the political agenda as it is in the personal agenda of European citizens. MEP Petru Constantin Luhan (EPP, RO), Winner of the 2013 MEP Award for Health, stressed the importance of engaging all relevant stakeholders.

Finally, MEP Kovatchev thanked all participants and invited his fellow colleagues from the Parliament to join him in the setting up of an informal Group of MEPs aimed at tackling this issue.

NEWS: Health First Europe attends the European Parliament’s workshop on patient safety

On 30 May, Health First Europe attended the European Parliament’s workshop co-chaired by the Rapporteur and Shadow Rapporteurs on the Own-initiative report on ‘Patient Safety’. The draft report will be considered in the Committee on Environment, Public Health and Food Safety on 20 June and the workshop provided an ideal setting to explore the various challenges faced by the EU and Member States for protecting patients while receiving care.

Rebecca Taylor (ALDE, UK), Shadow Rapporteur and chair of the first panel, invited the representative of the European Commission and her colleague MEP Oreste Rossi (EFD, Italy) to give their perspectives on the ongoing debate on patient safety. As Ms. Nathalie Chaze – Head of Unit for Healthcare Systems at the Directorate General for Health & Consumer – clarified, the Commission assessed Member States’ implementation of the Council Recommendations of 2009 in a report published in November 2012 (that HFE discussed with a roundtable of high-level attendees). The report shows that most countries have developed strategies for patient safety that include measures to prevent and control healthcare associated infections (HAIs). Even though the commitment from Member States on the issue is strong, the Commission sees room for improvement especially in regard to the surveillance of HAIs.

MEP Rossi gave an overview of his report which touches upon several recommendations put forward by Health First Europe. He highlighted the need to improve the training of healthcare professionals in the area of patient safety and urged Member States to do more in terms of prevention of HAIs which represent a major burden for society and even more so in times of austerity. As outlined in the report, MEP Rossi places great importance on harmonising classifications and indicators among Member States in order to have a clear picture of patient safety in Europe.

The second panel, chaired by Shadow Rapporteur MEP Michèle Rivasi (Greens, FR), looked specifically into the issue of HAIs. MEP Rivasi reminded the audience that millions of people are affected by such infections in Europe and gave the floor to Dr. Fabrizio Oleari of the Italian National Health Institute. HAIs refer to any infection acquired by patients in hospitals and they affect 1 of 10-to-20 hospitalised patients in Europe, Mr. Oleari explained. Most common infections include urinary tract infections and surgical wound infections. The sources of infection can be patients’ own flora (auto-infection), the environment (exogenous) or another patient or a member of the staff (cross infection). As the costs related to these adverse events cannot be internalised in the tariffs that citizens pay for healthcare services, they represent a real economic burden for Member States .The key challenge when discussing the monitoring of the quality of care through clinical indicators, reported Dr. Oleari, “is that everyone wants measurement but no one wants to be measured.”

Dr. Boudewijn Catry shared the outcome of a project carried out by the Scientific Institute of Public Health (WIV-ISP) in cooperation with the European Centre for Disease Prevention and Control (ECDC). The project, called HALT, aimed at measuring the phenomena of HAIs and antimicrobial resistance (AMR) in Long-Term Care facilities in Europe. When presenting the fifth Belgian hand hygiene campaign, Dr. Catry reported that nurses were more diligent than physicians. The main risk factors identified were impaired mobility, disorientation and incontinence. Dr. Catry concluded saying that intensive care units in hospitals are hotspots and called for patient side testing.

Another panel explored the way to respond to challenges in implementing a true European system of patient safety. Dr. Agnès Leotsakos updated the participants on the activities of the World Health Organization (WHO) in this field. A study conducted in 2009 shows that several structural factors,together with poor processes, contribute to unsafe medical care. Not only poor training, as rightly pointed out by the other speakers, but also stress and fatigue of healthcare workers put the safety of patients at risk. “If drivers are not allowed to drive when drunk,” Ms. Leotsakos asked, “why shouldn’t we pay the same attention to the conditions of hospital staff?” Finally, she concluded, the report shows that there is an overall culture of blame as well as a lack of data and evidence of what is the most effective way to promote patient safety.

Dr. Dominique Monnet from the ECDC expanded on the issue of how multidrug-resistant infections pose a threat to the safety of patients in Europe. To make the audience aware of the consequences of such a threat, he told the story of Lill-Karin, a patient from Norway who got infected with an antibiotic-resistant bacterium when having her hip replaced at a hospital in India.

A final panel was chaired by MEP Renate Sommer (EPP, DE). Between 25% and 50% of acute hospital beds are occupied by patients with wound and surgical site infections account for a good part of nosocomial infections, patient safety is a core issue in wound management. Therefore, the chair gave the floor to an organisation linking wound management associations in Europe, the European Wound Management Association (EWMA). As the challenges to achieving safe care are often associated with failing processes rather than related to individual practitioners, Prof. Zena Moore of the EWMA, made a case for multidisciplinary team work as well as education and training.

Ms. Cristina Padeanu, who thanked the MEPs Taylor and Rivasi for their support to the work of the European Patients’ Forum (EPF), said that patients are no longer passive recipients of care but they are playing an increasingly important role in the area of patient safety. Their involvement, she added, must be promoted both at the individual and at the collective level. The EPF views this new piece of EU legislation as an opportunity to foster patients’ engagement and on this note the organisation is carrying out a survey on the Council Recommendations among its members.

Overall, the workshop clearly demonstrated that while there is greater commitment from health ministries to discuss patient safety, there are still many necessary steps that must be taken to minimise avoidable risks to patients in healthcare settings. Mr. Rossi’s report will provide the European Parliament’s view on patient safety and hopefully help to drive increased safety for all EU citizens.

NEWS: “Time to improve men’s health: the next steps for the EU?”

19 March 2013 – Following the publication of the European Commission’s report on The State of Men’s Health in Europe (2011), Health First Europe attend the event held in the European Parliament entitled “Time to improve men’s health: the next steps for the EU?”. Focused on how to concretely improve the health of European men going forward, the event was hosted by MEP Christel Schaldemose (S&D, Denmark) and brought together leaders in men’s health as well as the European Health and Consumer Affairs Commissioner Tonio Borg, to consider how the EU can best support men to improve their health and well-being.

Opening the event, Ms. Schaldemose reflected on the outcomes of the Commission’s report which clearly show men have a lower life expectancy than women and declared that, “Policymakers can do something about it.” The gender equity aspect of healthcare was continued by Mr. Svend Aage Madsen, a co-author of the Commission’s report who provided an overview of men’s health particularly in Denmark, namely:

Difference of 6 years in life expectancy as compared to women
Self-perceived health for men is good, even though actual health is not
One of the strongest determinants of poor health is being single – divorce is a strong indicator of health (and divorce is rising)
Men often come to the doctor when it is too late

Dr. Ian Banks from the European Men’s Health Forum, expanded on Mr. Madsen’s statistics and highlighted the importance of communicating with men in the right way for them, giving them what they want and need to know. Discussing how disengaged most men are with the health services in the United Kingdom, Dr. Banks commented that “men use GPs very little when they are younger and only go when they are older – usually over 50. There are twice as many men in emergency care which is the most expensive part of medicine.” He reminded the audience that men’s health is not about a battle against women’s health rather both men and women have a responsibility to take care of each other.

A key aspect that must be addressed in men’s health is suicide. Hans Jorgen Knudsen of Lifeline Denmark explained that men are more prone to suicide and prevention is particularly important as it is the principle cause of death for men aged 30 – 39. In 2007, more than 40,000 men were lost in the EU due to suicide compared to 12,000 women. He suggested that there is a significant problem of undetected, untreated depression which often times can arise due to a loss of control or power. Men find such circumstances particularly difficult to deal with.

Showcasing how governments can tackle many of these health issues for men, Dr. Noel Richardson presented the Men’s Health Strategy in Ireland. Developing the policy over 10 years, Dr. Richardson described the steps involved in not only creating momentum and a mandate for policy, but outreach to stakeholders and particularly inter-sectoral and inter-departmental meetings to ensure men’s health policies were taken into account in horizontal policies. Ireland is focusing on 5 specific areas including: men’s health week (awareness-raising), men’s health training, gender-mainstreaming framework, community development and health in the workplace.

Closing the event, Health and Consumer Affairs Commissioner Tonio Borg discussed his personal experiences with stakeholders and stories of health inequalities and discrimination which can lead to reduced health outcomes for men and women. He shared how in certain areas, there is still the thinking that, “if a men comes to emergency care with chest pain, it is assumed to be a heart attack. If a woman comes to emergency care with chest pain, it is assumed to be depression.” He described ways in which the Commission is supporting initiatives on men’s health, women’s health and reducing health inequalities and discrimination. He said that the Commission will continue to focus on prevention including a conference in 2014 specific to that issue. The Commission will also be holding two upcoming events on discrimination in healthcare and the gender dimension in health. These initiatives are in addition to a Joint Action recently launched on mental health as well as an upcoming Joint Action on chronic diseases.

There was considerable commitment from all participants to improving the health of men and therefore the health of society. Underlining the need to consider specific health action plans for each gender (as they face particular difficulties) will be an important factor moving forward to facilitate more healthy living years for all EU citizens.

NEWS: Health First Europe attends E.C.H.O debate: “The care industry as a driver of economic development and public deficit reduction”

5 March 2013 – Health First Europe attended the European Confederation of Care Home Organisations (E.C.H.O.) event in the European Parliament which aimed to raise awareness about the key role care homes play in healthcare as well as the opportunities that exist for economic development by investing in care homes throughout the EU. The event brought together a variety of EU and Member State health stakeholders to discuss the rising demand for dependent care in Europe and the challenges for meeting the needs of 30 million dependent people in the coming years.

Providing a scope for the debate, MEP Roberta Angelilli (EPP, Italy) reinforced the fundamental guarantee that all EU citizens have to healthcare under the EU Charter and highlighted the value of the healthcare sector for European growth and jobs. Reminding the participants that 2012 was the European Year for Active Ageing and Solidarity and Solidarity Between Generations, she also reiterated the need to focus on prevention so as to allow elderly individuals to remain independent for as long as possible. Ms. Angelilli’s colleague in the Parliament, MEP Licia Ronzulli (EPP, Italy) reinforced the idea that healthcare should not be thought of as an expense, but rather an investment and suggested that “there is a huge opportunity for economic development in the care home sector.” MEP Andrea Cozzolino (S&D, Italy) agreed and discussed the commitment of the EU institutions to meet the challenges of the ageing population through various initiatives such as the Innovation Partnership on Active and Healthy Ageing, use of structural funds for infrastructure development and research within the next framework programme Horizon 2020.

Though the EU has recognised the challenge of ageing for healthcare systems, Mr. Alberto Marchiori from the EU Politics Delegation of Confcommercio Imprese per L’Italia, gave greater context to the actual challenge faced to provide care to elderly, dependent persons. Not only is there a shift from care away from the family, he explained that currently care homes are “trying to meet the needs of 20 million elderly people” which is growing all the time. President of E.C.H.O, Mr. Alberto De Santis, provided further detail regarding the role of care homes in caring for the most vulnerable people. Looking positively on the fact that people live longer, he proposed “ageing is a sign of well-being in the population, but it means additional needs and has impacts on the costs of services.” He also highlighted the importance of innovation to reach citizens in needs (whether that be in public administration or infrastructure). Building on Mr. De Santis, Mr. Alberto Echevarria, Secretary General of E.C.H.O., gave specific statistics on the challenges and opportunities for the care home sector. He provided startling statistics:

The older the people, the more dependent, and more than 26% of people over 75 are dependent
By 2040, 30% of the European population will be over the age of 65
There are now 20 million dependent individuals, (4% of the actual population) and only 3.5 million beds available for those individuals

Mr. Echeverria went on to describe the goals of E.C.H.O. for not only meeting the needs for future care, but also the potential achievements of the industry in terms of job creation and public deficit reduction. The industry aims to have a ratio of 6,000 care industry beds for every million people which equates to building 500,000 new beds at a cost to the industry of €30 million. Such expansion will result in 350,000 new jobs, created in the EU, staying in the EU. He ended by stating, “The care sector provides a real strategic opportunity for economic growth in terms of reducing public debt, stimulating the economy and creating jobs.”

Overall, the debate clearly outlined the challenges of an ageing population, specifically in terms of caring for the most vulnerable. The care home industry emphasised the role it plays in a complex system where we often forget about the people most in need of care and showcased how care homes can contribute to not only supporting dependent people, but also supporting growth and jobs throughout the European economy.

NEWS: Health First Europe attends the Workshop on ‘Regulation on Medical Devices (MDs) and In Vitro Diagnostic Medical Devices (IVDMDs)

On 26 February, Health First Europe attended the Workshop on ‘Regulation on Medical Devices (MDs) and In Vitro Diagnostic Medical Devices (IVDMDs)’ at the European Parliament. The event was the first public discussion on the dossier and brought together stakeholders from the EU health community to provide their positions on the current proposal before discussions amongst policymakers begin in March. It was clear that while many welcomed a more robust legal framework for the regulation of medical devices, stakeholders differed in the approach to balancing the needs for safety against the needs for innovation in healthcare.

MEP Dagmar Roth-Behrendt (S&D, Germany), Rapporteur for the revision of the Medical Devices Directive (MDD) and chair of the meeting welcomed the participants of the first panel and invited them to give their perspective on the current system of approval of medical devices. Ms. Paola Testori-Coggi, Director General of the Directorate General for Health & Consumer (DG SANCO), began by illustrating the key points of the Commission’s proposal, particularly highlighting the need to “reconcile the highest possible level of safety with the need to maintain innovation and competitiveness.” To this end, the Commission’s intent was to make the legal framework for medical devices more robust and to improve the transparency and traceability of the system in Europe while maintaining the current de-centralised system to ensure rapid access for patients to medical technologies.

Providing the industry perspective, the CEO of Medtech Europe, Eucomed and EDMA, Mr. Serge Bernasconi, underlined the need for greater transparency and stronger traceability and reinforced the support of the industry for many of the new statutes contained within the proposal. However, Mr. Bernasconi also insisted that any additional scrutiny on high risk devices must be undertaken within an effective and predictable system. Mr. Bernasconi agreed that the current system needs improvement, but expressed concern about the considerable delays patients could face for new technologies under the current proposal for scrutiny.

Prof. Werner Siebert, Director at the Orthopedic Center in Kassel, re-affirmed that improvements to the current systems are necessary, but maintained that the processes must bring added-value and questioned whether scrutiny for high risk devices would indeed achieve that goal. This opinion was echoed by the President of the European Society of Cardiology (ESC), Mr. Panos Vardas, who offered another medical perspective on the discussion. Mr. Vardas reminded the audience that life expectancy has significantly improved in the last few decades because of innovative medical technologies. He expressed that “The current system for testing and approving devices in Europe was established more than 20 years ago, and the ESC feels it is now necessary to adapt the regulation to technological advances and changing patterns of medical practice.” The Commission’s proposal was welcomed by ESC, but Mr. Vardas explained that he sees room for improvement in some key areas particularly with regards to transparency and stressed that clinical evaluations of medical devices should only be undertaken by accredited bodies and that there should be greater involvement of doctors in the approval process as clinicians could offer independent expertise.

The Director of the European Consumers’ Organisation, Ms. Monique Goyens, indicated the inconsistency of the current system in terms of classification of devices and also asserted that there a variety of differences in processes for approval depending on the notified body involved. Ms. Goyens called for a multi-disciplinary group at EU level to determine classification of products (particularly borderline medical devices) and for an EU wide system for binding assessment on high risk devices (via the European Medicines Association). She stated that, “Innovation cannot be encouraged at the expense of safety.”

Following Ms. Goyens, Mr. George Jessen, Representative for Proctor and Gamble in the Association of the European Self-Medication Industry (AESGP) Committee on Medical Devices, raise the “principle of proportionality” issue expressing that the new proposal must “facilitate innovation in the medical technology industry in a responsible way.” Mr. Jessen argued that the current system is working, but needs to be improved and this could be achieved by strengthening notifed bodies.

The end of the session saw two representatives from the pharmaceutical industry presenting their opinions. Firstly, Mr. Richard Bergström, Director General of the European Federation of Pharmaceutical Industries and Associations (EFPIA), expressed the importance of building trust between regulators through peer review, which is a basic principle in the field of pharmaceuticals. Mr. Bergström concluded his speech with a remark on reimbursement, an issue brought up by several speakers which often constitutes a real barrier for patients. He also urged policymakers to analyse what impact the proposed regulation would have on small and medium enterprises (SMEs) as such companies are unique to the medical device industry. Mr. Guido Rasi, Executive Director of the European Medicines Agency in London, followed Mr. Bergstrom’s remarks by recommending that a clear and harmonised definition of a device is proposed and indicated that while some have suggested the EMA play a role in medical technology regulation and oversight, the organisation has expertise only to contribute on borderline devices (such as companion diagnostics).

Overall, the discussions on medical devices provided a clear foundation of stakeholder views for the upcoming discussions on the proposed medical devices regulation. Clearly, the most important issue raised by all stakeholders was the need to ensure a high level of safety for patients. However, balancing the issue of safety against other concerns such as innovation, access and transparency, will be a clear challenge for policymakers as the discussions get underway.

NEWS: HFE attends 2nd Coordination Meeting of the European Network on Patient Safety and Quality of Care

14/15 January 2013 – Health First Europe continued its participation as a collaborating partner in the European Network for Patient Safety and Quality of Care during the second coordination of the network in Berlin, Germany. The second coordination meeting brought together all partners to discuss the tasks completed throughout the seven work packages during the first year of the project as well as to look forward and prepare for the next tasks ahead in 2013.

The Joint Action, which brings together 38 associated partners and 24 collaborating partners, aims to advance the Council Recommendations on patient safety including the prevention and control of healthcare associated infections (2009). Launched last year in Copenhagen under the Danish Presidency of the EU, the European Commission funded project has advanced significantly in its first year. The work packages, which include coordination, evaluation, dissemination, safe clinical practices exchange, safe clinical practices implementation, quality management systems implementation and network sustainability, will together provide substantial support to Member States for advancing various components of their patient safety strategies through knowledge sharing between participant countries and EU stakeholder organisations.

As a collaborating partner, HFE is supporting work packages on safe clinical practices exchange and implementation, in particular sharing its knowledge from the Task Force on Patient Safety which launched recommendations in 2012. Health First Europe is eager to contribute to this project which will not only look to exchange a variety of safe clinical practices (those with demonstrated effectiveness and newer, more innovative approaches to patient safety) but will also implement and report on 3-5 safe clinical practices in 16 Member States across Europe.

HFE will continue to be involved in the project throughout its three year mandate and looks forward to the continued success and collaboration of so many dedicated partners.

For more information about the network, the objectives, partners and work packages, visit the dedicated website at: http://pasq.eu/

NEWS: Health First Europe attended the roundtable debate on “e-Health – additional cost burden or efficiency factor for Europe’s health systems?”

30 November – Health First Europe attended the roundtable debate on “e-Health – additional cost burden or efficiency factor for Europe’s health systems?” organized by the European Policy Centre. The event brought together policymakers and stakeholders in order to discuss the economic rationale for using e-Health solutions.

John Hampson, e-Health Programme Director at NHS Yorkshire and the Humber, gave a national perspective on the issue. In the UK, the NHS will have to deliver up to £20 billion in efficiency savings over the next few years and technology is very much seen as a key contributor to this goal. Mr. Hampson informed the participants about two new major national initiatives being implemented in the country. On the basis of the results of the Whole Systems Demonstrator (WSD) programme – a randomised control trial of telehealth and the telecare services – the Department of Health considers that 3 million people with long term conditions will benefit from telehealth services over the next 5 years. This is how the project entitled 3 Million Lives was launched. A second ongoing initiative is called Digital First. Its aim is to improve the delivery of healthcare services by reducing unnecessary face-to-face contact between doctors and patients thanks to the use of existing technology. Mr. Hampson linked the implementation of ICT in the healthcare sector to patient empowerment and called e-health “a key driver of choice.”.

To further elaborate on the issue of the costs and benefits of ICT solutions, Mr. Dean Westcott from the Association of Chartered Certified Accountants (ACCA) presented “Telecardiology in Italy: benefits from a telemedicine network connecting chronic patients, general practitioners and healthcare provider organisations”. The ACCA study based on a telecardiology project in Italy, showed how healthcare provider organisations and citizens benefited directly from e-Health solutions. Mr Westcott, who has been evaluating healthcare projects for the European Commission for a number of years, welcomed the opportunity for debating the crucial topic of e-Health. In fact, he is persuaded that the challenges posed by an ageing population and by growing pressures on healthcare budgets, require different solutions. Alongside the value in terms of saving resources, he pointed out that e-Health is vital to live up to patients’ expectations in the age of internet.

Balazs Szathmary, Senior Director at Oracle, contributed to the discussion by outlining the outstanding challenges that need to be addressed in order to realize the full potential of e-Health. He suggested that. “While it is widely accepted that building a dam will give a Return of Investment (ROI) in no less than 20 years, people seem less willing to accept this horizon in healthcare.” The fact that investments and benefits occur at different levels, Mr. Szathmary pointed out, is one of the main reasons why national policymakers are still reluctant to invest in e-Health.

e-Health features in the Digital Agenda for Europe and a new Action plan will be released soon by the European Commission. Mr. Pēteris Zilgalvis, from the Directorate General for Communications Networks, Content and Technology, cited a few projects implemented in different Member States as evidence of the cost-effectiveness of e-Health. In Sweden, for instance, more than 80% of all prescriptions are electronically transferred from the doctor to the pharmacy with cost benefits of €330 million. The gross value of the Scottish Telecare Programme funded efficiencies are estimated around €77 million for the period 2006-2010. In Denmark, the streamlined services provided by the Health Data Network lead to cumulative savings of €92 million per year. In order to ensure the successfully deployment of e-Health solutions, Mr. Zilgalvis stressed the importance of having favourable regulatory frameworks in Member States. Finally, he shared with the audience that on the basis of a Memorandum of Understanding, the European institutions are engaged in a dialogue with the United States in order to foster mutual understanding of the challenges faced by both sides in advancing the use of eHealth.

During the debate, eHealth was referred to by all speakers as a tool to improve access to healthcare while reducing costs. It was also agreed that the deployment of ICT solutions in healthcare needs to go hand in hand with IT and health literacy in order to promote patient empowerment. Overall, the participants agreed that the short term costs of eHealth will be far outweighed by the potential long term benefits.