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 3rd Coordination 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 26 September 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. GoyensMr. 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 opinionsFirstlyMr. 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.

NEWS: Health First Europe encouraged by progress on patient safety – Calls on EU to support greater standards to protect patients

16 November 2012 – Health First Europe welcomes the European Commission report published today outlining the progress achieved by Member States since the adoption of the Council Recommendations on patient safety in 2009.  While encouraged by the outcomes of the report, Health First Europe believes that further steps are needed to ensure that patient safety is a priority for all healthcare institutions with clear standards in place as well as reduction targets for healthcare associated infections (HCAIs).

The Commission’s report identifies the number of Member States which have implemented the 13 actions adopted by the Council in 2009 and finds that all Member States have developed specific policies on patient safety.   However, clear gaps still exist among Member States regarding issues such as standards for patient safety, training of healthcare professionals and education of patients about safety within healthcare settings.  Additionally, though most Member States have surveillance networks for healthcare associated infections, not all infections are monitored and the systems in place are not comparable, which continues to prevent a clear understanding of the prevalence of healthcare associated infection across Europe.

Health First Europe launched its recommendations for strengthening patient safety in Member States in April 2012 which called for minimum standards for patient safety at EU level, including harmonised reporting systems, setting measurable improvements targets for patient safety determined by each Member State and monitored by the EU, and development of a European strategy to prevent HCAI.

In response to the Commission’s report, Honorary President John Bowis said:

We very much welcome the Commission’s future focus on proposing guidelines for introducing patient safety standards, common terminology on patient safety and research on the cost-effectiveness of patient safety strategies.  It is imperative for patients, however, that Member States are encouraged to set reduction targets for healthcare associated infections to facilitate improved surveillance and reporting. For patients to be involved in the safety of their care, they need to be aware of the way risks are managed as well as the real versus perceived possibility for adverse events in a healthcare setting.

Health First Europe will be discussing this report in depth as well as the next steps for patient safety at its upcoming event in the European Parliament entitled Advancing Patient Safety in the EU: Reducing healthcare associated infections. Expert panelists include the European Commission, World Health Organization, German Coalition for Patient Safety, European Parliament, German Society for Hospital Hygiene, and the International Society for Quality in Healthcare.

To read the European Commission’s report, click here.

To read Health First Europe’s recommendations on patient safety, click here.

To read the outcome report of Health First Europe’s launch event in April, click here.

NEWS: Health First Europe attends “Medical Devices: is the new legislation sufficient to protect patients?”

14 November 2012 – Health First Europe attended the Seminar “Medical Devices: is the new legislation sufficient to protect patients?” organized by the ALDE Group at the European Parliament. The Seminar brought together representatives from the EU institutions to give their perspectives on the proposal for a revised Medical Devices Directive published by the European Commission in September.

MEP Corinne Lepage opened the seminar by welcoming the opportunity to discuss the crucial issue of revising the European legislation on medical devices. Afterwards she gave the floor to Ms. Sabine Lecrenier, from the Directorate General for Health and Consumers of the European Commission, and MEP Peter Liese, Rapporteur for the proposal for a Regulation on in-vitro diagnostic medical devices, who informed the participants on the perspective of the European institutions with regards to the proposed legislation.

Ms. Lecrenier pointed out that the current legal framework consists of Directive 90/385/EEC regarding active implantable medical devices, Directive 93/42/EEC regarding medical devices and Directive 98/79/EC regarding in vitro diagnostic medical devices. Ms. Lecrenier suggested that the new proposal is meant to adapt to scientific progress and to address the weaknesses of the existing system as well as to take over international developments in the field. Ms. Lecrenier explained the main changes that the proposed legislation would bring about. First of all, the scope of the regulation will be extended to cover products utilizing non-viable human tissues and invasive devices without medical purpose (e.g. aesthetic). Secondly, she  explained that the Commission proposal aims at introducing stricter minimum legislative requirements for medical devices as well as increasing the power of notified bodies responsible for assessing the safety of devices for market approval . Lastly, the new legislation provides for a centralized system for reporting incidents and seeks to further improve transparency.

MEP Peter Liese, Rapporteur for the Regulation on in-vitro medical devices, told the audience that a revision of the current regulatory framework is urgently needed. Speaking on behalf of the EPP Group, MEP Liese declared that pre-market approvals by Member States are not the best way to address the issue. Such measures, he pointed out, would not have prevented the breast implant scandal from happening and hinder rapid access for patients  to innovative medical technologies.

MEP Mairead McGuinness intervened in her role as appointed Shadow Rapporteur on the Regulation proposal on medical devices. She drew attention to the key role of medical professionals who are the link between the patients and the industry. She felt that medical professionals should be better informed about products and safety standards. She expressed, “Policymakers shall not forget that the life of many patients significantly improved thanks to innovative medical devices and therefore innovation shall be allowed to flourish.”

Ms. Lecrenier welcomed the point raised by MEP McGuinness and ensured her that the Commission is trying to keep a balance between the exigency to ensure safety and the need to let innovation thrive in Europe.

The second panel was moderated by MEP Rebecca Taylor, who invited different academics and stakeholders to share their point of view with the audience. Dr. Alan Fraser from the Wales Heart Research Institute was representing the European Society of Cardiology (ESC). He gave a clinical perspective on the recast of the directive referring to the recommendations on the clinical evaluation of cardiovascular devices elaborated by ESC. Dr. Fraser stressed that greater transparency and expert professional advice are vital to ensure safety forpatients.

On his part, Mr. Serge Bernasconi, CEO of MedTech Europe, stressed that the amended legislation should not make it harder for patients to access medical devices. According to the industry, the revision should aim at ensuring patient safety by preventing incidents, but it should also guarantee that essential and necessary  technology is available to patients without hampering innovation. This, said Mr. Bernasconi, can be achieved by strengthening post-market surveillance and by enhancing the traceability of products.

Ms. Ilaria Passarani from the European Consumers’ Organisation (BEUC) considers the revision of the regulatory framework a unique opportunity to improve consumers’ protection. After sharing with the audience a video recorded by a Spanish woman who received toxic breast implants, she stressed the need of providing adequate information to patients and particularly welcomed the proposed new legislation insofar as it provides for greater traceability and closer cooperation among Member States.

Mr. Hans-Heiner Junker, Representative of the European Association for Medical Devices of Notified Bodies, welcomed  the proposal of the Commission in its entirety and was very pleased to see all stakeholders involved in the discussion. The Notified Bodies are particularly satisfied with the new legislation providing a legal basis for them to test products that are already on the market. MEP McGuinness then raised the point of the striking differences among Notified Bodies, considering that around 20% of them are carrying out most of the work for all European medical technologies and that somee lack the relevant experience.

Overall, the seminar was a unique occasion to stimulate the debate among the stakeholders and the institutions on the new legislation which will no doubt impact patients. MEP Taylor concluded the conference by saying that patient safety is the number one priority for everyone and called for a future-proof legislation.

NEWS: Health First Europe attends European Innovation Partnership: First conference of partners

6 November 2012: Health First Europe attended the European Innovation Partnership (EIP) on Active and Healthy Ageing (AHA): First Conference of Partners. Bringing together partners of the EIP on AHA, the conference outlined the progress achieved by the six designated Action Groups of the project. Each group presented its Action Plan for delivering specific objectives which will contribute to the overall goal of the partnership: 2 additional healthy living years for each European citizen by 2020.  Over 300 stakeholders from all Member States are participating in the Commission’s initiative originally launched in 2010.

The event was opened by Neelie Kroes, Vice-President of the European Commission, who emphasised the overwhelmingly challenge Europe faces due to its ageing population. Commissioner Kroes encouraged the partners to “learn together, share and build together” and confirmed that the Commission will continue to support partners now and in the future through research and innovation funding programmes.  She also declared that by transforming the delivery of care, together we could contribute to savings of over 60 billion Euros, an amount that is worth more than any EU funding.

Furthering many of the points raised by Commissioner Kroes, Kathleen Lynch, Minister of State for Disability, Equality, Mental Health and Older People at the Department of Justice, Equality and Defence in Ireland, expressed that the partnership is a good example of what “Europe can achieve when all nations buy into a single project.” The ultimate goal of the initiative, she told the audience, is not simply to treat broken hips and joints but to prevent these incidents from happening in the first place. Minister Lynch informed the stakeholders that active ageing is at the heart of the priorities of the Irish Presidency about to begin in January 2013.

Dr María Pilar Farjas Abadía, Secretary General of Health and Consumers at the Spanish Ministry of Health, Social Services and Equality finished the opening session of the conference discussing the importance of keeping the population healthy as it ages.  She praised the partnership for focusing on actions that will really have an impact on health for all individuals across Europe.

Following the opening remarks, the Action Plans of each of the six Action Groups in the partnership were presented by the leader of each group.  Prof. Sergio Pecorelli, President of the Italian Regulatory Agency for Medicines, gave a brief overview of the Action Plan on ‘Prescription and adherence to treatment’.  Patient Empowerment, explained Prof. Pecorelli, is at the core of the action. By developing early warning systems and IT platforms, the relative Action Group aims at improving patients’ adherence to care plans. The Action Group also intends to contribute to research and methodology on adherence and to foster communication between different actors.

Dr. Nick Guldemond, Program Director of Health at the Delft University of Technology, illustrated the Action Plan on ‘Personalized health management, starting with a Falls Prevention Initiative”. When considering that one in every three adults over 65 falls and that falls are one of the leading causes of injury deaths, Dr. Guldemond said that tackling this issue would permit not only to reduce costs but also to increase independence and quality of life for seniors in the EU.

Olle Ljungqvist, Professor of Surgery at the Örebro University Hospital in Sweden, talked about the Action Plan on ‘Prevention and early diagnosis of frailty and functional decline, both physical and cognitive, in older people”. Managing functional decline and frailty, empowering older people, promoting systematic routine screening in at risk patients and creating integrated pathways of care are among the main objectives of the plan.

The presentations continued with the speech of Professor George Crooks who serves as the Medical Director for NHS 24 and for the Scottish Centre for Telehealth & Telecare. He told the audience that the Action Plan on integrated care is the largest initiative within the EIP and is made up of 144 participants. Its aim is to deliver transformational change across the healthcare system in Europe. This year, a questionnaire was provided to the partners of the Action Plan to better understand the perspectives of regions and delivery organisations. In his final point, Prof. George Crooks called for greater collaboration among regions, delivery organisations, organisations of patients and carers, academia and industry.

Mariëlle Swinkels, Policy Advisor involved in the regional program ‘Health and Social Care Economy’ of the province of Noord-Brabant in the Netherlands, informed the participants about the Action Plan on ‘Development of interoperable independent living solutions, including guidelines for business models”. The targets set for 2015 focus on having key global standards and validated implementations of interoperable platforms as well as on gathering evidence on the Return on Investment of these solutions.

The presentation was concluded by Anne-Sophie Parent, Secretary General of AGE Platform Europe, who explained the headline objectives of the Action Plan on ‘Innovation for Age-friendly buildings, cities and environments”. The Action Group will contribute to achieving two additional healthy life years for older people in the European Union by fostering greater collaboration among private and public stakeholders and greater deployment of ICT solutions as well as by accelerating the implementation of supportive physical and social environments.

The morning session concluded with the intervention of John Beard, Director of the Department of Ageing and Life Course at the World Health Organization (WHO) talking about the organisation’s Strategy on Age-Friendly Cities encouraging cities to think about health promotion across the life course, primary health care and long-term care, age-friendly environments and rethinking ageing. For instance, New York City implemented changes to crossing-speeds after listening and responding to the needs described by older citizens. Mr. Beard also explained how New York City began using school buses to transport the elderly during the day when not in use – thus contributing to enhancing the quality of life of senior citizens with no additional costs to the city.

Máire Geoghegan-Quinn, the European Commissioner for research, innovation and science, opened the afternoon session congratulating all members of the Action groups. Commissioner Quinn declared that it is necessary to keep the momentum going and turn ideas into actual results as the partnership evolves.  She also highlighted the importance of Horizon 2020 (the upcoming framework programme for research and innovation) for supporting the actions of the partnership to “identify gaps in knowledge, anticipate new and possible technologies and new models of social innovation and ensure rapid uptake.”

Overall the conference focused on the how the Commission’s pilot initiative has rapidly emerged from an idea into concrete plans with deliverables and timelines in order to reach the goals set by the Steering Committee in 2011.  As the first of its kind, the public/private partnership supported by three Commission Directorate Generals, is quickly moving ahead and the achievements expected through this new partnership approach will likely encourage new ways of working together to facilitate greater uptake of health technologies for all EU citizens.

NEWS: Health First Europe participates as a Collaborating Partner to the EU Network for Patient Safety and Quality of Care (PaSQ) Joint Action

Health First Europe (HFE) is pleased to inform that the European Union Network for Patient Safety and Quality of Care (PaSQ) Joint Action (JA) has launched a new website.

The PaSQ project was officially launched in May 2012 with the aim of supporting the implementation of the Council Recommendations on Patient Safety by promoting cooperation between Member States, stakeholders and international organizations. Building on the existing permanent network for Patient Safety, this initiative will promote the establishment of platforms in all European Member States. The JA is co-funded by the European Commission and will be performed through seven Work Packages (WP).

Health First Europe (HFE) is actively participating to this initiative as a Collaborating Partner and attended the WP 5 meeting in Madrid at the beginning of the month. HFE members, the European Federation of Nurses (EFN) and the European Union of Private Hospitals (UEHP), are also engaged in the Joint Action as Associated Partners and working on the implementation and monitoring of safe clinical practices as well as participating in other work packages of the Joint Action.

NEWS: HFE attends European Parliament Roundtable on the “Nursing Education”

16 October 2012 – Health First Europe attended a roundtable event jointly organised by the European Federation of Nurses (EFN) and the European Parliament to discuss professional qualifications for nurses.  This issue is currently being debated in the European Parliament as part of the Directive 36 (known as the Professional Qualifications Directive).  The event brought together a variety of stakeholders, including Members of the European Parliament, representatives of Member State health ministries and permanent representations as well as nurses and EU health organisations to present the diverse positions of stakeholders and to better understand the impact of this directive on the nursing profession and patients.

The roundtable was opened by MEP Mario Pirillo (S&D, Italy) who is a Shadow Rapporteur on Directive 36, in conjunction with his colleague, MEP Bernadette Vergnaud (S&D, France) who is the Rapporteur for Directive 36.  The MEPs outlined the key issue at stake in the debate which centres on the number of years of general education which would be required for a person to be recognised as a nurse in the EU. The Commission proposal sets out a minimum requirement of 12 years of general education.  However, some Member States currently have in place systems which only require 10 years of general education to go into the nursing profession. The assistant to Ms. Vergnaud explained that in order to remedy this dispute, she suggests that Member States are given a transition period to implement the new regulation, or, as proposed by MEPs Andreas Schwab (EPP, Germany) and Ana Weisgerber (EPP, Germany), to allow for two possible routes of education for nurses – one level of competencies for a nurse with 10 years of general education, and another level of competencies for a nurse with 12 years of general education.

Following this introduction, multiple stakeholders were given three minutes each to provide their opinion regarding Directive 36.  Thierry Lothaire, from the Belgian Nurses Association, argued for one level of education to support the efficiency of structural reform.  While Ms. Reka Kovacs from the Hungarian Permanent Representation, declared that Hungary could not support the proposal of the Commission for 12 years of education because Hungary believed the proposal to be based on years of education rather than competencies.  The representative from the Dutch government, Ms. Leon Van Berkel, argued that two types of nurses are needed (vocational and those with Bachelor’s degrees) and that the definition of general education is extremely important in this Directive in order to clearly understand the overall education nurses are receiving (not based on years).

Speaking on behalf of the nurses, President of EFN Unni Hembre, described the supporting evidence for ensuring the higher level of education of nurses.  She presented RN4Cast, a Commission project, which looked at several nursing variables that can have an impact on quality of care.  In the study, which involved 12 Member States and more than 300 hospitals, the higher education of nurses correlated to lower mortality: for every 10% increase in nurses with Bachelor’s degrees, there was a 7% reduction in patient deaths. She expressed that “the cost of lower patient outcomes is sure to be more costly for Member States than implementing Directive 36.”

Additionally, Monica Kosinska, Secretary General for the European Public Health Alliance, also spoke in favour of the 12 years of education by highlighting the importance of nurses’ education for patient safety.  She declared that we do not want “a race to the bottom” for healthcare professionals especially during times of economic austerity when healthcare budgets are shrinking.  Supporting her statement, MEP Antonyia Parvanova, (ALDE, Bulgaria) considered that if a child begins his/her general education at the age of 4, and has only 10 years of general education before going into nursing, is this person old enough to have this type of responsibility?  She asked the participants, “Is this person ready to take a decision about someone’s life?”

Overall, the debate provided very interesting perspectives not only on the importance of education for nurses, but also the overwhelming importance of nurses for health systems and particularly the safety of patients.  As nurses are typically the primary carer for a patient in a healthcare setting, it is clear that their knowledge, experience and education play a vital role in how that care is delivered and the level of care that is received.