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.

NEWS: Health First Europe attends MedTech Forum 2012

10/11 October 2012 – Health First Europe attended the MedTech Forum 2012 which aimed to present the value of the medical technology industry for health systems across Europe. Launching the new MedTech Alliance between the European Diagnostics Manufacturers Association (EDMA) and Eucomed, the three day event brought together high-level policymakers, hospital managers, patients and industry to discuss the challenges facing all health stakeholders as well as offering potential solutions.

The leaders of the organising associations (Eucomed, EDMA and the MedTech Alliance), opened the event discussing priorities for the associations for providing quality of care to patients during difficult economic times. Guy Lebeau, Eucomed Chairman, declared that, “People need to understand the value of the industry for healthcare” which will “serve patients across the EU.”  EDMA President, Jurgen Holtz, expressed that he believes the greatest issues of importance to health systems include patient safety, health technology assessment and the recent proposal for a new Medical Devices Directive. The new CEO for the Alliance, Serge Bernasconi, said his real focus will be making the alliance between the two associations “work.”

Presenting an overview of the medical technology industry and the current challenges for the industry and health systems in general, Chris Llewellyn from McKinsey and Company discussed how the nature of healthcare spending will change despite growth in healthcare spending for the last 100 years. He suggested that there will be a “re-definition of every stakeholder in healthcare” because of the change in spending, and this change will be seen through the re-designing of care along the patient pathway.  Following Mr. Llewellyn, Marc Campbell from the National Institute of Clinical Excellence in the UK (NICE) discussed how his organisation evaluates and advises about the value proposition of new health technologies through health technology assessments (HTA). He clarified that NICE does not make determinations about which health technologies are made available to patients, NICE only evaluates the value of those technologies for patients, professionals and health systems. Mr. Campbell suggested that a European-wide assessment for a particular technology would be very difficult given the fact that HTAs should inform on the value of a new technology for a particular health system.

Following the overview on the state of health technologies, Health and Consumer Policy Commissioner John Dalli provided his vision and plan for sustainable and innovation-friendly healthcare policy in Europe. Commissioner Dalli re-iterated his belief that health is an investment, focusing on Commission initiatives and policies that further support investment in healthcare. He discussed the Commission’s initiative on Active and Healthy Ageing, which aims to “translate innovative ideas into tangible products and services that really respond to the needs of older Europeans” as well as highlighting the need for smart investment in health to facilitate “efficiency gains to help secure the quality and sustainability of healthcare systems.” He also discussed the Commission’s proposals for new medical device regulation and insisted that the Commission’s objective is to further improve the protection of health and safety for patients. Commissioner Dalli made clear that the Commission believes smart innovation and smart investment will be the keys to more efficient healthcare in the future.

Martin Whitehead, Director of the GSMA Europe, built upon the issue of innovation discussed by Mr. Dalli and spoke about the uptake of mHealth technology as a support mechanism for sustainable healthcare. He highlighted the importance of confidence in mHealth technologies in order for patients and consumers to feel secure in using technology to support their health.  Giving the patient perspective with regards to using medical technologies such as mHealth, Sebastian Hauck, Founder of Adventure Diabetes, demonstrated the enormous need for interoperability as he showed the audience the multitude of devices he carries with him at all times to monitor and care for his Type 1 Diabetes.  He clearly showed how patient quality of life could be improved by integrating device connections, but he also explained that the technologies he uses to support his active lifestyle are often not reimbursed and most of them he paid entirely out of his own pocket.  The reimbursement barrier was further discussed by Gerald McAteer, Global Director of Health Policy at Siemens Healthcare, who discussed the need for common incentives amongst health stakeholders in order to facilitate greater adoption of mHealth in health systems.  He suggested that barriers besides reimbursement include access to information about these technologies, as well as including patients as partners in the development of technologies.

With the release of the European Commission’s proposal for new regulation on medical devices, much of the discussion during MedTech 2012 focused on how these proposals would impact health systems. Director General in the Directorate-General for Health and Consumers, Paola Testori Coggi gave on overview of the new proposed legislation with a particular emphasis on how it will include increased involvement of patients and professionals through greater information and transparency. The new proposal will also make much of the information on medical technologies available to patients and professionals through EUDAMED. Susanna Palkonen, Vice-President of the European Patients’ Forum, agreed that the new proposals are more inclusive of patients and suggested that the new regulation should allow for medical technologies to “support patients to become co-managers of their own health.”   She also highlighted the need to ensure access to high quality care as well as having information on all aspects of care of which health literacy remains a key component.

Much of the technology in the medical device sector occurs through research and development, making the video address from Commissioner Máire Geoghegan-Quinn, Directorate General for Research and Innovation, an interesting overview of how the EU is supporting the development of health technologies for patients. Commissioner Geoghegan-Quinn explained that EU support for the medical technology industry has been almost €1 billion over the last 7 years and that DG Research intends to continue fostering innovation in healthcare through the Framework Programme Horizon 2020. She declared, “Count on EU’s support for improving the innovation framework” which will include greater access to financing.

Overall, the event showcased both the opportunities and challenges for health systems due to economic austerity measures, rising demand for healthcare and new regulation. While there clearly are difficulties involved in financing high quality of care for patients with current public budgetary constraints, many of the speakers also discussed the fact that the economic crisis will force health systems to change which may also be a great opportunity to realise new systems of care and improved quality and safety for patients.

NEWS: HFE attends “The electronic health record: transforming Healthcare communications in Europe”

On 2 October 2012, Health First Europe attended the conference “The electronic health record: transforming Healthcare communications in Europe” at the European Parliament. The event was organised by the Emilia Romagna Region in order to discuss the crucial issue of electronic health management with EU policymakers and representatives of different European regions. MEP Salvatore Caronna and MEP Vittorio Prodi, an HFE Supporter and Member of the Committee on the Environment, Public Health and Food Safety, co-chaired the conference and provided a brief overview of the topic.

Mr. Jerome Boehm, from the Directorate General for Health and Consumers of the European Commission, highlighted the significant potential benefits that the deployment of e-health could bring about. The Commission is actively involved in the revision of the legal framework on data protection which is one of the main barriers identified by stakeholders so far. Mr. Boehm concluded his speech by urging Member States to concretely engage in the implementation of the Directive on patients’ rights in cross-border healthcare adopted in March 2011.

Discussing implementation in Member States, Ms. Anna Darchini explained how the Italian Regional Administration of Emilia Romagna has gradually introduced ICT in healthcare services. As of today, all citizens who give their consent have access to their Electronic Health Record (EHR) online. A patient’s EHR contains medical prescriptions and referrals as well as a patient summary. Mr. Mauro Moruzzi, General Manager of C.U.P. Spa, the company who realized the EHR platform in Emilia Romagna, further highlighted how implementation can occur showing the audience how the record can be consulted by citizens online and even via a specific application designed for smart phones. Finally, he emphasised the importance of providing a Help Desk service supporting both patients and doctors using the network.

Following the presentation of concrete initiatives in Emilia Romagna, Ms. Lorenza Badiello, Head of the Representation Office of the Emilia Romagna Region in Brussels, gave the floor to three expert panelists from various Member States. She invited them to clarify how Peter, an imaginary patient who suffered a stroke, would be treated in their respective regions. Mr. Søren Thaulow presented the “Helbredsprofilen” project that has been implemented in the Zealand Region of Denmark. As a user of “”, Peter would be able to decide who can actually monitor his profile. In Zealand a high percentage of retired people have internet access, but convincing them to use the network still represents a challenge for Mr. Thaulow and his colleagues who hope to reach 1500 users by 2013.

As illustrated by Ms Petra Hasselqvist from the Swedish Association of Local Authorities and Regions, in Sweden patients like Peter have had access to e-prescriptions since 1995. The country has also developed an anti-infection tool – whenever doctors prescribe antibiotics, they fill out a sheet that is part of a national database. This procedure enables the health authorities to get updated information on infections spreading on a national scale.

In Spain, the use of e-prescriptions is rapidly spreading through all regions. Moreover, concrete pilot projects have been implemented by several local communities in the field of EHR. Mr. Gregorio Gomez from the Comundidad Valenciana explained how in his region the protection of patients’ data is safeguarded through the use of electronic signatures for healthcare professionals.

Overall, the speakers agreed that in times of austerity and financial crises, it is of the outmost importance to find solutions that help promote the efficiency of the healthcare systems around Europe. Technology is seen as a tool to improve the efficiency of healthcare but stakeholders feel that some barriers still need to be tackled in order to enable the full deployment of e-health.

NEWS: HFE attends “Financing healthcare research and innovation: Who should do what and with whom?”

On 11 July, Health First Europe attended the lunch briefing on “Financing healthcare research and innovation: who should do what and with whom?” organized by European Voice in Brussels. The briefing brought together experts in healthcare research and innovation sector, industry voices and policymakers to discuss the severe challenges currently faced by the health sector and new funding opportunities.

Opening the two-hour discussion, European Voice’s Assistant Editor, Simon Taylor, introduced the panel of speakers and provided a brief overview of the topic, stating that investing in research and development is becoming more and more difficult with the economic crisis continuing and the costs of bringing new medicines to the market constantly rising. Bernard Munos, the founder of InnoThink consultancy, agreed and stressed the difficulties currently faced by the industrial sector. The increase in the average age of the population in the majority of EU countries, in combination with the rising expectations of patients to have access to the most advanced medicines and treatments, creates increased pressure on healthcare spending. Therefore, Mr. Munos suggested that there is a need to develop both medicines and treatments which will deal with the shifting landscape of common diseases. Mr. Munos also highlighted the importance of innovation in health and welfare as the keys to the future success of the pharmaceutical sector.

When discussing how to better finance health care while still rewarding innovation, some industry representatives suggested that the large pharmaceutical companies should outsource their R&D activities to small firms specialized in innovation. Schemes as such are considered to be a collaboration involving R&D funding programmes and the private sector and are held-up as a model for public-private partnership. Mr. Munos expressed his agreement by advocating that there is a need for closer collaboration and more intensified exchange of knowledge and expertise.

Professor Daan Crommelin from University of Utrecht continued the discussion calling further attention to the academic sector and the existing networks that lead to innovation. He also agreed that public-private partnerships can play a vital role in providing and fostering innovation techniques. However, he underlined that the existing landscape falls short in specialised knowledge and expertise and this is where academia could contribute the most. Professor Crommelin stated that there is a need for industry and academic institutions to work closely together to ensure a better and more effective way for exchanging information and data in order to address specific challenges of the healthcare sector.

Providing the perspective of the European venture capital industry, Dr. Jos Peeters, founder and managing partner of Capricorn Venture Partners, focused on the priorities and the goals of the industrial sector, referring to ICT activities and biotechnology. He called attention to the increasing interest in the close collaboration of companies and universities, adding that expanding support especially to small businesses and to Europe’s need for venture capital is of great importance.

Overall, the discussion focused on the debate about what each sector should do and how they should do it in order to address the challenges that health systems are facing today. Participants concluded that investing in research and development is the key strategy that leads to innovation and success. Participants also agreed that understanding the needs, interests and challenges in health could provide a foundation for a more holistic and effective health policy.

NEWS: Health priorities of the Cypriot Presidency

On 1 July 2012, Cyprus will begin its Presidency of the Council of the European Union for the second half of 2012. It is the first time that Cyprus will hold the EU Presidency since joining the European Union in 2004. Cyprus is the third Member State of the current Trio, along with Poland and Denmark which will conclude on December 31, 2012. During its Presidency, Cyprus aims to work towards a better, more relevant Europe for its citizens and to the world, meaning a more effective Europe. The Presidency has also prioritised growth and job creation, promoting social cohesion and providing hope to its citizens.

Concerning the Cypriot health priorities, the Presidency will focus on addressing serious cross border health threats by developing activities through close collaboration with both EU and non-EU countries as well as with international organisations. Apart from health security and capacity building, the Presidency will focus on healthy ageing in relation to the European Health Strategy 2008-2013. This issue has also been dealt with by previous Presidencies, achieving various findings, one of which demonstrates that healthy ageing is closely related to the implementation of preventive and health promotion in early years of life. Within the framework of the year 2012 as the European Year of Active Ageing and Solidarity between generations, the Cypriot Presidency will also take into consideration the current economic crisis and the ageing of population, with the aim of underlining the need to review the structure of health care services and redirect investments for cost reduction in the healthcare sector. In addition, the Cypriot Presidency will be dealing with a proposal for a revised legislation that regulates clinical trials, based on a public consultation launched in February 2010. Lastly, the Cypriot Presidency plans to adopt Council Conclusions, which will further invite the Member States, the European Commission and other EU institutions to undertake concrete actions in ensuring public awareness on the importance of organ donation and transplantation and securing EU funds for the development of programmes in this field.

NEWS: HFE attends “Gender and Health Through Life”

On 14 June, Health First Europe attended the Copenhagen Conference 2012 “Gender and Health Through Life” organised by the European Men’s Health Forum, the European Patients Forum, the European Cancer Patient Coalition, the European Cancer Organisation and the Men’s Health Society in Denmark.  The conference brought together experts in men’s and women’s health, including Health First Europe Honorary President John Bowis, to discuss gender dimensions of healthcare policy.

Opening the two-day conference, the Minister for Gender Equality in Denmark, Mr. Manu Sareen, stated that,” looking at gender and health differences will undoubtedly benefit men, women and society” particularly because men and women have differing knowledge of healthcare and have differing healthcare problems.  Professor Alan White of Leeds University agreed, and discussed specific issues facing men including premature deaths.   Current demographic challenges faced by Europe will increase because it is predicted that by 2060 there will be nearly 24 million less men of working age due to premature deaths, according to Professor White.  He stated that “over 630,000 male deaths occur in working age (15-64) in Europe compared to 300,000 women” with nearly all of the deaths preventable.  He argued that these deaths are due to social structures and policies – not biology – and are attributable to less use of and access to healthcare services by men in addition to lifestyle issues and choices, socialization and concepts of maleness including risk-taking, bio-physiological issues and attitudes of health care professionals.  He argued that the EU needs its own health strategy to combat these challenges for men’s health.

Giving the women’s health perspective, Mrs. Maria Merce Rovira, from the European Institute of Women’s Health, also referred to the demographics of Europe and the impact of gender on healthcare.  She explained that women make up more than 2/3 of the population over 65 years of age in Europe and on average live 6 years longer than their male counterparts.  However, she emphasised that “healthy life expectancy is only 18 months longer than men.”  This is in part also due to non-biological factors such as the fact that women do double work (home and at work), earn lower salaries, have higher risks of stress from violence and depression and also suffer in greater numbers from sleeping disorders, low physical exercising due to time schedule changes and eating disorders.  Ms. Merce Rovira argued that the key to tackling these challenges for women is promoting health policies that enable older women to maintain quality of life and remain independent.

Dr. Carsten Hendriksen from Copenhagen University in Denmark called further attention to the ageing process and both the similarities and differences between men and women as they age.  He suggested that the best way for both genders to age well is to have good genes, graduate, be employed, avoid chronic diseases and have a close social network.  However, he also argued that they best strategy for increasing the healthy ageing of both genders is physical activity warning that the “sedentary lifestyle is dangerous.”

Following discussions about the proven differences between men and women in terms of health behaviours and outcomes, the afternoon session brought together keynote speakers and thought leaders to discuss whether such differences require gender-targeted health policies at both the EU and national level.  Dr. Noel Richardson from Ireland shared that driving the policy agenda is a critcial step for encouraging governments to look at gender policies in healthcare.  He said that “a more targeted and focused approach to men’s health is needed” but involving all governmental departments in the process can be very difficult.  Scott Williams, representing the US government, agreed with Dr. Richarson and added that policymakers believe that “women’s health saves money, while men’s health costs money” because women seek preventive care where men do not.  He shared that a report undertaken in the US estimated that ignoring men’s health actually cost the government $5 billion annually due to the fact that fewer men think about their health until it is too late.

Additionally, further panelists discussed how to approach gender in healthcare policy and make facilitate policy changes.   Isabel Yordi Aguirre from the WHO Regional Office for Europe suggested that expanding the idea of health is of great importance in terms of minimizing health inequalities and integrating the social and gender approaches to all policy.  Additionally, HFE Honorary President John Bowis gave the political perspective for achieving more holistic healthcare policy suggesting that the key is to “get the attention of politicians” so that “health and gender health is in all policies.”

Overall, the conference began an important debate about how policymakers and governments may be able to achieve better health outcomes for both genders by considering how the genders differ in their use of and access to healthcare.  Participants agreed that understanding the needs, interests and challenges in health for both men and women could provide a foundation for more holistic and effective health policy.

NEWS: Restructuring health systems: How to promote health in times of austerity?

On 6 June 2012, Health First Europe attended the annual conference of the European Public Health Alliance which focused on how to promote health in times of financial crisis.  The conference brought together representatives from various international and European organisations to discuss not only the impacts of austerity on health systems, but also solutions to the current challenges presented by ageing populations, shortages of healthcare professionals and declines in social and healthcare spending.

The event featured a keynote speech by Zsuzsanna Jakab, WHO Regional Director for Europe, who highlighted the importance of making the economic argument for promoting health in times of austerity. She discussed how keeping the population healthier provides enormous economic benefits for Member States.  For example, she cited that a 1% increase in life expectancy translates into a 6% increase in GDP for a nation.  She proposed that in order to ensure health is still a priority in times of austerity, governments should avoid across the board budgets cuts, target public expenditures better to the poor and vulnerable,  seek efficiency gains through wiser use of medicines and technologies and use the crisis to introduce long overdue reforms.

Discussing the cost of the economic crisis for populations and health, speakers described some of the significant issues being faced by individuals, professionals and systems.  Maria Nyman, Director of Mental Health Europe, pointed out the sharp increases in mental health related problems due to fears about redundancy and reductions in benefits.  David Stuckler, Social Epidemiologist and Lecturer at Cambridge University, provided examples of costs to the system during austerity such as a 20% increase in diagnoses of depression in Spain and a 52% increase in HIV in Greece due to sharing of needles by drug users.  He suggested that “cutting health budgets in times of austerity is madness” as it only creates more health problems for the society.  Paul de Raeve, Secretary General for the European Federation of Nurses, reminded participants of the impact of cuts on nurses – 92% of which are women.  Mr. de Raeve highlighted that the decreases in recruitment and retention of nurses due to declining salaries will significantly impact the quality and safety of care throughout Europe.

Changing the focus from the challenges of the crisis to potential solutions, Pascal Garel, Chief Executive at the European Hospital and Healthcare Federation (HOPE), reminded participants that “There is no one solution to austerity measures – we are too different.”  The differing revenues of Member States and the various contributions of public money to healthcare were highlighted by many panelists as a consideration when determining potential solutions.  However, Christoph Schwierz, Policy Analyst at the Economist unit in DG Economic and Financial Affairs, as well as Valerie Moran, Health Analyst from the OECD, stressed the fact that health expenditures will continue to rise faster than GDP creating considerable future challenges for health systems.  Pervenche Béres, Member of the European Parliament (S&D, France) underlined the fact that even in times of austerity, we need to remember that human dignity must be maintained for all and the most vulnerable populations must not be forgotten.

The question of whether the financial crisis will be an impetus for change was also raised at the event.  Deputy Director of the Fiscal Affairs Department at the International Monetary Fund, Sanjeev Gupta, presented alarming statistics showing growth to debt ratios of countries throughout the world in addition to showcasing some viable solutions to contain public health spending growth.  He suggested that options could include: 1) budget caps (Italy, Japan and Sweden); 2) greater sub-national government involvement; 3) greater competition and choice (Germany and Japan) – insurance and providers; 4) greater reliance on private financing, especially on complimentary healthcare outside public package (Australia, Canada, France); 5) restricting supply of health inputs/outputs (doctors/beds, etc.).  He further declared that solutions are specific to each country and some reforms are more beneficial than others.  Following on Mr. Gupta’s presentation, Josep Figueras, Director of the European Observatory on Health Systems and Policies at the WHO European Centre on Health Policy, stated that “this is the time to be radical” and proposed that reforms should allow for patients to have more choice in order to reduce costs.

Overall, the event clearly showed the impact the financial crisis is having on health systems and individual patients. Though solutions exist for creating sustainable healthcare systems during times of austerity, the most important issue is for governments is to make healthcare a priority.  Economic evidence showing the value of health and healthcare for societies exists, but convincing governments to change healthcare systems, remains the ultimate challenge.

NEWS: Health First Europe attends the debate on State of Men’s Health in Europe

On 26 April, Health First Europe attended a lunch debate on men’s health in Europe organised by the Premier League Network at the European Parliament. The European Commission recently launched a major report entitled “The State of Men’s Health in Europe” which identified a number of very important issues about men’s health – with significant implications for health, social care and the economy – in society. Chaired by MEP Linda McAvan (S&D, UK), the event called for increasing knowledge about men’s health issues with the support of the European Commission, the European Parliament, academics and other stakeholders such as football clubs.

Regarding the current situation of men’s health, MEP Linda McAvan remarked that men in the United Kingdom are at a far greater risk than women of developing, and dying from, chronic diseases. She remarked that the situation is particularly alarming in the UK and that adequate measures must be taken to reduce the incidence of chronic diseases in men.

The Principal Adviser at the Directorate General for Health and Consumers, Isabel de la Mata, highlighted that knowledge exists regarding the differing behaviours of men about their health. Showing important differences in terms of interest in health between women and men, Ms. de la Mata suggested that the gender equity aspect has to be improved. She discussed how many men do not go to doctor because they are unsure of know how to deal with the healthcare system. Ms. De la Mata also declared that this is why Europe’s men need their own health strategy.  She underlined that greater attention on social conditions and economic circumstances could prevent many of the male deaths currently caused by chronic diseases.

Professor Alan White, Leeds Metropolitan University and lead author of the European Commission Report “The State of Men’s Health in Europe“, argued two main points regarding the current situation for men: 1) a high level of morbidity in men is preventable by better addressing problems through concrete actions; and 2) the necessity of improving the physical and mental health of men to ensure the economic and social well – being of the entire European Community.  Professor White explained that various factors can explain men’s health problems including lifestyle issues and choices, social determinants of health, socialization and concepts of “maleness” including risk-taking, usage of and access to services, bio-physiological issues and the attitude of health care professionals.

Representing around 36 experts across Europe including working groups, managing groups and abroad reference groups, the Premier League Network works on a broad range of health conditions such as obesity, cancer, etc. This Network aims to develop projects with both the cooperation and involvement of men to integrate them in diverse activities said Simon Morgan, Head of Community Development Premier League and former Captain of Fulham Football Club. For him, “the power of football allows changes to come true“. Mr. Morgan discussed  how a football club can help men, through sport, to learn about prevention of disease and implement new social models.

Participants agreed that it is key to involve men as much as possible in their own health strategy. Policymakers and society in general have to encourage young males struggling with social and economic health for men, exist in schools and the workplace.

NEWS: Health First Europe urges EU policymakers to do more to protect patients

EU policymakers should strengthen the standards for patient safety in Member State healthcare systems, adopt measurable improvement targets for Member States on patient safety, and develop a European strategy to combat the incidence of healthcare associated infections, according to Health First Europe’s Recommendations on Patient Safety launched today. The publication provides concrete, targeted and researched proposals for Member States reflecting the areas of patient safety outlined by the Council in 2009.

Highlighting key issues such as the need for internationally harmonised data on adverse events and healthcare associated infections and public reporting on the state of patient safety within healthcare organisations, HFE’s recommendations focus on areas where further action is necessary three years after the adoption of the Council Recommendations on patient safety including the prevention and control of healthcare associated infections (2009). HFE’s recommendations target areas where the EU can provide added value and advise Member States with regards to how to improve patient safety in their healthcare systems.

Under the Patronage of MEP Christofer Fjellner, (EPP, Sweden), Health First Europe’s Task Force on Patient Safety produced the recommendations alongside the ongoing review by the European Commission of the Member States’ implementation of the Council Recommendations on patient safety including the prevention and control of healthcare associated infections (2009). Comprised of representatives from patient groups, healthcare professionals, hospitals, academics and industry, the recommendations of the Task Force take account of the various constituencies involved in protecting the safety of patients in healthcare settings.

MEP Fjellner expressed the importance of HFE’s work stating:

Health First Europe’s recommendations promote specific proposals where the EU can and should play a role in enhancing patient safety in healthcare systems throughout Europe.  The safety of patients is the most crucial element of quality of care and Member States must be supported to prioritise patient safety in healthcare policy.”

Health First Europe Honorary President and Chair of the Task Force John Bowis added:

Direct and consistent emphasis must be placed on patient safety in healthcare settings throughout the EU. HFE’s recommendations for EU policymakers to create EU minimum standards, measurable improvement targets for Member States and an EU HCAI strategy, support the objective of all policymakers in health: to protect patients.”

Health First Europe’s recommendations on both general patient safety and healthcare-associated infections will be debated by policymakers from the European Commission, European Parliament, Council and European Centre for Disease Control during the Health First Europe Open Forum Debate: Road Map for the Future of Patient Safety on 24 April 2012 in the European Parliament.

Click here to read Health First Europe’s Recommendations on Patient Safety and Healthcare Associated Infections.

Participants in the HFE Task Force on patient safety include: International Association of Patients Organisations (IAPO); European Health Telematics Association (EHTEL); European Medical Association (EMA); European Union of Private Hospitals (UEHP); International Diabetes Federation Europe (IDF- Europe); European Federation of Public Service Employees Union (Eurofedop); Medical Technology Group; EUCOMED.

NEWS: Health First Europe attends “Innovation Partnership on Active and Healthy Ageing: From Plan to Action”

3 April 2012 – Health First Europe attended the European Commission’s conference on the European Innovation Partnership (EIP) on Active and Healthy Ageing (AHA) which looked to launch the Partnership from the planning stage to the implementation stage.  With the political support and participation of three European Commissioners including Neelie Kroes, John Dalli and Laszlo Andor, the conference highlighted the progress made over the last year towards reaching the EU 2020 goal of two additional healthy life years for European citizens by 2020.  Following the Commission’s Communication in February 2012, the conference brought together stakeholders from all areas of health to inspire implementation of the Strategic Implementation Plan adopted by the Commission for taking forward priority action areas in integrated care and healthy ageing throughout the EU.

Opening the conference, Vice-President and Digital Agenda Commissioner Neelie Kroes championed the Commission’s new way of working through public/private partnerships and suggested that the demographic changes Europe is facing cannot be solved by thinking small.  She stated, “We need a whole new way of operating, to turn this into an opportunity, to turn costs into investments. Smart innovation with ICT can help.” Following Commissioner Kroes, Commissioner for Health and Consumer Affairs, John Dalli, also declared that smart investment is the key to ensuring sustainable healthcare services throughout Europe.  He further suggested that a partnership approach is essential stating, “Only by working together, by pooling valuable knowledge and resources can we take significant steps for care services.”  Lastly, Commissioner for Employment, Social Affairs and Inclusion, Lazlo Andor, connected the aims of the EIP on AHA to employment and social inclusion goals for Europe.  He explained that the only way to ensure people are working is to ensure they are healthy. He stated that ageing will transform Europe – either for better or worse and declared that only by putting social innovation at the core of public policy, will this transformation be positive.

Following the opening of the conference by the Commissioners, the first session focused on the Strategic Implementation Plan (SIP) and included panelists from various organisations which participated in the Steering Committee and were responsible for the development of the SIP.  As the SIP begins to be implemented by stakeholders throughout the EU, representatives such as the European Patients’ Forum, the AGE Platform, Philips, Danone, the Danish Ministry of Finance, Italian Medicines Agency and Capricorn Venture Partners discussed how they envision committing to the partnership and how it will continue to develop over the coming year.  In particular, Nicola Bedlington of the European Patients’ Forum stressed that the partnership “must have at its’ heart the human dimension – the rights and needs of older patients.”  The various stakeholders on the panel showcased how partnerships have already formed for implementing projects on a larger scale in order to reach more patients, provide better outcomes, and achieve greater efficiency utilising a partnership approach.

The event broke into parallel sessions for participants to learn more about ongoing work which underwrites many of the action areas and goals of the EIP on AHA. In the integrated care session, Ministers from Northern Ireland and the Basque Region of Spain discussed how their Ministries are using innovative organisational tools to produce integrated care models which benefit patients and also provide cost savings to the system.  George Crooks, Clinical Director/Chief Operating Officer for NHS 24 in Scotland highlighted that today’s systems “have to encourage patients to think of themselves as deliverers of their own care” and suggested that co-production of care must be part of an integrated health system.

Ending the conference will practical information about how to participate in the EIP on AHA, Maria Iglesia-Gomez, Head of Unit, Innovation for Health and Consumers at DG SANCO, announced the launch of the marketplace for ideas which will assist stakeholders in finding partners to undertake projects which meet the criteria laid out in the SIP.  She emphasised the various avenues for stakeholder participation in addition to the marketplace for ideas, including the invitations for commitment and reference sites.  All three aspects allow for stakeholders to participate in ways which are conducive to their ongoing work on active and healthy ageing.  Paul Timmers, Director, ICT for Addressing Societal Challenges at DG INFSO, added further information about what stakeholders can expect to get out of the partnership including facilitation and assistance in overcoming barriers to the innovation process, achieving scalable results, exchanging of good practice and learning from one another, championing good and proven models, products and other innovative solutions and being an opinion leader on innovation for active and healthy ageing.

Overall, the conference showcased a new and successful way of working in the EU – the public/private partnership.  Having put emphasis on aligning funding instruments, stakeholders should find it easier to participate in developing and replicating successful projects in active and healthy ageing which benefit health systems, healthcare professionals, industry and, most of all patients.  The partnership will continue to develop over the coming months and the Commission expects to bring all interested stakeholders together again before the end of the year to review the progress achieved and evaluate how much further stakeholders can do together.

NEWS: Health First Europe attends Stockholm Network meeting on “A new vision for the future of healthcare”

On 28 March, the Stockholm Network invited scientists, academics and professionals to share discussions about the current challenges and obstacles in the health sector and to bring ideas to the table to build together a new vision for the future of the healthcare systems in Europe. To widen the debate, the panellists presented the various points of view of different stakeholders: patients with new behaviours and expectations; health professionals with new skills and competencies; and finally, industry with new challenges and interests to move towards a more innovative, safe and efficient health care sector.

According to Professor Paul Corrigan CBE, the healthcare system has to cope with new sources of value where the patient is a key player (or co-producer) to involve. As regards the increased demand and expectations for healthcare, static resources mean there is significant need for innovation to provide better health outcomes and create new value in healthcare. In developed countries there is about a 4% increase in annual demand for healthcare. In addition, 66% of the expenditure is on patients with long-term conditions. Professor Corrigan suggested that the answer seems to be very simple in theory: in order to increase new sources of value, the system needs to increase the amount of creators of value including increasing the amount of nurses, doctors and/or promoting the substitution of medical products (e.g. generic medicines).

As regards the patient’s potentiality, the self-management of their own health allows financial opportunities such as a lower use of emergency hospital care. Moreover, better self-management could be developed if the health service input was aimed at improving the self-management itself. However, at the moment, the health service is not yet ready for this tranformation. Besides a further empowerment of patients, Professor Corrigan added that healthcare sector has to make progress in other fields at the same time: accessibility to information and treatments, competition and sustainability in healthcare services, more integrated systems and services.

From a health professional’s point of view, the panelist suggested that these changes are mostly located in three domains. First, the patient-doctor relationship is evolving in such way that we can observe a deeper knowledge gap. Dr. Alphonse Crespo, a Swiss orthopaedic surgeon, stated that the trend should go towards an equal-equal partnership to establish more confidence and collaboration between the doctor and his/her patient. Secondly, all healthcare workers have to adapt to, and work in, a new institutional environment which ask is for more and more precisions in treatments and surgery and which often sees treatments become obsolete quickly (i.e. new evidence-based medicines etc.).

To achieve all these changes in structures, panellists declared that innovation must be seen as a long-term investment rather than a cost. Training for health workers, more adapted and integrated services and innovation is necessary to support future healthcare delivery. In addition, the societal perception including policy-makers, industry and citizens must also be addressed in order to facilitate these changes and extend potentialities to become concrete outcomes for the healthcare sector.

NEWS: Health First Europe attends EP Interest Group on Rheumatic and Musculoskeletal Diseases Meeting

NEWS: Health First Europe attended the 8th meeting of the European Parliament Interest Group on Rheumatic and Musculoskeletal Diseases (RMDs) which was held on 20 March at the European Parliament. This EP Interest Group, in line with the Council Conclusions of 2010 on chronic diseases, aims to develop an EU strategy on chronic diseases generally, and to discuss the EU reflection on chronic diseases in particular. Chaired by MEP Edite Estrela (S&D, Portugal) and co-chaired by Antonyia Parvanova (ALDE, Bulgaria), this meeting brought together representatives from the European Commission, experts and associations to launch a further discussion with key stakeholders in the area of chronic diseases and related issues.

According to Michael Huebel, Head of Unit Health Determinants, DG Health and Consumers, challenges such as cutting health budgets, better addressing and preventing illnesses are all part of the chronic disease issue. Across the European institutions and national authorities, chronic disease remains a key debate and some positive developments can be seen on the horizon. Indeed, a discussion paper on the EU reflection process on chronic diseases has been prepared to guide stakeholders in preparing an initial position as part of a reflection process on the issue led by the European Commission and EU Member States. The aim is to identify issues, gaps and suggestions for action to improve current policies and activities on chronic diseases, both at national and EU levels. Under the Belgian Presidency of the European Union, the Council Conclusions on Chronic Diseases were adopted in 2010 by focusing on four chapters: social and health issues, long-term care, disease management and research.

Attending the meeting, the Danish Presidency of the European Union reminded stakeholders of the the Danish priority in the chronic disease debate- prevent the burden of chronic conditions by promoting an active self-management and a longer active and healthy ageing life.

From a RMDs perspective, the reflection process on chronic diseases aims to optimise the response to the challenges of chronic diseases and cooperation between Member States in four areas: health promotion and prevention, healthcare, research and comparable information. Priorities should be given to major initiatives including actions addressing main societal challenges (e.g. healthy ageing, mobility); groups of diseases representing a major burden on individuals and societies (not only focus on mortality rates, but also on morbidity, co-morbidity, disability and social and economic impact); expand research activities, basic, clinical and transnational, in chronic diseases; and achieve a balance between primary prevention, secondary prevention and treatment of chronic diseases. Keeping people longer at work (one of the main challenges the EU is facing); to adopt a specific RMDs strategy with an action plan for a significant economy impact.

As regards the proliferation of strategies at the EU level, those in attendance suggested that policy-makers have to adopt more sensible, specific actions to address chronic diseases with an efficient prevention system by adding in components of analysis and good practices and keeping cross- sector collaboration in this area. Moreover, a positive attitude from MEPs and the European Commission will ensure the success towards an EU strategy on RMDs.