Transcript Robert Madelin Presentation - Royal College of Physicians

Quality of Healthcare
in Europe
Royal College of Physicians
London Council Chamber
19 January 2009
Robert Madelin
Director General for
Health and Consumers
European Commission
Quality challenges
Multitude of definitions
Differences in scope of quality action across Europe
Different levels of political commitment
Significant disparities in quality strategies
Lack of clear and transparent information
Lack of comparable process and outcome data
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European
Union
today
27 countries
493 million citizens
Health sector:
• Total expenditure on health: 8.2% of GDP (OECD 2006)
• Employer for 10% of the EU workforce (with 70% of
budget allocated to salaries and other charges)
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But European Union today =
major differences between MS …
… in health status
Healthy Life Years
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
EU25
BE
CZ
DK
DE
GR
EE
ES
FR
IE
All the data 2006 except IT and EU-25 2005
IT
CY
LV
LT
LU
HU
MT
NL
AT
PL
PT
SI
SK
FI
SW
UK
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But European Union today =
major differences between MS …
… in health status
Standardised death rate by 100 000 inhabitants
Source: EUROSTAT
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But European Union today =
major differences between MS …
Cervix uteri cancer
Breast cancer
… in effectiveness of healthcare systems
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Adults diagnosed 1990-1994.
Source: EUROCARE-3
But European Union today =
major differences between MS …
… in effectiveness of healthcare systems
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Source: EC Report on Implementation of the Council Recommendation of 2 December 2003 on cancer screening
Role of the EU:
Improving public health
Community action in the field of public health shall
fully respect the responsibilities of the Member
States for the organisation and delivery of health
services and medical care.
The Community shall encourage cooperation
between the Member States ---- and ---- lend
support to their action.
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Role of the EU:
Abolition of obstacles to
the free movement of
goods, persons, services
and capital
In the health area:
Free movement of health profesionals
Free movement of patients
Free movement of goods (pharmaceutical products)
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Role of the EU:
Contributing to the economic development
and sustainability of health systems
(Lisbon Strategy for Growth and Jobs)
Sustainability of health systems is one of
three priorities of the current Czech
Presidency
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Common values and principles
of EU Member States (2006)
universality
access to good quality healthcare
equity
solidarity
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Together for Health (2007)
Strategic objective 3: Supporting dynamic
health systems and new technologies
Commission action: Community framework
for safe, high quality and efficient health
services
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Geographica
l and
financial
access to
care
Information
for patients
Patientcentered
care
Coordination
and continuity
of care
Good quality healthcare
for patients
Attention
to natural
caregivers
Comparable
health data
Well trained
professionals
Effective
healthcare
system
Research
Safety and quality
standards
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Europe for Patients
to inform what is
done to improve
healthcare for all in
Europe
to encourage sharing
information by
opening the webpage
to citizen
contribution
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Current initiatives I
Proposal for a Directive on the
application of patients' rights in
the cross-border healthcare.
(Adopted 2 July 2008)
Green paper on the
European Workforce for
Health
(adopted 10 Dec 08)
Commission Communication and
Council Recommendation on a European
action in the field of rare diseases
(Adopted 11 November 2008)
Action against cancer:
European Platform and Report
on implementation of the
Cancer Screening
Recommendation of 2003
(Done 22 December 2008)
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Current initiatives II
Commission Communication
and Council Recommendation
on patient safety including
the prevention and control of HCAI
(adopted 15 Dec 08)
Proposal for a directive setting
standards of quality and safety
of human organs intended
for transplantation
(adopted 8 Dec 2008)
Prudent use of antibiotics
2nd report from the Commission
on the implementation of the Council
recommendation. (Due 2009)
European Antibiotic Awareness Day,
Council recommendation
18 November 2008. Managed by ECDC
on cross-border aspects of
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childhood immunisation (due 2009)
Patients' Rights I
Aims of proposed directive:
Helping patients to exercise their right to access
cross-border healthcare and to be reimbursed.
Ensuring safe and high quality cross-border
healthcare.
Fostering cooperation between EU healthcare
systems where useful.
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Patients' Rights II
Major improvement for individual patients
No significant impact on national healthcare
systems
A number of safeguards to ensure fair, equitable
and sustainable system
European cooperation helping to improve
quality and safety for all in the long-term
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Workforce I
• Challenges facing European health & care
systems – ageing population; ageing workforce;
• Threats to health
• New technology
• Ever-rising expectations and rising costs
• Health services labour intensive – regional
shortages of personnel
• Responding to challenges requires highquality health workforce throughout EU
without impacting on developing countries
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Workforce II
Green Paper published on 10 December
2008
Public consultation until end March 2009
Responses will inform consideration of
what EU can do to support Member States
in tackling the health workforce
challenges facing European health
systems now and in the future
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Patient Safety I
Overarching approach to
patient safety:
Communication and proposal for a
Council Recommendation on patient
safety,
including prevention and control of
healthcare-associated infections.
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Patient Safety II
Develop national patient safety policies and
programmes.
Empower and inform citizens and patients.
Establish or strengthen reporting and learning
systems on adverse events.
Include patient safety in the education and
training of health professionals.
Develop and promote research on patient safety.
Classify, codify and measure patient safety.
Share knowledge, experience and best practice at
European level.
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Patient Safety III
What next?
The proposal for a Council Recommendation is transmitted to
the Council for discussion in CZ Presidency.
Adoption 2009
Member States to report within 2 years to the Commission on
how they implement the Council Recommendation. One year
later, the Commission will produce an implementation report
to the Council.
On HCAI, the ECDC will assist Member States, e.g. by developing
guidance, by helping to set up or further strengthen surveillance
systems.
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Other EC initiatives
Standards of quality and safety for the collection,
testing, processing, storage and distribution of
human blood and blood components
Standards of quality and safety for the donation,
procurement, testing, processing, preservation,
storage and distribution of human tissues and cells
OECD project, co-funded by EU, on quality
indicators of health care
The Open Method of Coordination
Pharmaceuticals package
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Common reflection of MS and EC
Working Party on Public Health at Senior Level met on
9 December to discuss added value of possible EU
action in healthcare quality
Member States agree:
that quality is an important wide-ranging issue; key to
improving health systems, linked to patient safety,
technology assessment
to take forward work at EU level e.g. to exchange good
practice/set indicators to compare and measure
progress
to develop specific action using Commission’s working
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group on patient safety and quality
Thank You!
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