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Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones A EUROPE OF PATIENTS? EUROPEAN SYSTEMS IN A CHANGING ENVIRONMENT POLITICAL.

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Presentation on theme: "Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones A EUROPE OF PATIENTS? EUROPEAN SYSTEMS IN A CHANGING ENVIRONMENT POLITICAL."— Presentation transcript:

1 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones A EUROPE OF PATIENTS? EUROPEAN SYSTEMS IN A CHANGING ENVIRONMENT POLITICAL DIMENSION SPAIN

2 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones PREMISES Exclusive competence of MS. SEM: freedom of movement: persons, capital, goods and services. Pillar of the welfare state. Challenge: Consumer? Citizen?. ECJ.

3 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones  Universality  Equity  Solidarity GENERAL PRINCIPLES  Universal coverage  Wide benefits  Public financing  Private sector supplementary MAINCHARACTERISTICS EUROPEAN HEALTH SYSTEMS

4 Dirección General de Planificación Sanitaria, Sistemas de Información y PrestacionesMINIMUMMAXIMUM % GDP HEALTH EXPENDITURE EUROPEAN HEALTH SYSTEMS6,0 4,7 56,3 8,6 6,5 75,5 10,3 7,8 92,4 Public expenditure Total expenditure Public/Total

5 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones OBJECTIVES Services closer Cost containment Increase citizens’ satisfaction Improve quality REFORMS EUROPEAN HEALTH SYSTEMS

6 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones COST CONTAINMENT Slow increase Achieved Increasing more than Economy REFORMS EUROPEAN HEALTH SYSTEMS

7 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones CLOSER TO THE CITIZEN Devolution/decentralisation REFORMS EUROPEAN HEALTH SYSTEMS

8 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones IMPROVE QUALITY Evaluation, accreditation, homologation, recertification Health Professionals Institutions REFORMS EUROPEAN HEALTH SYSTEMS

9 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones SATISFACTION? REFORMS EUROPEAN HEALTH SYSTEMS

10 Dirección General de Planificación Sanitaria, Sistemas de Información y PrestacionesSATISFACTION EUROPEAN HEALTH SYSTEMS 0 10 20 30 40 50 60 70 80 90 100 010002000300040005000 $ p.c. PPP % Pob. satisfecha I E IRL RU AUS F ASUE B DN FIN H LUX

11 Dirección General de Planificación Sanitaria, Sistemas de Información y PrestacionesSATISFACTION EUROPEAN HEALTH SYSTEMS -20 -10 0 10 20 -5 5 152535 Incremento gasto público p.c. 1995-97 Incremento satisfacción 1996-98 I E IRL RU AUS F A GR B DN POR H LUX

12 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones ASPECTS PUBLIC HEALTH CARE SECTOR EUROPEAN HEALTH SYSTEMS Financing: Solidarity Citizen’s rights Provision: Guarantee of Quality-safety Sustainability and cost control

13 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones ACTIONS Guarantee of quality and safety Health care rights of European citizens Compensation systems Actions to facilitate the movement MOVEMENT OF PATIENTS EUROPE OF HEALTH

14 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones Health affair Not a problem, but an opportunity Paradoxe: to protect, regulate SPANISH VIEW EUROPE OF HEALTH

15 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones Politicians, not Courts. Health, not Social Affairs The Health Ministers wish to have a say in the matters being debated which affect health and health care SPANISH VIEW EUROPE OF HEALTH WHICH ONE?

16 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones ADDED VALUE Borders Centers of excellence Waiting lists Long stays MOVEMENT OF PATIENTS EUROPE OF HEALTH

17 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones Circulation of patients: Methods   The relevance of arrangements made under Regulation 1408/71 in helping to address the issue, and whether improvements could be made which would be advantageous   The kind of information needed in order to help European citizens to improve their choice   The possibilities for studying quality at a European level, and in what way to ensure added value   The extent to which agreements (eg bilateral, multilateral, or Europe-wide, etc.) over a basic package of health care services are essential to facilitate movement of people around Europe   Health card

18 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones Circulation of patients: Objectives  To formalise the coincidences of the Ministers of Health on the important topic of Circulation of Patients and the Impact of EU on the Health sector.  To suggest to the appropriate EU institutions to launch a debate that allows the Health responsible of the EU member states to have a voice on matters that influence the performance of the health systems.

19 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones Circulation of patients: Objectives  To carry out further detailed work on the added value that might be gained from looking at certain health issues, identified by Health Ministers in Malaga, from a perspective that goes beyond national

20 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones Foreign residents in Spain, 2000. SPAIN

21 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones E-FORMS SPAIN

22 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones THE FUTURE Distribution of competences among UE and MS White Paper

23 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones CONCLUSIONS I: Centres of excellence Rare and exceptional disorders. Knowledge centres and training centres (high tech or specific skills). Main purpose: to treat patients. Catalogue of existing facilities and their capacity, resources, competence and medical results Real institutions accepting patients from all over Europe Virtual working through networking Mobile teams moving to different parts of Europe Joint ventures subsidiarity

24 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones CONCLUSIONS II: Spare capacity Different procedures Quality of treatment Not displace local patients Not distabilize national security system Information exchanges: processes, rights, experiences Moving the patients or moving the spare capacity

25 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones CONCLUSIONS III: Neighbouring regions Europe without borders Pragmatic procedures Euregios Standard guidelines for projects Provide patients and other actors with information Use of posibilities of 1408/71 Quality standards and regulation for all patients Coordinate use of national health insurance cards

26 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones CONCLUSIONS IV: long-term visits European health card Basic health care benefits package Universal quality standards and indicators Guides of clinical practice Systems of certification European alert system Exchange of best practices Improve access: health care resources in touristic planning, clarify E-forms, solve language barriers, European-wide information networks, to protocolize all the information

27 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones HEALTH COUNCIL emerging interaction between health systems within the European Union particularly as a result of the free movement of citizens, and their desire to have access to high quality health respect the responsibilities of the Member States for the organisation and delivery of health services and medical care there is added value in examining certain health issues from a perspective that goes beyond national borders the delivery of care shall be another main concern together with the administrative issues

28 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones HEALTH COUNCIL bilateral or regional arrangements can play important role patient mobility, especially concerned with tourism or long-term residence abroad: need to exchange clinical and other information, in order to ensure proper follow-up and continuity of care benefit of reference centres, in order to facilitate the most effective treatment for those diseases requiring specialist interventions the new programme of Community action in the field of public health, the new research and telematics programmes provide a framework, in particular aspects relating to information and exchanges of experience

29 Dirección General de Planificación Sanitaria, Sistemas de Información y Prestaciones HEALTH COUNCIL need to strengthen co-operation in order to promote the greatest opportunities for access to health care of high quality while maintaining the financial sustainability of healthcare systems in the European Union high level process of reflection will return to this issue at the next meeting of the Health Council

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