1. EUROPEAN HEALTH FORUM – BAD GASTEIN PARALLEL FORUM A 1 “HEALTH CHALLENGES IN THE ENLARGED EUROPE” “THE ROLE OF PATIENTS IN PUBLIC HEALTH AND HEALTH SERVICES” BY: RODNEY ELGIE, PRESIDENT EUROPEAN PATIENTS FORUM

2. Health of greatest importance to all citizens Face three major challenges today Firstly Declining birth rate = depleted future work force Expanding ageing population = need for greater resources Cost effective issues for the elderly

3. Secondly Greater public demand for health care – increased expectations Developments in innovative technology Patients represent the greatest challenge to any healthcare system Patients have responsibility to use system efficiently and effectively

4. Thirdly Development following dismantling of communist regime Agricultural revolution, industrial revolution, technological revolution Rapid rise in suicides between 1990 and 1995 Migration of rural communities to urban developments Overcrowding, homelessness, pressure on health sevices

5. Areas of responsibility Preventative measures Optimal use of services Reduced wastage Requires awareness, education, information and knowledge

6. Patients have responsibility to set good examples Many citizens will be patients of the future Move away from diagnose and treat to predict and prevent Value of preventative measures – lifestyle and screening Should lifestyle be a barrier to treatment

7. The patients educational role Awareness and education = more effective treatment Better diagnosis, less mis, non and under-diagnosis The UK experience with diabetes The European experience with mental health The rule of halves and its cost implications

8. Require today’s citizens to stay healthy for longer Issues of diet, exercise and self management of chronic conditions Balance of activity and rest – workplace may be dangerous Information from governments not enough and limited effect Patients can provide hard-hitting messages and examples Resources not used as effectively as possible = increased rationing

9. Value and usefulness of patient surveys Reveal problems and successes at grass roots Are experts in their disease – know what works well and not so well Aware of problems of living with a condition Health professionals may assume different priorities Leads to less effective treatment and incorrect prioritisation

10. Inappropriate use = wastage and less effective or fewer available treatment for others UK experience in accident and emergency Issues of compliance and concordance Health professionals and patients to blamed in equal measure Need to promote the partnership approach

11. Good health viewed as an investment : not a cost Bad or poor health results in infinitely greater cost Fear of explosion in demand for prescription drugs Fear of loss of health experts in new member states Need for level playing field across Europe for all citizens In fields of accessibility, availability and quality

12. Need to work on eradication of more diseases in EU Greater patient mobility Improved match between needs and resources Enhanced communication – share good practices, avoid wheel reinvention Better patient information on treatments

13. Conclusions Use patients as effective educational tool to all citizens Value of early and correct diagnosis to improve outcomes Reduction in wastage – doing more with same resources Quality of life important – we all want best services Must learn from the past and not continuously repeat mistakes Best economic policy – keep citizens healthy for longer Otherwise death is most economic solution