(European Hospital and Healthcare Federation)
The past year has been extremely eventful in the field of healthcare policy, further complicating an already complex situation. But slow progress at intergovernmental level has not prevented the development of major health initiatives. The European Hospital and Healthcare Federation (HOPE) is keeping pace with the key issues and responding to the demands of different EU institutions, cultures and strategies.
The EU is based on the freedom of movement for goods, services, people and capital, and over the years this has influenced the healthcare picture. In every EU country, health is a major (and growing) component of the economy and thereby directly connected to market forces. Several recent EU initiatives focusing on patient information and interoperability have approached healthcare from this angle.
In 2006, HOPE was invited to join the EU General Enterprise Directorate’s pharmaceutical forum, which was set up in 2005 by Commissioners Verheugen (Enterprise) and Kyprianou (Health) to bring together ministers and stakeholders and provide a high-level political platform on which to address issues surrounding the competitiveness of the pharmaceutical industry. The forum has moved on from its original brief of drug quality and treatment access to include provision of patient information on authorised medicines.
HOPE was also asked to join the Information Society and Media Directorate eHealth stakeholders’ group to support and enhance work on e-health interoperability over the next two years. Again, the economic ramifications of a wider market have been driving work on interoperability in patient records, patient and professional identifiers and an emergency minimum data set.
Finally, the major consultation on health services proposed by the Health and Consumer Protection Directorate may be well received, coming after years of European Court of Justice judgements in which it was confirmed that healthcare is a service like any other.
On the other hand, the EU is also seeking social cohesion and regional development, where the main driver is cooperation not competition. In this context, new EU members are settling into the enlarged Europe with fewer resources – particularly in the field of healthcare. They need support, stability and a vision.
There is little doubt that the four key freedoms of the EU are out of alignment with its goals of later years. This creates uncertainty, particularly in view of the fact that healthcare responsibilities are present at national, regional and even local levels. The key is to find the right balance.
There is clearly space for European cooperation. Recent consultations by the Health and Consumer Protection Directorate on healthcare-associated infections, mental health, organ donation and transplantation policy options at EU level are showing the way forward for collaboration. The Research Directorate is funding an increasing number of innovative projects, such as the MARQuIS project. Run by a consortium of European accreditation bodies and academic research units, MARQuIS seeks to: identify, compare and assess the adoption by Member States of different quality strategies; identify and synthesise the quality requirements for cross-border patients; and show how in some states hospitals have applied national quality strategies and met the defined requirements of these patients.
Finally, the core issue for the coming years is undoubtedly patient safety. This is a growing concern for patients and citizens, and it now forms part of the strategy of the European Commission and is high on the health agenda of most Member States. Let’s hope that 2008 will bring concrete improvements. HOPE will work to achieve them.