Brussels, 09/11/2005 (Agence Europe) - At the informal meeting held in North London on 20 and 21 October, the healthcare ministers of the European Union held a debate devoted to the subject of mobility and patient safety, a team which is close to the heart of the UK Presidency but also to that of patient associations, as shown by the statement made in Brussels on Tuesday 8 November by Mel Read on a health-care strategy centred on the patient. "We are pleading in favour of improved access to healthcare, which can be achieved via a substantial investment on the part of the EU in the form of an appropriate budgetary allocation, fair cross-border access for EU patients and better use of the collective expertise and resources of the EU", said the former British member of the European Parliament and honorary president of Health First Europe, who was speaking at the annual Open Health Forum organised by the European Commission.
"Between the meeting in Malaga and the one in London, there has been a real change in atmosphere", a Commission staff member observed, referring to the two ministerial meetings, the first having been held in February 2002 under the Spanish Presidency. At the time, the patient was just coming into the debate of the ministers further to several rulings by the Court of Justice, not really having been invited. Three high-level meetings were arranged- with the interested ministers taking part in 2003- and a group of high-level civil servants will be set up, with responsibility for determining the values shared by the various health-care systems and pragmatically to seek possibilities to move forward the idea of taking patient mobility into account, without attacking the balance of health care systems and their national specific characteristics. The progress made in three years has been considerable, as evinced by the fact that at the end of October, several ministers were able to raise the need for a legal framework on patient mobility, without being shouted down by others opposing the idea. Although the United Kingdom and Germany would, essentially, like to exclude health care services from the services directive, Belgium, Sweden and Portugal have clearly called for specific rules to be drawn up for healthcare services as part of a sectorial directive. France would like to bring in a small change to this proposal: it would like a directive covering social services of general interest.
For its part, the Commission is continuing its efforts to develop practical cooperation. This will focus on (1) the promotion of cross-border cooperation in health care matters, (2) the creation of European reference centres for the treatment of certain diseases (it is hoped that the first pilot project will see the light of day in 2006) and (3) patient safety. Somewhat paradoxically, even the healthcare ministers who were reluctant to address the issue of mobility supported a procedure aiming to ensure that under the heading of mobility, patients can find the level of safety they require everywhere. The analysis also showed that there is a genuine safety problem in hospitals, which are today working on an industrial scale with methods which bear more relation to the craft sector and in a total absence of traceability and quality control. The result of this is an average rate of damages (operational accidents and various nosocomial infections) for 10% of all patients hospitalised. These incidents, which bear no relation to the disease, account for one death for every 300 patients hospitalised. By way of comparison, the mortality rate per passenger in civil aviation in the 1930s was 1/300; safety programmes enabled this rate to be brought down to one in every 3 million. In the Union, countries such as the United Kingdom, Denmark and the Netherlands recently made considerable progress in hospital safety, by such measures as the introduction of legislation partially compensating healthcare staff and doctors if they declare a mistake. Declaring errors often allows measures to be taken to avoid any fallout. In certain cases, a bonus is also payable if the possibility of an error is detected before it occurs. Denmark has also set in place a system which penalises the regional hospital services if the patient was obliged to go elsewhere to seek a health-care offer which was not forthcoming closer to home. Following on from the one held in Luxembourg in the spring, a second conference on patient safety is planned for the end of November in the United Kingdom. This procedure to assess safety levels and to exchange best practice is also likely to be added to by the implementation of a European network to assess healthcare technologies.
This work is all the more useful as the phasing in of the European health insurance card may generate a relative increase- partly temporarily- of demand for the healthcare it is set to facilitate. Figures on its use have not yet been made available, but it is already known that the card has gone down extremely well with the citizens-some 50 million cards have been issued to date, even though distribution starts only in December 2005 in Hungary and in 2006 in the Netherlands, Cyprus, Malta, Poland and Slovakia.