Structural Funds and health Cross border health care Brussels, 21 March 2006

1. Structural Funds and health Cross border health care Brussels, 21 March 2006 COHEUR ALAIN Director european affairs

2. National Union of Socialist Mutual Health Funds Some figures :- 19 regional federation- 2 925 000 beneficiaries – 30% of the population- 4 500 employees - 20 home service units- 46 optical centres- 58 polyclinics- 6 general hospitals offering 1452 beds- 23 warehouses loaning out equipment- 17 holiday centres

3. COMMUNITY INITIATIVES 2000 - 2006 • INTERREG 4.9 billion euro • LEADER 2.0 - - • EQUAL 2.8 - - • URBAN 0.7 - - • TOTAL 10.3 - -

4. INTERREG III 2000 - 2006 Increased budget : - 2000-2006: 4.9 billion euro - 1994-1999: 3.6 billion euro General principles : • Economic and social cohesion • Balanced and sustainable development of the European territory • Territorial integration with candidate and other neighbouring countries 3 strands : - A : Cross-border co-operation(67%) - B : Trans-national co-operation(27%) - C : Interregional co-operation(6%)

5. INTERREG III - STRAND A Cross Borderco-operation Eligible regions

6. Strand B Co-operation Areas

7. INTERREG III STRAND A - B • B : Thematic priorities (not exhaustive) : • Spatial development strategies • Cities’ and Rural/Urban co-operation • Transport and communications systems • Management of natural resources (e.g. water) • Management of cultural heritage • Small-scale infrastructure • Maritime and insular co-operation • A : Priority actions (not exhaustive) : • urban, rural (incl. coastal) development • entrepreneurship, SMEs, local development • labour market integration & social inclusion • RTDI, culture, info/communications networks, • environment and energy (espc. renewable) • transport infrastructure • institutional capacity building

8. Origin of the collaboration in health-care European tendencies: • growing mobility of the citizens, esp. in euregions, the first European citizens • mobility of working, mobility of living and residing, migration,… • ageing population in Western Europe • growing challenges in health-care • mobility of patients, especially in border-regions: "health-care in the neighbourhood, even across borders" • freedom of settlement for providers of health-care, e-health developments, …

9. Kartographie und Gestaltung: Büro Dr. Sweekhorts, Aachen · Tel. 0049 (0)241 55 937 911 · Fax 0049 (0)241 55 937 999 Eligible zone between France & Belgium and Belgium – Germany – The Netherlands

10. INTERREG III STRAND A • Cross border care Franco-Belgian Health Observatory (OFBS) The Euregio Meuse-Rhin platform • - Forum for cross border matters and groups together people with numerous skills from organisations involved in health domain (sanitary domain and health insurance) • Permanent arena for discussion, prospective studies and activities. The partners analyse concrete problems which exist in this area with a view to resolving them in the best possible may • Bring competence and expertise to those who want to improve access to health care for the citizens in the frontier zone by way of cross border co-operation projects.

11. INTERREG III STRAND A • Cross border care Franco-Belgian Health Observatory The Euregio Meuse-Rhin platform • The assignments are as follows : • to have a knowledge not only of the expectations of the population but also the health care available in the border zone • to carry out studies which open up potentials ways of co-operation and complementarities • to bring help and advice to projects operators • to follow legal developments in national and Community law • to be a vector of communication for the people and the health professionals and healthcare establishments settled on the border zone • to be a catalyser for the cross border co-operation in the areas of public health and health promotion

12. INTERREG III STRAND A • Cross border care Franco-Belgian Health Observatory The Euregio Meuse-Rhin platform • The results : • Creation of areas of access organised for cross border health care • interhospital co-operation agreements in diverse domains such as urology, radiology, dialysis, infectious illness, pediaetric heart surgery, medical analysis for genetic illness • evaluation of the cover for the elderly • emergency services cross border • accessibility to information for patients and professionnals via a website

13. INTERREG III STRAND B • Trans national border care The transnational Strasbourg – Liège – Luxembourg hospital co-operation network WHY : To optimise the ways of contributing to the development and to the planning of the territory of North-West Europe

14. INTERREG III STRAND B • Trans national border care The objectives Pooling • potential medical – human – technological – scientific - intellectual • respective know-how in order to - create an example and centres of excellence in the health sector - create a dynamic between professionals and encourage their mobility - promote the co-ordination of action - develop new techniques of communication, data-processing

15. INTERREG III STRAND B • Cross border care 3 fields of action The new information technologies Creation of a transnational data-processing communication network Treatment of patients and technological innovations in the health sector Transnational development of innovative cognitive methods of treatment for patients with schizophrenia Optimisation of the treatment and rehabilitation of liver transplant patients in North-West Europe Technological innovation and transnational development of cell therapy treatment, haematology and oncology Human resources and in-service training Vocational training for nursing care managers Joint transnational action to improve the quality of care in operating theatres

16. Cooperation obstacles and difficulties • At the macro level • the historical and legal development of social context • organization and financing of social security and health insurance • the legislation in the field of public health, the role played by authorities, social partners and private organizations in the decision-making process concerning the projects and their implementation

17. Cooperation obstacles and difficulties • At the micro level • language used • remuneration of doctors and medical demography • equivalence of medical protocols • management of the patient in the sense of continuity of care • impact of the coverage of care on the hospital budget • noscomial infections • financial burden for the patient

18. Synergies and potentials for co-operation • Existence of formal structures can occurs : • role of facilatator (of assistance) by creating working parties • role of identifier of supply and demand • role of negociator (of representative) in the contacts with authorities, providers and insurance organizations • role of catalyst and diffuser of experiences and results with other partners

19. Synergies and potentials for co-operation • Cross-border cooperation enables : • better access to health infrastructures and can therefore reduce distances of access and possible waiting lists • better knowledge of regional and cultural differences and constitutes therefore a powerful factor of integration • better exchange of information and favours therefore the development of exchange and training for the medical hospital staff • better consideration of deficiencies and insufficiencies of the offer and can therefore lead to reflections on the maintenance of services or installation of common equipment (cross-border planning of health infrastructures

20. Thank you very much for your attention