Forum 3 European Health Forum Gastein 2005 Dr. Birgit Weihrauch Member of the Board

1. Forum 3 European Health Forum Gastein 2005 Dr. Birgit Weihrauch Member of the Board European Public Health Centre (EPHC) NRW INVOLVED CITIZENS: PARTNERS FOR HEALTH INTRODUCTION BY THE CHAIR EHFG October 2005

2. EUROPEAN PUBLIC HEALTH CENTRE (EPHC) NRW WHO ARE WE? MEMBERS: REPRESENTATIVES OF AUTHORITIES ,UNIVERSITIES, ASSOCIATIONS OF THE HEALTH CARE SECTOR PURPOSE AND OBJECTIVES: PROMOTION OF DIALOGUE BETWEEN POLITICS, SCIENCE AND PRACTICE IN EUROPEAN HEALTH POLICY AND PUBLIC HEALTH INFORMATION:www.ephz.de EHFG October 2005

3. NORTH- RHINE WESTPHALIA (NRW) Who are we? • NRW – the most populated German state (Land NRW) - 18 million inhabitants • Located in the middle of Europe – bordering Belgium and the Netherlands • A European region with numerous initiatives for supporting the European integration process in the field of health care EHFG October 2005

4. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH EXPERT COUNCIL FOR THE CONCERTED ACTION IN THE HEALTH SYSTEM - GERMANY 1992: PARTNERSHIP INSTEAD OF PATERNALISM NEEDED IN THE RELATIONSHIP BETWEEN PHYSICIAN AND PATIENT - EHFG October 2005

5. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH MESSAGE TODAY: COMPETENT CITIZENS AND PATIENTS AND THEIR ACTIVE INVOLVEMENT STRENGTHEN THE POSSIBILITIES OF SELF-RESPONSIBILITY AND WELLBEING ALSO IN THE CASE OF DISEASE AND CONTRIBUTE TO A FUTURE - ORIENTED HEALTH SYSTEM EHFG October 2005

6. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH EUROPEWIDE A CHANGE IN UNDERSTANDING: A SOCIETAL PROCESS FOR PATIENTS AND PROVIDERS • THAT TAKES IST TIME AND • THAT IS DIFFERING IN FOCUS AND QUICKNESS EHFG October 2005

7. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH EXAMPLES OF INTERNATIONAL ACTIVITIES • 1979 - CHARTER OF HOSPITAL PATIENT (EU) • 1986 - DECLARATION ON THE PROMOTION OF PATIENTS RIGHTS…(WHO) • 1994 – DECLARATION ON THE PROMOTION OF PATIENTS´ RIGHTS…(WHO) • 1997 – CONVENTION FOR THE PROTECTION OF HUMAN RIGHTS…(OECD) • 1997 – GOTHENBURG WORKSHOP: PATIENTS´ RIGHTS IN EUROPE…(WHO) • 2000 – RECOMMENDATION REC (2000) 5…(OECD) • Since 2001 – EUROPEAN HEALTH FORUM …(EU) EHFG October 2005

8. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH 1990– 2005 IN MANY COUNTRIES PATIENTS‘RIGHTS LAWS: (E.G.: FINLAND, NETHERLANDS, ISRAEL, LITHUANIA, ICELAND, LATVIA, HUNGARY, GREECE,DENMARK, NORWAY, GEORGIA, FRANCE, BELGIUM, SWITZERLAND, RUSSIA, ESTONIA, CYPRUS) OR CHARTERS OF THE RIGHTS OF PATIENTS: (E.G.:FRANCE, SAN MARINO, UK, CZECH REPUBLIC, SPAIN, IRELAND, MALAYSIA, SOUTH AFRICA, PORTUGAL, HONG KONG, GERMANY, POLAND, SLOVAKIA, AUSTRIA, CYPRUS, ITALY) Source: Internet - without guarantee EHFG October 2005

9. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH WHAT ARE THE MAIN ISSUES? • CHANGING ROLE (PARTNERSHIP INSTEAD OF PATERNALISM) • INFORMATION AND TRANSPARENCY • ACTIVE INVOLVEMENT OF CITIZENS AND PATIENTS (INDIVIDUAL MATTERS AND MATTERS OF THE SYSTEM) • QUALITY, SAFETY, PROTECTION (STILL PATERNALISTICAPPROACH) EHFG October 2005

10. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH WHAT ARE THE CHALLENGES ? • PREDOMINANT CHRONIC DISEASES(PATIENT AS A COPRODUCER) • RISING IMPORTANCE OF PREVENTION AND HEALTH PROMOTION • MORE COMPETITION AND FINANCIAL CONTRIBUTION OF PATIENTS (HEALTH MARKET) • NEW ETHICAL QUESTIONS WITH TECHNICAL PROGRESS • THE MODEL OF A SELF RESPONSIBLE CITIZEN EHFG October 2005

11. FORUM 3INVOLVED CITIZENS: PARTNERS FOR HEALTH TWO MAIN ASPECTS • INFORMATION AND TRANSPARENCY -HOW AND WHO- • ACTIVE INVOLVEMENT PREREQUISITES AND BENEFITS EHFG October 2005

12. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH INFORMATION AND COMPETENCE PREREQUISITES FOR: • SELF- DETERMINED ACTING • ACTIVE INVOLVEMENT AS A CITIZEN • FULL USE OF POSSIBILITIES AND RIGHTS EHFG October 2005

13. FORUM 3INVOLVED PATIENTS: PARTNERS FOR HEALTH THE RIGHT INFORMATION AT THE RIGHT TIME WHAT ARE THE PROBLEMS? • ACCESSIBILITY • UNDERSTANDABLE LANGUAGE • QUALITY AND RELIABILITY • EQUITY- REACH THE LOWER SOCIAL CLASSES EHFG October 2005

14. FORUM 3INVOLVED CITIZENS: PARTNERS FOR HEALTH THE RIGHT INFORMATION AT THE RIGHT TIME WHO IS RESPONSIBLE? • PHYSICIAN • HEALTH CARE ORGANISATIONS/PROVIDERS • EDUCATIONAL INSTITUTIONS ------------------------------------------------------------------------------- • FRAME CONDITIONS THROUGH HEALTH POLICY EHFG October 2005

15. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH ACTIVE INVOLVEMENT OFCITIZENS AND PATIENTS IN HEALTH POLITICAL DEVELOPMENT PROCESSES AIMS: MORE ORIENTATION AT INTERESTS AND MATTERS OF THE PATIENTS LEADS TO • MORE COMPLIANCE AND MORE SATISFACTION OF PATIENTS • MORE QUALITY OF THE HEALTH SYSTEM • MORE EFFICIENCY OF RESOURCES EHFG October 2005

16. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH THE GERMAN EXAMPLE: CHANGES IN SOCIAL CODE V (2003) • REPRESENTATIVE OF PATIENTS IN THE GOVERNMENT • ACTIVE INVOLVEMENT OF PATIENTS IN DIFFERENT HEALTH COMMITTEES • NEW INSTITUTE FOR QUALITY AND EFFICIENCY – A.O.WITH THE TASK OF PATIENT INFORMATION EHFG October 2005

17. FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH SOME NRW EXAMPLES: • ACTIVE INVOLVEMENT OF PATIENTS IN THE STATE HEALTHCONFERENCE (BY LAW) A.O.COMMITTES • WWW: GESUNDHEIT. NRW.DE – HEALTH PORTAL BY THESTATE AND THE STATE HEALTH CONFERENCE • BREAST CENTRES NRW • STANDARDIZED QUALITY • STRUCTURED PATIENT INVOLVEMENT EHFG October 2005