European Health Forum, Gastein 1st-4th October, 2003 REGIONAL CO-OPERATION

1. European Health Forum, Gastein 1st-4th October, 2003 REGIONAL CO-OPERATION IN HEALTH CARE SERVICES A Prospective Collaboration between the Veneto Region, Italy and Timiş County, Romania. Dana Paica, Timis Region Luigi Bertinato, Veneto Region

2. Introduction • The process of political decentralization in Europe from the national level moves alongside the important enlargement of the European Union. • Twenty-five per cent of European Countries have a population of less than 5 million inhabitants which corresponds to many of the average sized European Regions. • Health care services differ widely among European Regions • Decentralized Member States have an important role in anticipating solutions for the collaboration of the National Health Care systems in the future enlarged Europe. • This highlights an urgent need for health system re-organization in new EU Member States • We hereby present the current co-operation underway between the Veneto Region and the Timiş County Region, Romania in adapting health care systems to E.U. standards

3. Romania: within the context of EU enlargement • Romania is one of ten new countries invited in December 2002 to join the EU by 2007 • Problems of joining the EURO, migration, agriculture and harmonizing and improving Health Care Services to conform with EU Standards.

4. Reasons for collaboration from a dual persepctive: The Veneto Region & the Timis Region VenetoTimis Population size: 4.5M 682,409 Surface Area(km2):24,840 8,697

5. The Veneto: Background of the Collaboration • Following the Romanian Revolution of the late 1980s, and democratic reform of the early 1990s Italian businesses have invested heavily in Romania • Over 7,000 Italian businesses have transferred their operations to Romania, 4,000 of which from the Veneto Region alone • The strongest component of the Veneto economy consists of small and medium-sized family-owned companies which produce high-quality consumer goods such as clothing, furniture, kitchen equipment, eye-wear and white goods. • Over 15,000 Italians, predominantly from the Veneto Region, currently live and work in Timiş County

6. Timis: Background of the Collaboration • Timis County has a strong and diversified economy characterised by a highly skilled work force • It is based mainly on the service industries – based mainly in Timisoara - accounting for 64% of the County’s economy • The Regional Authorities in Timisoara have committed themselves strongly to joining the European Union • They are therefore willing to adapt their current health systems to meet European standards • As of this year, the Romanian Authorities have started a process of decentralizing their national health system to the Regions

7. Veneto Regional Ministry & Timis County Public Health Care Systems : comparative data Veneto RegionTimis County Population size approx.4.5 million 682,409 Surface Area km224,840km2 8,697km2 n. hospitals 74 public+25 private 16 n. health districts 73 34 n. medical units n/a 193 n. health centres n/a 4 Total n. medical 57,365 n/a practitioners Total n. physicians approx. 7,515 2,552 Total n. nurses approx. 25,699 4,056 Life expectancy* 7970 Child Mortality rate* 619(x1000) *As of 2002, source: UNICEF 2002 Report

8. Selected areas for health sector co-operation initiatives between the Veneto & Timis Regions: • to assist the Timis Region in a process of decentralization from the National Health System in Romania to the Regions; • to assist in the development of a Regional Ministry of Health in Timis, both at a political and a technical level; • to establish a comparison between public health strategies in the following areas: health prevention, screening, and epidemiological data collection on the main pathologies; • to introduce to the Timis Region new standards for training health personnel in line with standards currently in use in the Veneto; • to promote a partnership for European Projects; • to link the Timis Region to the European Network.

9. Armenia Sunik Austria Carinthia Belgium Flemish Community Bulgaria Varna Czech Republic Usti Silesia-Moravia Germany Lower Saxony North Rhine-Westphalia Hungary Bács Kiskun Györ Moson Sopron Szabolcs-Szatmár Israel Northern Region Italy Emilia-Romagna Sicily P.A. Bolzano Veneto Lithuania Kaunas Norway Rogaland Poland Silesia Portugal Madeira Romania Timis (new) Russia Vologda Spain Catalonia Valencia Sweden Västra Götaland Östergötland Switzerland Ticino United Kingdom North West England Northern Ireland Wales Members of the Region Health Network - 2003

10. Selected Areas for Collaboration in 2004 • Project I: To set up a surveillance system of the major communicable & chronic diseases in the Timis Region; • Project II: A research study on the health of Timis adolescents (aged 11,13,15 years) using the WHO protocol “Health Behaviour in School Aged Children”; • Project II: Evaluation of the impact of the re-orientation of social services for abandoned and orphaned children;

11. Conclusions • European Co-operation between Regions is no longer an isolated experience among political entities, at either the national or regional levels, but becomes a necessity for the future of an enlarged Europe. • The Regions are in the frontline in the health sector for anticipating methods of collaboration between European States in an enlarged Europe.