First Gastein Health Declaration to refocus attention on the patient

Vienna 04 January 2000In its health policy, the European Union really should focus on the patient. This unanimous consensus emerged at the occasion of the European Health Forum Gastein, the annual Conference that is held at Bad Hofgastein near Salzburg. At the beginning of October 1999, over 300 European experts representing all groups participating in health policy decisions, e.g. science, business, industry, public administration, politics, health care, and patient representatives, elaborated joint proposals and guidelines on current health political topics. The scientifically elaborated results are available now.


At the presentation of the First Gastein Health Declaration on the 4th of January, 2000 at the RadioCafé in Vienna, the President of the Forum and Member of the National Council, Dr. Günther Leiner, defined the promotion of more self-responsibility, an intensive information campaign on medical risks among citizens, equal opportunities in access to medical care, and the integration of social fringe groups as priority health objectives. Apart from the member states, the European Union is called upon to employ new information technologies in medicine and when introducing new kinds of drugs to fight rare diseases.

"Costs in the pharmaceutical sector should not be allowed to rise even more", underscored Dr. Leiner. His special interest goes to the dialogue between industry and society which is a special focus of Forum Gastein and has not existed as such hitherto. In Europe, there exist some considerable life expectancy differences between the countries, for men from 61 years in Russia to 74 years in France and even higher. Even within the countries of Western Europe, there are big disparities between the life expectancy of the higher and that of lower social strata.

"It is very difficult to eliminate the injustices in health care", Dr. Leiner complained, "such as poverty, unemployment, inadequate education, nutrition, and housing." The Gastein Health Declaration calls for a definition of regional poverty limits and problem zones to make targeted local assistance in the regions concerned possible. The creation of work must have absolute priority in all countries to avoid misery and secure a life in dignity. Dr. Leiner stated that having a job is a determining factor for health. With regard to preventive medicine, industry is also summoned to comply in the choice of its advertisement methods. Dr. Leiner strongly criticised the custom of the tobacco industry to specifically target socially weak groups with its promotion.

The right to health for all must be enshrined in the European Civil Rights Charta, Dr. Leiner stressed, thus quoting another demand of the Gastein Declaration. In future, patients should be able to define the criteria for quality improvement in health care and evaluate the quality of medical care themselves. The European Union is called upon to formulate the necessary standards and objectives and to promote high-level quality. Furthermore, the Union is summoned to promote patient and consumer groups so that these become involved in the process of quality improvement.

The Essential Demands of the First Gastein Health Declaration are:

  1. Improving the Quality of Care: the patient decides and the European Union takes care of mediation and exchange
    • Access to good health quality for all in care, treatment, and services within reasonable time.
    • Development of quality standards and quality targets for health care.
  2. Equity: create employment and define regional poverty limits
    • The existing gap in access, scope, and quality of health must be studied and gradually abolished, whereas certain groups of persons, e.g. migrants and refugees; the adjustment of the membership candidates; and certain areas, e.g. employment possibilities, alcohol, and drugs require particular attention.
    • The creation of employment and the establishment of dignified living conditions constitute political and social priorities.
    • Health regions with comparable health-related situations must be defined as well as poverty limits.
    • Improve health information, science transfer, and data exchange.
  3. Public Health and Health Promotion: health as a citizen's right
    • The proposed EU declaration of the rights of citizens must include references to health and public health measures.
    • Public health research must be integrated more efficiently into existing structures, both within the EU and in the member states.
  4. Information Technology: this has been previously left to technicians
    • A system for the certification of Health Care Telematic products at the European level should be set up. Certification should be carried out by independent neutral bodies.
    • The system shall ensure that these products are medically cost beneficial, technically interoperable and reliable as well as beneficial to the patient directly or indirectly.
  5. Rare Disorders and Orphan Drugs: release of the entire budget
    • The original budget for the Rare Disease Programme of 30 million euro should be restored, because the current reduction to 6.5 million euro threatens the success of the programme.
    • The European Agency for the Evaluation of Medical Products (EMEA) should be given a dedicated budget of 1 million euro to enable it to operate the Orphan Medicinal Products regulations effectively and ensure the speedy release of orphan drugs on the market.
  6. Biotechnology: politics need to create rules and limits
    The basic biotechnological research will lead to the development of new drugs, vaccinations, diagnostic methods, and medical procedures. In order to derive practical benefits from these achievements for those affected, it is necessary to establish an open dialogue and a functioning communication between researchers in biotechnology, other experts, and the general public.
    • Both basic and problem oriented research need to be increasingly funded. There will be no applied research without continuing basic research.
    • Nations ought to have clear ethical and legal guidelines on research. A common European standard is necessary.

The entire catalogue of demands and tasks drawn up by the workgroups of the European Health Forum has been published as the First Gastein Health Declaration to serve as a guide and basis for decisions for European health policy. This paper will be sent to all Directorate Generals of the European Commission concerned, the World Health Organisation (WHO), the European Parliament, to all European health ministries and patient organisations, the universities, companies, specialised associations, and the media.

The paper shall serve as basis for further discussions in the framework of the European Health Forum Gastein 2000, which this year will take place from September 27-30, 2000 in Bad Hofgastein and will be organised in co-operation with the Austrian Broadcasting Company and the Federal Ministry of Labour, Health, and Social Affairs under the motto "Communication in Health Care". The entire text of the Gastein Health Declaration as well as additional information concerning the EHFG and its mission can be found on the homepage of the European Health Forum Gastein.

Leslie Versweyveld

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