European Health Forum Gastein: the source of ideas for European Union health policy

Bad Hofgastein 22 September 2008In the past decade the European Health Forum Gastein (EHFG) has developed into an indispensable institution in the scope of European health policy. Held for the first time in 1998, since then it has made a decisive contribution to the development of guidelines and above all the cross-border exchange of experience and use of synergies. Furthermore, at the EHFG numerous initiatives and future areas of focus in European Union health policy are presented for the first time to an audience of experts. This year, for example, the two holders of the Euroepan Union Council Presidency in 2009, the Czech Republic and Sweden, will present the priorities of their health policy activities during their presidency.


About 600 leading experts will participate in the 11th edition of the EHFG in Bad Hofgastein from 1 to 4 October, 2008. The unparalleled mix of participants including leading country- and European Union-level representatives from the areas of health policy, administration, science, business and patient organisations is especially critical for the success of this event.

"This makes the EHFG a unique platform to meet and for the transfer of knowledge and opinions between various interest groups", EHFG President Günther Leiner pointed out. "The events of the EHFG and the issues formulated there often shape European Union health policy in subsequent years."

This is also the essential function of the EHFG: "Health policy is subject to numerous economic, social and political constraints, which beyond the most urgent day-to-day problems results all too easily in the neglect of medium and long-term perspectives", Günther Leiner stated. "This prevents, or at least delays, an increase in efficiency and quality. Orientation around successful models in other European Union countries would often be enough to achieve improvements."

The "European Health Forum Award" established in 2007 also follows this guiding principle. This award is presented to international health policy initiatives which help overcome key challenges in the area of public health and health care services. The prize is awarded by a high-profile jury of experts based on a two-stage process. In 2007 25 first-rate projects were submitted for it.

The key theme of the 11th European Health Forum Gastein in October 2008 is "Values in Health - from Vision to Reality". Numerous individual events discuss the challenges resulting from the stipulation and practical implementation of ethical standards in modern health policy. Even setting the necessary priorities unavoidably confronts decision-makers and society with ethical problems such as the question of how much society wants to spend on health care as a whole and in which measures and research projects will investments be made or not.

"Whether at the national or European level, those following the current health policy discussions could easily conclude that they revolve solely around the economic challenge of optimising costs and benefits", EHFG President Günther Leiner criticised. "We have to remind ourselves that health policy is also a matter of other non-economic goals such as quality of life, patient orientation, quality and safety in health care and ultimately a longer life. That attention is to be given to economic constraints and efficiency-related considerations is obvious, but they must not be the most important decision-making criteria."

As generally accepted as these principles are likely to be, they are hardly obvious when put into practice. The "Rare Diseases" forum highlights one particularly serious set of problems between economic and ethical considerations. "As a rule, from an economic perspective the development of treatment methods for rare diseases has hardly been of interest for industry. But is it acceptable that little is done for these patient groups because it simply isn't worth it?" Günther Leiner asked. "Policies are needed for the rapid development of solutions without losing sight of the investments in the treatment of common diseases."

Welcome tendencies in modern health care policies raise ethical questions as well. For example, the increased emphasis on patients' personal responsibility in practice leads to better educated and wealthier social groups benefiting substantially more from public health care services than other groups in the population. "There is a field of tension between social and personal responsibility and 'it's your own fault' is certainly not an adequate answer to social status-related differences in peoples' health-related behaviour."

The inadequacy or lack of progress in the prevention of errors in medical treatment in hospitals and medical practices has become one of the most important quality problems of the national health care systems. "Patient safety is the foundation for a high-quality health care system", the European Commission noted to its member states, attesting to their significant deficits in this regard. Experts say there is enormous potential for improvement in health care in the systematic fight against mistakes. For this reason "patient safety" is also a key theme at the European Health Forum Gastein (EHFG) this year. There are several forums and workshops devoted to opportunities for tackling this urgent problem from various sides.

"Decision-makers simply don't take the dimension of this problem seriously enough", EHFG President Günther Leiner stated. "Policy, science, doctors and, last but not least, public health officials are focused far too much on headline-making achievements in top medicine instead of doing their medical 'homework'. The potentials for improvement are not located primarily in the prevention of classic 'malpractice', rather in the areas of hygiene, acceleration of procedures in acute cases, certainty of diagnosis, reduction of waiting times and similar things."

"As wonderful as it is when a new transplant technology for another organ saves a human life, we can hardly overlook the fact that with far less investment and medical competence ten other patients could be helped from becoming the victims of preventable and often extremely banal mistakes", Günther Leiner stated.

Numerous measures for the targeted improvement of patient safety are possible even without added financial costs. A simple change of processes and procedures or ensuring effective communication between all players are often enough to achieve remarkable improvements. "First and foremost we don't need any more money here, rather another attitude toward the problem instead", Günther Leiner explained.

Günther Leiner's criticism is scientifically well-substantiated by diverse studies. Several of them show that ten percent of all hospital patients are affected by some form of medical mistake. Since the 1980's there has basically been no sign of improvement. The most extensive United States study in this area to date, "To Err is Human" (1999), estimates 44.000 to 98.000 fatalities as a result of mistakes in medical treatment - more than the victims of traffic accidents, AIDS or breast cancer. According to statements by the European Commission, treatment errors are estimated in an average of ten percent of hospital admissions. This year's EHFG will tackle this issue and present the last few years' results and developments in the area of medical treatment errors.

Obviously the patients are often more aware of the problem than those in charge. According to Eurobarometer, 78 percent of all European Union citizens consider the lack of patient safety to be a serious problem in their respective national health care system. Experts expect significant progress from the new European Union directive on patient rights. Increasing options for taking advantage of health care service abroad are also heightening pressure for a commensurate improvement of quality standards in the member states.

"The primary reason for the fully inadequate progress in the area of patient safety is that no one seems to really feel responsible for it", Günther Leiner explained. "This is because lasting achievement is only actually possible if doctors, hospital managers, scientists and health policymakers approach the problem together." Consequently, the European Health Forum, which brings all the groups to the table with its interdisciplinary approach, plays a key role in the further development and particularly in the implementation of effective strategies for improving patient safety in the European Union.

Events on the issue of patient safety at the EHFG 2008 include:

  • Quality and safety (Forum 6): One of the central forums of the EHFG 2008 provides an extensive explanation of the current situation and new initiatives in the quality control and improvement of the health care industry in the European Union countries. EU-level strategies may result in higher quality standards.

In numerous other events patient safety issues play an important role:

  • Innovations in co-ordinated health care (Forum 5): Possibilities for improving quality through the increased use of innovative information and communication technology solutions and the resulting improvement in the co-ordination of treatment processes.
  • Improvement of patient safety by the example of thrombosis prophylaxis (workshop): Deep vein thrombosis leads to a half million fatalities in European hospitals every year and causes lasting damage in many other patients. With the appropriate organisation and adherence to quality standards a substantial number of cases can be prevented.
  • Antibiotic-resistant germs (EU Presidency Workshop): The violation of safety standards fosters the development of antibiotic-resistant germs which in turn represent a considerable risk factor for hospital patients - presentation of measures to battle the problem.
  • European Union draft directive on patient rights in cross-border health care (workshop): Patient safety and patient rights are central areas in the development of a body of legislation for obtaining health care service in other European Union countries (cross-border health care). This directive aims at supporting patients in availing cross-border health care services by guaranteeing safety and quality and promoting better co-operation between the national health care systems.

Leslie Versweyveld

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