Public health leadership; Meeting the challenge of health inequalities (F1)

photo 4After a short introduction by Harry Rutter from London School of Hygiene and Tropical medicine, Ma Ying-Jeou the President of Taiwan R.O.C. bid us welcome. In his welcoming video he pointed out that finding ways to reduce health inequalities, is the major task of public health leaders. Since introducing a national weight reduction program, the average Taiwanese has lost 1.5 kg and the President has contributed with 4 kg.

Kasia Czabanowska from Maastricht University, addressed the question; what is public health leadership? A question to which there are many answers. I’ll sum up some of the takes on this question:

“Public health leaders need to think globally and act locally, and find the balance between health and social injustice” – When-Ta Chiu Minister of Health and Welfare Taiwan

“Finding a way to secure that health care is available to everyone” Harm Jan Driessen

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Kasia concluded by saying that modern public health leadership needs no more heroes. The young upcoming leaders in public health today, needs to be willing to join the work in the field, and impose a horizontal leadership. We need a radically different leadership in our century, and without emotional competence, you are no leader at all.

 

It seems to me that the era of top-down leadership within public health in Europe is over.

Harry Burns from the University of Stratchlyde went further into the challenges of health inequalities.  He pointed out that public health problems are often oversimplified, by addressing single factors like smoking or alcohol consumption, and that this leads to ineffective measures. The main contributor to premature mortality in Scotland is economic inequality, affecting younger working age people according to the professor. Therefore efforts to increase public health should address problems arising in socio-economic underprivileged parts of the society.

Sara Riggare (Karolinska Instituet) contributed a personal story: getting diagnosed with Parkinsons at a young age, she has a degree in engineering and public health, and is currently doing a ph. d. project on patient leadership. Defining herself as a “patients rights extremist” she advocated strongly for engaging patients in self care, a form of leadership that can be taken at the patient level.

Closing off the session of Forum 1, Jin-Chuan Sheu and Hsiao-Ching Nien from the Liver Disease Prevention and Treatment Research Foundation in Taiwan, contributed an NGO perspective to healthcare leadership. The Foundation has managed to address the major challenge of hepatocellular carcinoma, a disease that mainly results from chronic hepatitis B and C in Taiwan. Taiwan started a national vaccination program in 1984, and Dr. Sheu and Dr. Nien were convincingly asserting us that they wouldn’t give up before they had beat the challenge of hepatocellular carcinoma in Taiwan. A song from Taiwan performed by Dr. Nien beautifully finished this session. (I hope to upload a video of this performance)

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The summarising discussion addressed the importance of implementing training in public health leadership in more levels of the educational system, from pre- to post-graduate level. Children were noted as being great advocates to bring the message of a healthy lifestyle to the homes of families, highlighting how the school environment can often be a better arena for promoting public health than in the hospital.

Finally the session participants addressed the problem that free market laws potentially threaten the implementation of health providing regulations and can potentially remove investments from social responsible projects.

All in all the modern leaders of public health today, need to stay in connection with the people they represent, be emotionally engaged and tough when addressing the health problems related to social and economic inequality.

By: Bendik Brinchmann (YFG) on behalf of Working Group 1.

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An interactive afternoon on gatekeepers, goalkeepers, health brokers, coordinators, navigators & patient choice (F3)

The European Health Forum in Gastein has taken off again. On a rainy Wednesday afternoon in 2014, the 1th of October to be exact, I find myself learning more about balancing care coordination and patient choice. Looking around the conference room, I am clearly not the only one who is interested in the matter. Over 50 conference participants are curious to hear more on the following dilemma: gatekeeping and guiding patients throughout the health system on the one hand, and taking into account patients freedom to make their own choices on the other. Not an easy dilemma, but certainly one that has to be addressed in order to achieve a sustainable health system that ensures accessibility to high quality care at a reasonable price. To sharpen everybody’s mindset, Sabine Oberhauser – the new Austrian Minister of Health as of the 1st of September – welcomes us all and kindly invites us to share our opinion and experience on the matter at hand: off we go!

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Josep Figueras (director at the European Observatory on Health Systems and Policies) is the session moderator and he enthusiastically explains to us that the complete session is set up as an extremely interactive one. Only two presentations will be given and throughout the whole session a lot of voting and discussion with the audience will take place. Clearly, the organizers of this session are interested in our opinion. Here is how it works: statements on the matter at hand are presented on a big screen in front of us, and we as a audience are asked to vote for one (or more) of the options. Here is an example of one of the statements that we were asked to express our opinion on:

What are the most important types of choice (choose top three):

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The outcome of this vote led to a debate on the concept of gatekeeping. Both Peter Groenewegen (director at NIVEL in the Netherlands) and Dominique Polton (economist at CNAMTS in France) stated that the concept of gatekeeping can be operationalized in many ways. Ideally, gatekeeping leads to shared decision making as a result of an interactive process in which both the primary health care provider and the patient participate and act like a team. That sounds good, however it requires both parties to develop the necessary knowledge and skills to actually do so. As far as I am concerned, something that is well worth investing in. Given the broad integrative scope that primary care health providers offer, their interaction with patients is crucial since it guides or navigates patients throughout the complex world of hospital care and specialists.

In addition, it is mentioned that the term gatekeeping has a negative connotation. Similar to the goalkeeper in a football team who prevents the opposing team from scoring goals, the term suggests that a gatekeeper is someone who prevents patients from getting access to (specialized) care. In line with the above mentioned operationalization of gatekeeping as a process of shared decision making, primary health care providers should not be labeled as gatekeepers but rather as health brokers, or even better as health coordinators.

It is clear that the interactive set-up of the session created a lot of energy in the audience and provided concrete elements for an interactive debate on various issues. I myself even completely forgot about the rainy weather in the Gastein valley today. In addition, it got me thinking on the following issue: will I be able to team up with my primary health care provider when deemed necessary? I am not completely sure to be honest. Will you be able to do so?

Jochen Mikolajczak, Young Gasteiner

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What’s new at the EHFG?

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Dear participants, friends and colleagues,
A warm welcome to you on behalf of the EHFG team! We have an exciting year behind us during which we have worked together with our Board and Advisory Committee on developing the Forum further – a big thank you to all of the members of these two main EHFG bodies.

We continue to make small improvements building on the solid basis of the last 17 years, the fundamental elements of which have helped the Forum develop into the successful conference that it is today. The steps we have taken are based on your feedback and on discussions with colleagues. Please continue to let us know what you think and give us feedback on further steps you would like us to take.

Programme:
As announced last year, we are looking to develop the content further and introduce
new topics, new partners and formats, while relying on our long-term partners, like the DG for Health and Consumers from the European Commission and the Austrian Federal Ministry of Health who have contributed to making the EHFG what it is now.
An important step was to allow for one of our pillars, civil society, to be represented more visibly and independently by introducing a competition to win a free-of-fee NGO workshop slot. Eight NGOs submitted proposals and we are happy to announce that the Platform for International Cooperation on Undocumented Migrants (PICUM) was selected to organise a workshop on “Undocumented migrants”. Congratulations! Other important players who have been underrepresented in previous years are social health insurance institutions, so we are proud to announce the first workshop organised jointly by institutions from Austria, Germany, Belgium, France and the Netherlands in cooperation with the European Observatory on Health Systems and Policies.
We have also answered a recurring call for an increased presence of Young Gasteiners in the main conference programme and thank DNV GL for supporting and organising the first YFG workshop on “Person-centred care”. The EHFG is a member of the South-eastern Europe Health Network (SEEHN), and for the first time introduces a workshop in conjunction with WHO Europe, kindly supported by EuroHealthNet and CRPRC Studiorum on the health vision of the SEE 2020 Growth Strategy.
Eurohealth:
Please find the special Gastein edition of Eurohealth based on the main EHFG 2014
sessions in your conference bag – thanks to the Eurohealth team!
External events:
Answering the call for the EHFG to be more visible throughout the year we have
organised two main events. To better disseminate our conference outcomes within the Austrian community, we co-organised an “EHFG outcomes workshop” with the Forum of the Research-based Pharmaceutical Industry (FOPI), inviting high-level stakeholders to discuss the results. To further the scope of the Young Forum Gastein network, we co-organised a “mock expert panel” on person-centred care in Brussels, supported by MSD. The young experts presented their working group results to a critical but constructive senior expert panel at the end of the workshop day. We are planning
similar events in 2015.
Live Cartooning:
The EHFG 2014 features the live cartoonist Floris Oudshoorn who will depict the
content and atmosphere of the conference, focusing on topical cartooning. Looks out for his cartoons in the course of the event!
Poetry break:
It’s not too late to contribute to the EHFG 2014 poetry break. Get creative and share
your vision on your ideal Europe of the future on the “The Europe I want” pinboard.
EHFG Smoothie Express:
We are looking out for your health in two ways this year – you get to
workout and produce your own healthy fruit smoothie. Look out for the Smoothie Express in front of the conference centre.
Welcome to Gastein! Enjoy the EHFG 2014!
Dorli Kahr-Gottlieb,
Secretary General, International Forum Gastein

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The Europe we want!! Have your say!

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During the course of the conference and especially in the plenary sessions we would like to address the following questions:

 

 

1. What are the possible developments of the European social model and its core values?

2. After the first 20 years of an EU health mandate what should be the EU’s role in health and health systems in the next 20 years?

3. In preparation for the next legislative period and the implementation of its Europe 2020 Growth Strategy, how will the current policy frameworks and instruments have to be used or reviewed in order for the EU to fulfill its role in promoting, protecting and restoring the health of its citizens?

4. As European citizens demand more value for money in health care, what can the EU contribute to improving the performance and efficiency of Member States’ health systems?

We would like you to think about these questions prior to the conference and there will be opportunities to express your views onsite so these can be discussed at the closing plenary on 3rd October at 1p.m.

If you need inspiration please have a look at the special Eurohealth Gastein issue.

We are looking forward to seeing you in Bad Hofgastein very soon!

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Our newest team member!

My name is Josef Wenninger and I am the new addition to the European Health Forum Gastein team. I will be supporting the team as project manager for the Young Forum Gastein project and the South East European Health Network while Louise Boyle is on maternity leave from mid November 2014. Additionally, I will be responsible for the cooperation with EU institutions and other stakeholders.
I have a MSc degree in Conflict Resolution and Governance and a Magister degree in Political Sciences. I have been fortunate to gather experience in a wide range of fields including work within the European Parliament, the Austrian Foreign Ministry and the NGO sector in the Middle East. Now I am happy to return to my hometown Salzburg and to dedicate myself to new tasks within an important international platform for health policy.
Working for such a crucial international forum makes me proud and I am very much looking forward to working in the field of health. I will do all I can to ensure the continuous success of the EHFG!

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