European health consumer index presentation

LITHUANIAN HEALTH MINISTER VYTENIS POVILAS ANDRIUKAITIS SPEECH

28 November 2013

Dear participants of the event,

Today it is good occasion to present certain interim results of Lithuanian EU presidency in health field and about the importance of health monitoring in the national and European context. This monitoring based on proper indicators is especially important as the tool of making evidence based health policy at local, regional, national or international levels. As you perfectly know the properly selected indicators could be also measure of progress of health policy actions or measures applied but we need to find commonly agreed and acceptable methodology and this is not only technical discussion. On the other hand, the indicators also reflect not only technical or scientific but political side as well.

We know the Euro Health Consumer Index (EHCI) is today the leading public measurement of how national healthcare systems perform in 35 European countries and is the most extensive Index yet. We have recently learned that the European Commission after assessing various benchmarks has found the EHCI to be the most accurate and reliable comparison. Countries can find successful practice for improving their national action on this spreading disease. Indexes, offers reality checks for policy makers, empowerment to patients and consumers and takes opportunity for stakeholders to highlight weak and strong aspects of healthcare, suggests a number of areas for improvement, forming a best practice for Europe.

EHCI 2012 map showed a fragmented healthcare of Europe: one group of highly developed, already consumer-influenced healthcare systems, another the quickly climbing countries including Lithuania, a category of well established countries indicating problems to keep up speed with the new challenges and a group of constant under-performers without any real improvement.

This means that European healthcare is far from equal. This goes for basic services, such as infant vaccination or mammography, as well as for heart surgery or access to new cancer pharmaceuticals.

Speaking about Lithuania we could say that Lithuania is constantly improving its indicators. Lithuania has recently adopted the amendments of the Law on Health Insurance implementing the directive 2011/24/ES on the application of patients’ rights in cross-border healthcare. The insured person is free to choose to receive health care services (both outpatient and inpatient) in any other EU Member State or EEA country and after that to get the reimbursement from the budget of the Compulsory Health Insurance.

Infant mortality rate has decreased in Lithuania by almost three times over the past 15 years and in 2012 year is 3,87/1000 live births. 95 % of healthcare institutions report that waiting times for CT scan are no longer than 10 days. But we still have much to improve and much to be done not only in Lithuania.

Let me say also few words about our EU Presidency priorities and state of play.

The draft of Council conclusions is currently finalized in the Council Working Party on Public Health and expected to be adopted by Health Ministers in December, 2013 on these main points of reflection process:

  • health in the context of the Europe 2020 strategy and the European Semester;
  • success factors for the effective use of Structural Funds for investments in health;
  • efficient use of medicinal products;
  • models of integrated care and better hospital management;
  • measuring and monitoring the effectiveness of investments in health.

In principle we usually all agree during different health forums that health systems should be understood much wider than only health care systems including political, social, economic and other aspects and from this point of view the expanded health monitoring becomes even more important. Health monitoring and agreed set of health indicators becomes more important also in the context of health systems performance assessment as this is already done by finance ministers during European semester and should be agreed also between health ministers as a basis and instrument of modern health systems policy.

Seeking better prevention of chronic diseases the Lithuanian Presidency goal is to conclude the first reading negotiations with the European Parliament before the end of 2013 which would allow the revised Tobacco Products Directive to be officially adopted before the European Parliament’s elections. The main objective is to ensure that young people would not start to smoke and others quit or reduce smoking. Lithuania is doing much in this area including prohibition of smoking in public places, prohibition of advertising and we all need to do more in Europe to limit this dangerous risk factor and here monitoring of negative effects on health and evidence based policy should play the major role.

Seeking to regain more innovations and more health research in Europe in order to develop new medicinal products and better use of existing medicinal products for the benefit of European patients and to strengthen the competitiveness of the EU, Lithuania aims also to adopt the Regulation on Clinical Trials of medicinal products for human use. This Regulation corresponds to the aim mentioned as foresees reducing the administrative burden while maintaining the highest possible subject protection. The Presidency has received a mandate from Coreper and negotiations with the European Parliament already have started. The aim is to conclude negotiations before the end 2013 in order to have this legal act adopted in first reading before the European Parliament elections.

The Presidency is also committed to making maximum progress on two proposals for regulations on Medical Devices and In-Vitro Diagnostic Medical Devices. As you know the proposals introduce important changes in the current regime for authorisations of medical devices. It means that a lot of technical issues that have been regulated at the national level within the framework of two Directives will have to be agreed at the EU level. The objective of the Lithuanian Presidency is to conclude the first detailed read-through the text of two proposals.

In both areas mentioned monitoring of efficiency of health and related investments is particularly important aspect in order to have streamlined planning and policy making.

As you could see in every field the proper selection and agreement of health monitoring methods, procedures and indicators seems to be very important aspect for health policy making especially at European level. As you could see that since 2005 almost all countries show improving scores and healthcare keeps doing better for Europeans and we need find the optimal ways to keep up the progress. I wish you fruitful discussions and further work for the sake of better measurement of health seeking to improve health of all Europeans.