NDPHS Continues Efforts to Have Health Prioritised on the Regional Agenda

Transcription

1 Northern Dimension Partnership in Public Health and Social Well-being A partnership committed to achieving tangible results e-newsletter Issue 1/2012 Contents NDPHS Continues Efforts to Have Health Prioritised on the Regional Agenda 1 The Demography Challenge in the Baltic Sea Region 2 Making Success Stories with Russian Partners 4 3 rd EUSBSR Annual Forum Discusses the Review of the Strategy Action Plan 5 PrimCareIT: Counteracting Brain Drain and Professional Isolation of Health 6 Dear Reader It is widely recognised that health is crucial in the context of the ageing society and challenges posed to sustainable economic development. Yet, the importance of health is not properly reflected on the regional cooperation agenda. One example is the Action Plan of the EU Strategy for the Baltic Sea Region (EUSBSR), where health has been listed as a sub-priority. Since last year our Partnership has taken several actions to address this problem and our efforts will continue. This issue of our e-newsletter will give you some details on this. Following the above is an article about the 9 th Baltic Sea States Summit held in May 2012 in Stralsund, Germany and, more specifically, its plenary session on the impact of demographic change. The Prime Ministers had a stimulating debate on main challenges posed by the demographic change and discussed policies to induce win-win situations for the future. You will also find two articles about the 3 rd Annual Forum of the EU Strategy for the Baltic Sea Region held a few days ago in Denmark. Many interesting events took place during it, which provided an opportunity to discuss the progress so far and the way forward. One of them was a session Making Success Stories with Russian Partners co-organised by the NDPHS. NDPHS Continues Efforts to Have Health Prioritised on the Regional Agenda Last year the NDPHS embarked on the challenging task of ensuring that health would be given a more prominent role on the regional agenda. In line with this, our Partnership is taking actions to ensure that health be visibly exposed among the funding priorities during the next EU financial period. The NDPHS position paper ( adopted by the Ministers responsible for health during the 8 th Partnership Annual Conference on 25 November 2011, is a basis for the Partnership s work towards this objective. Mr. Per Bødker Andersen, President of the Union of the Baltic Cities Northern Dimension Partnership in Public Health and Social Well-being Our prosperity of the region is based on human capital. Consequently a healthy population is a critical factor behind sustainable economic development. Improvement of people s health is particularly important in the context of the ageing society, one of the greatest regional challenges in the 21 st century. Unless counteracted, a decline in the working age population and a higher number of people with chronic non-communicable diseases will put an immense pressure on the national budgets and will lead to loss of productivity in the decades to come. By investing in health improve- 2

2 NDPHS Continues Efforts to Have Health Prioritised on the Regional Agenda 1 ment and promotion, the economic gain will be two-fold: given in the EUSBSR Action Plan a status adequate to its role (i) healthy people are more likely to stay at the labour market and importance in the region s societies. During the current longer and remain productive and (ii) reduced spending on days of austerity, some decision makers may feel tempted to treatment of ill health. focus too much on short-term gains and neglect the fact that The key role of health as a precondition for economic development is increasingly recognized not only at the national, of diabetes and the emerging lack of effective antibiotics can- challenges such as the aging of society, the growing epidemic but also the supranational level. However, this recognition not be put aside and left in a waiting room. If they are, the has so far not been sufficiently reflected when defining the future costs to our societies of today s inaction or inadequate strategic priorities. For example, only a few European funding action will be significantly higher than what we should pay programmes currently operating in the Northern Dimension now. Being aware of this the NDPHS is taking efforts to elevate the importance of health and social well-being in the area have explicitly included health among their priorities. Another example is the EU Strategy for the Baltic Sea Region EUSBSR and have health included as a separate Priority Area (EUSBSR) and its Action Plan. Regarding the latter, regrettably, whereas other sectors are included as separate priorities, Surveys indicate that individuals place health among the in the EUSBSR Action Plan. health has been listed as a sub-priority (along with education, top priorities in their life and a recent Eurobarometer survey tourism and culture). This approach undermines the value, ranks healthcare system among the main concerns of the Europeans. The review process of the EUSBSR Action Plan pro- visibility and importance of health vis-à-vis other sectors. The EUSBSR Action Plan is currently being reviewed. To vides an opportunity to recognise a key role of health in contributing to smart and inclusive growth and to demonstrate that end the number and content of the Priority Areas is currently being discussed, which will supposedly lead to some to people that their priorities and concerns are properly reflected on the regional cooperation agenda. of the areas being merged or split. The Ministerial-level 8th Partnership Annual Conference agreed that health should be The Demography Challenge in the Baltic Sea Region The recent 9th Baltic Sea States Summit that took place in the Baltic Sea coastal town of Stralsund, Germany on the May focused its second plenary session on demography. The Summit of Prime Ministers hosted by Dr. Angela Merkel differed from previous Summits by inviting a keynote speaker for each session to provide the Heads of Government with an expert outline of the chosen subject for reflection and discussion. The issue of Demographic change consequences of an ageing society was introduced by Prof. James W. Vaupel of the Max Plank Institute for Demographic Research. The topic is of course particularly relevant in the context of health. Back in February of this year the Prime Ministers of the Nordic-Baltic 8 cooperation plus the United Kingdom met in Stockholm at the Northern Future Forum hosted by the Swedish Prime Minister, Fredrik Reinfeldt, to discuss this exact issue as well as the Forum s other chosen topic of female participation in the labour market. Both of these topics link to competiveness and the untapped potential for economic growth and sustainability of the labour market. The Summit deliberations in Stralsund can be viewed through the lens of an inclusive extension of that discussion. The need to investigate ways of creating a sustainable labour market that deals with both inclusion of senior citizens and youth in gainful and productive employment as well as creating a good work-life balance, healthy lifestyles and flexible employment cultures are all crucial for future prosperity and health of our region. In the current times of austerity there is a risk that longterm sustainable demography policy will be brushed aside by short term crisis management. The average age of our region s citizens is increasing but the retirement age has not increased to off-set this upwards trend in life expectancy. Pension systems are therefore ill-equipped to take the full strain of longer lives with fewer average working hours over the entire life-cycle. The health care system as well as the service provision for our elderly are also in need of a re-think away from its current form. People expect more flexibility and more choice, which is tailored specifically to their needs but without a trade-off of possibilities for government to stagger their departure from employment over a longer period to ease the burden of the tax revenues as well as retain an active ageing policy. 3 2 Northern Dimension Partnership in Public Health and Social Well-being

3 The Demography Challenge in the Baltic Sea Region 2 The Heads of Delegations discussed how best the countries could develop policies which would take a holistic view of the inter-relations between the different positions and possible policy options involved. The main questions were centred upon which combinations of incentives and reforms could be introduced to induce win-win scenarios for the future? A complex array of issues were discussed in detail from different country experiences of what had worked or was being tested; such as pension reform, tax incentives for the retention of older workers in the workforce, life-long learning educational schemes, encouragement of an entrepreneurial mindset, especially for older workers, pre-school system provision and parental leave packages that give flexibility and enablement to both parents to stay in the workforce, fighting youth unemployment and social exclusion of young adults by easing the thresholds into the labour market through training schemes and placements to gain experience, targeting Human Resource and Management programmes to devise special schemes for older workers for knowledge and experience retention, highlighting mentorship programmes and other policies to support women in the workplace and to focus on time management over the lifespan as well as healthy living. A follow up question further developed - how can innovation bring about an improvement in the current demographic situation faced by the region? In the Baltic Sea Region as in other parts of the world the general conditions for growth need to be strengthened. A few days ago the 3 rd EUSBSR Annual Forum was held in Copenhagen under the auspices of the Danish Presidency of the Council of the European Union where economic competitiveness was at the front of the participant s minds and discussions. But competiveness is not just about investment in infrastructure of large scale or public private partnerships for energy production or transport super-ways. Competiveness is crucially in the small details that enable one society or region to have the edge over another. Here the ability to explore one s full potential (and productivity as a citizen) is intrinsically linked to one s own health throughout the entire life. Social services are currently under immense pressure in Europe due to the economic crises and budget constraints and cuts. In the future, as is already the case today in some parts of the world, more people will need social and health care services for a longer time span and potentially a more progressively costly type of specialised care. This challenge highlights a need to focus on innovation in assistance provision and health services. Resources must be used more efficiently to maintain the high quality of care from re-tooling the care and provision to suit new developments and techniques as they come online. This is also a way to create new jobs in the service and health sectors of our labour market with these innovations if we focus hard enough - even becoming a source of expertise for export and growth to other regions. This is a common challenge for all of us and it needs to be discussed on a pan-european level is the year of solidarity between the generations and active ageing after all. In an age where the plasticity of longevity is fluid and extensive, these challenges should be viewed as an opportunity for economic growth. The Cohesion policy package proposed by the European Commission lists e-health, health infrastructure, inequalities in health and healthy ageing among other investment priorities these areas are not only important for health in general but for productivity, competiveness and overall fiscal policy. Self-monitoring tools for individuals who want to retain a level of independence in their elderly years, tele-health and remote diagnosis technologies, innovations in primary care education to boost nurse capacities and develop roles for practitioners and physician assistants combined with moveability of professionals by common recognition of skills and fast tracking recruitments could all lead to efficiency gains across the system and the region to ease the ensuing burden. We hope that the detailed dialogue enjoyed by our region s Prime Ministers will clarify the value of health promotion and optimization of delivery of care as one part of the demography conundrum in the coming years ahead. Anthony Jay Olsson Head of Media and Communications Council of the Baltic Sea States Secretariat Northern Dimension Partnership in Public Health and Social Well-being 3 Photo: Council of the Baltic Sea States Secretariat

4 Making Success Stories with Russian Partners The European Union Strategy for the Baltic Sea Region (EUSBSR) aims at reinforcing regional cooperation to tackle common challenges. The EUSBSR includes objectives which call for constructive cooperation with non-eu partner countries, in particular, with Russia, in order to achieve concrete results. Despite growing interest in cooperating with Russian partners, this effort has achieved varying degrees of success and it is widely recognised that this cooperation should be intensified. Pragmatic solutions must be sought, based on a partner-to-partner dialogue and mutual benefits. There are examples of a fruitful collaboration involving EU and Russian partners established at various levels and engaging various stakeholders national governments, parliamentarians, sub-regional and local authorities, universities, businesses and grass-root NGOs. Some of these examples were presented at the session entitled Making Success Stories with Russian Partners during the EUSBSR Annual Forum held on June 2012 in Copenhagen, Denmark. The session was co-organised by the NDPHS and the Turku process, both of which have a track record of such accomplishments. It aimed to provide inspiration for those engaged in the EUSBSR who would like to make their own success stories with Russian partners, and, in this way, to help advance cooperation between EU and Russian partners that would contribute to fostering the objectives of the EUSBSR. The session was co-moderated by Mr. Marek Maciejowski of the and Mr. Mikko Lohikoski of the Turku process and benefited from contributions of distinguished speakers who came from a variety of institutions and organisations operating at different levels: Ms. Hanna Lehtinen, Deputy Director General, Ministry for Foreign Affairs of Finland; Prof. Dr. Yulia Mikhaylova, First Deputy Director, Federal Research Institute for Health Care Organization and Information (speaking on behalf of the Ministry of Healthcare of the Russian Federation); Mr. Arne Grove, Director, Nordic Council of Ministers Information Office in Kaliningrad; Ms. Sofia Rekord, Vice Rector, Head of International Economic Relations, St. Petersburg State University of Economics and Finance, Russia; Ms. Daria Akhutina, Director, NORDEN Association of Russia. It was underlined that it is neither reasonable nor realistic to expect non-member States to sign up to an EU strategy. Pragmatic solutions must, therefore, be sought, based on a partner-to-partner dialogue and mutual benefits. To that end, common interests have to be found and common denominators identified for joint activities in the Baltic Sea region. The Strategy of social and economic development of the North-West Federal District of the Russian Federation and the EUSBSR were mentioned in this regard as good points of departure in partners dialogue. It was also noted that the existing frameworks need to be used as much as possible in establishing and fostering cooperation. The NDPHS, the NCM, the Turku process, the CBSS and other regional organisations were named as useful cooperation frameworks. The speakers shared experiences and lessons learned as well as provided examples of the established EU-Russia cooperation along the lines of the EUSBSR Action Plan. Ms. Hanna Lehtinen mentioned that the Northern Dimension structures provided a functioning format for implementation of the external aspects of the EUSBSR. In particular, she noted that the NDPHS framework provides an example of pragmatic and successful collaboration between the EU and non-eu countries, including in the context of the EUSBSR. Further examples of successful cooperation within the NDPHS were presented by Prof. Yulia Mikhaylova who stressed the importance of transnational cooperation in the field of health to avoid scattering resources on a fragmented approach and duplication of efforts in addressing shared challenges that all Baltic Sea region countries are facing, such as an ageing society, the increasing burden of non-communicable diseases and new health threats. She also stressed that health is crucial for economic growth and deserves to be made a separate Priority Area in the EUSBSR, not a sub-area as it is now. The way ahead towards more success stories of cooperation between EU and Russian partners was also discussed during the session. The speakers and participants have identified several factors that made it possible to have the success stories achieved (and could be taken into account by other stakeholders interested in establishing or strengthening cooperation between EU and Russian partners). In particular, it was mentioned that there is a willingness on both sides to pursue pragmatic and mutually beneficial cooperation and solid cooperation platforms have already been available, covering a wide range of sectors. Also, funding provided by the NCM (approx. 20 million DKK per year) and by Norway 5 4 Northern Dimension Partnership in Public Health and Social Well-being

5 Making Success Stories with Russian Partners 4 (through the NDPHS Project Pipeline), as well as seed money provided through the EU Delegation to Russia and the DG REGIO were named as very helpful in supporting cooperation between EU and Russian partners. Even though the overall conclusion was that there are more opportunities than constraints for a fruitful collaboration between EU and Russian partners, it was obvious that a number of challenges are present that one needs to be aware of when developing cooperation. Several speakers stressed that more needs to be done in designing the funding programmes so that both EU and Russian partners could jointly benefit from financial support. The on-going work on the preparation of the EU financial framework was mentioned as a good opportunity to make improvements in this regard. The need to ensure a stronger involvement of a civil society and local partners was also stressed. Among other complications technical problems (such as different technical standards and language barriers) were mentioned. The session proved that the main driver for cooperation is the potential to achieve better results by working together. It provided many inspiring examples regarding cooperation between EU and Russian partners as well as useful tools and cooperation frameworks, which can be used by interested stakeholders in their own work. We would like to sincerely thank the speakers and the participants for an inspiring and thought-provoking session, and we are looking forward to future success stories made between EU and Russian partners. Undoubtedly, the session itself was an example of a successful collaboration between EU and Russian partners. 3 rd EUSBSR Annual Forum Discusses the Review of the Strategy Action Plan The EU Strategy for the Baltic Sea Region (EUSBSR) was launched in It was the first macro region strategy of the EU (the EU Strategy for the Danube Region was subsequently ImPrim project team members discussing with Commissioner Johannes Hahn the importance of healthy society launched in 2011). The EUSBSR aims at making the Baltic Sea Region cleaner, more connected and more prosperous. It is accompanied by the Action Plan comprising 15 Priority Areas, which represent the main areas where the EUSBSR can contribute to improvements. The Action Plan has been updated several times, in order to take into account the relevant developments in the region. Almost three years after its adoption, a more fundamental review of the EUSBSR Action Plan is currently being performed, to be completed by the end of 2012 or early The most important elements of this review will be the introduction of objectives, indicators and targets to enable measuring the success of the Strategy and to focus efforts on the most urgent challenges. In addition, there will also be an assessment of the number and content of the Priority Areas, to decide if they could be merged or reinforced. Last but not least, the Strategy needs to be aligned with the Europe 2020 objectives and the financing programmes of the next EU financial period. An overall analysis is currently being prepared by the Priority Area Coordinators and the Horizontal Action Leaders. During the 3 rd Annual EUSBSR Forum held in Copenhagen on June 2012 two sessions were devoted to the review of the Strategy and its Action Plan. The Forum provided an excellent opportunity for the interested stakeholders to contribute to the drafting of the Action Plan by voicing their views and concerns. The following were the main views expressed during the event and the conclusions from it: The EUSBSR has succeeded in fostering cooperation and in finding new ways of cooperation. However, the progress among different Priority Areas has been uneven an issue that should be addressed in an open way and reflected in the revised EUSBSR Action Plan; Focusing on delivering results is of vital importance. The targets and indicators will be a useful tool for monitoring the progress and increasing the accountability of the actors involved; Close alignment with the Europe 2020 Strategy and the next EU financial period ( ) is indispensable to ensure further success of the Strategy; Relevant stakeholders from EU and non-eu countries should be better involved, including representatives of civil society, business and local level; Some of the actors involved call for a reduction of a number of Priority Areas. Others stress that the reduction should not be an aim per se. Proportionality and assessment of performance should be applied in this respect (NB. The latter is what also the NDPHS stressed on many occasions); Social dimension should be stronger reflected in the EUSBSR. Northern Dimension Partnership in Public Health and Social Well-being 5

6 PrimCareIT: Counteracting Brain Drain and Professional Isolation of Health The nations in the Baltic Sea Region as well as the rest of Europe face the challenges of an ageing population. This leads to a rising demand for primary health care services. Rural and remote areas of the regions are affected most because of the free movement of medical professionals within the regions and even the whole EU. The PrimCareIT project is a flagship initiative part-financed by the Baltic Sea Region Programme , bringing together 16 institutions from 7 Baltic Sea Region countries (Belarus, Estonia, Finland, Germany, Latvia, Lithuania and Sweden). Project partners are elaborating an idea that the use of tele-consultation and tele-mentoring has a strong potential to provide opportunities for professional networking, continuing medical education and career development for younger and experienced doctors and health workers in remote areas. This in turn counteracts brain drain and professional isolation in sparsely populated areas for more equal access to primary health care in the BSR. The project is developed under the umbrella of the ehealth for Regions network, which has been appointed by the NDPHS to coordinate the ehealth component within the EUSBSR Action Plan. The project s partnership is a composition of healthcare institutions, medical doctors associations, planning and financing authorities, regional development administrations, health and IT research institutions. The South Ostrobothnia Health Care District, Finland has assumed the lead partner role in the project. By reusing their outputs the PrimCareIT project also complements two other EUSBSR flagship projects also part-financed by the Baltic Sea Region Programme , namely the ICT for Health and the ImPrim. The project has already had its two successful kick-off meetings, one in Seinäjoki, Finland (February 2012) and the other in Karlskrona, Sweden (April 2012). The partners started the project work by analysing the existing barriers to large scale deployment of tele-consultation and tele-mentoring such as technology acceptance, work flows, daily routines or legal uncertainties. Six project work packages have started their work efficiently: the WP3, which is led by the Flensburg University of Applied Sciences, is preparing a transnational literature review on the current state and the challenges facing the deployment of tele-consultation and tele-mentoring, as well as making arrangements for expert interviews which will take place in the partner countries later this year. Tele-consultation and tele-mentoring solutions between health workers, general practitioners and medical specialists in pilot sites are being designed and prepared in the WP 4 (led by the Blekinge Institute of Technology) and the WP5 (led by the Estonian Society of Family Doctors), and will be implemented by the end of the year. The WP6 (also led by the Blekinge Institute of Technology) is responsible for raising the awareness among the political stakeholders. The WP1, which is led by the South Ostrobothnia Health Care District, manages the overall project activities, and the WP2, which is led by Vilnius University Hospital Santariškių Klinikos, is responsible for the project communication and dissemination of the results to the public. The project website will be launched in June 2012 ( For further information please contact Sami Perälä, Prim- CareIT Lead Partner, South Ostrobothnia Health Care District (sami.perala@eptek.fi, ). Sami Perälä PrimCareIT Lead Partner The NDPHS e-newsletter is published by the Northern Dimension Partnership in Public Health and Social Wellbeing (NDPHS) Secretariat in Stockholm, Sweden. It is published bi-annually and is available in electronic format through direct mailing to subscribers, and on the NDPHS website, where you can also subscribe to it ( The newsletter may be freely reproduced and reprinted, provided that the source is cited. While the contributions received for this issue are highly appreciated, it should be noted that the views and opinions expressed by the contributors do not necessarily reflect those of the publisher. We plan to publish the next issue in late August Contributions are encouraged and welcome. If you are interested, please contact us at the. Slussplan 9 P.O. Box 2010 SE Stockholm, Sweden Tel: Fax: secretariat@ndphs.org Website: Northern Dimension Partnership in Public Health and Social Well-being 6