Rapporteur on Innovation in Social and Health Care

Rapporteur on Innovationin Social and Health CareReportOslo, 2017Baltic Sea Parliamentary ConferenceBaltic Sea Parliamentary ConferenceRapporteur on Innovationin Social and Health CareReportOslo, 20172Report of the BSPC Rapporteur on Innovationin Social and Health Care© Oslo, 2017T ext: Olaug Bollestad Editing: Bodo BahrLayout: produktionsbüro TINUSBaltic Sea Parliamentary ConferenceBodo BahrSecretary General +49 171 5512557bodo.bahr@bspcmail.netwww.bspc.netBSPC Secretariatc/o Lennéstraße 119053 SchwerinGermanyThe Baltic Sea Parliamentary Conference (BSPC) was established in 1991 as a forum forpolitical dialogue between parliamentarians from the Baltic Sea Region. BSPC aims at rais-ing awareness and opinion on issues of current political interest and relevance for the Baltic Sea Region. It promotes and drives various in-itiatives and efforts to support a sustainable environmental, social and economic develop-ment of the Baltic Sea Region. It strives at en-hancing the visibility of the Baltic Sea Region and its issues in a wider European context.BSPC gathers parliamentarians from 11national parliaments, 11 regional parliaments and 5 parliamentary organisations around the Baltic Sea. The BSPC thus constitutes aunique parliamentary bridge between all theEU- and non-EU countries of the Baltic SeaRegion.BSPC external interfaces include parlia-mentary, governmental, sub-regional and oth-er organizations in the Baltic Sea Region andthe Northern Dimension area, among themCBSS, HELCOM, the Northern Dimension Partnership in Health and Social Well-Being (NDPHS), the Baltic Sea Labour Forum (BSLF), the Baltic Sea States Sub-regional Co-operation (BSSSC) and the Baltic Develop-ment Forum.BSPC shall initiate and guide political ac-tivities in the region; support and strengthen democratic institutions in the participating states; improve dialogue between govern-ments, parliaments and civil society; strength-en the common identity of the Baltic Sea Re-gion by means of close co-operation between national and regional parliaments on the basis of equality; and initiate and guide political ac-tivities in the Baltic Sea Region, endowing them with additional democratic legitimacy and parliamentary authority.The political recommendations of the an-nual Parliamentary Conferences are expressed in a Conference Resolution adopted by con-sensus by the Conference. The adopted Reso-lution shall be submitted to the governments of the Baltic Sea Region, the CBSS and the EU, and disseminated to other relevant na-tional, regional and local stakeholders in the Baltic Sea Region and its neighbourhood.3ContentsI. Background ........................................ 5II. Introduction ....................................... 6III. Follow-up of the Conference Resolutionadopted by the 24th BSPC ........................... 7A. Cross-border Cooperation in Health Care(Recommendation 13 – 26) ........................ 7B. Health Economy(Recommendation 27 – 39) ........................ 9C. Sustainable and Accessible Social and Health Care(Recommendation 40 – 57) ....................... 114 I. Background5 I. BackgroundI. BackgroundIn 2013 the Baltic Sea Parliamentary Conference (BSPC) estab-lished a working group on Innovation in Social and Health Care(ISHC) in order to raise the political attention on these issues. Theworking group consisted of parliamentarians from nine different countries, with the aim being to contribute to the exchange of knowledge and best practices, and to develop a set of recommenda-tions that should be pursued in national parliaments and govern-ments. The final report was presented to the 24th BSPC in Rostock in Mecklenburg-Vorpommern in September 2015.In order to follow up the recommendations on innovation in socialand health care made by the working group and the BSPC, a rap-porteur was appointed. The basic role of the rapporteur is to followup the implementation of the recommendations within the subjectarea. It is therefore a great pleasure for me to submit this report to the 26th BSPC Conference, and I would encourage you to engage in these essential issues for our future.Olaug Bollestad6 II. IntroductionII. IntroductionMany countries today face similar challenges within social welfareand health care. These include an ageing population, health ine-qualities, financial pressure on the service systems, vested interestsof the pharmaceutical and medical industries, and a rising shortage of qualified personnel.Virtually all countries have to cope with these challenges causedboth by external development trends, such as the financial crisis, and by internal transformations. As a consequence, we must learn to think differently. Innovation will be an important tool and strat-egy to counter these challenges.A diversity of supportive measures at different societal levels and ina broad range of sectors is necessary to address the challenges andpromote ISHC. Such measures could consist of, for example, polit-ical strategies and programmes for the benefit of ISHC, fiscal meas-ures, information and awareness-raising campaigns, research andeducation.On the basis of its mandate, the working group on ISHC proposed45 political recommendations grouped under the following threeheadings: Cross-border Cooperation in Health Care; Health Econ-omy; and Sustainable and Accessible Social and Health Care. These recommendations include proposals of the meetings of the Stand-ing Committee of the BSPC in 2015, and the contribution of theBSPC to the 4th Northern Dimension Parliamentary Dialogue.This report aims to summarize the member states’ and regions’ fol-low-up of recommendation 13 to 57 in the Conference Resolutionadopted by the BSPC in 2015, and to give an overview of the state of social and health care in the Baltic Sea Region.7 III. Follow-up of the Conference Resolution adopted by the 24th BSPCIII. Follow-up of theConference Resolution adoptedby the 24th BSPCA. Cross-border Cooperation in Health Care (Recommendation 13 – 26)Paragraph 20· to improve transnational cooperation and medical speciali-zation in the treatment of rare diseases, bearing in mind the cost-effective usage of medical equipment;Paragraph 21· to regulate transnational emergency care in a way that thefastest possible health care provision can be guaranteed re-gardless of the health care providers ́ country of originParagraph 23· to reduce the usage of antibiotics – general – and for agricul-ture (livestock farming) to a minimum in order to prevent further increase of antimicrobial resistanceMost countries report placing great value in cross-border cooper-ation in health care. However, it is particularly relevant to high-light Nordic cooperation in this matter. The Nordic countrieswork together closely on such subjects as specialised care, rare dis-eases, drugs, education, supervision in the health care professions, financing of health care, and prevention and management of anti-microbial resistance. The Könberg Report, commissioned by theNordic countries, identifies areas of development for collabora-tion in health care. Consequently, several of the objectives men-tioned in the paragraphs have already been accomplished within the Nordic cooperation. Some countries note that the experience8 III. Follow-up of the Conference Resolution adopted by the 24th BSPCgained from the Nordic cooperation on health could serve as anexample for the Baltic Sea region.Other important areas of cross-border cooperation are the North-ern Dimension Partnership in Public Health and Social Well-be-ing, and the participation of certain countries in European re-search projects.Concerning the aim to reduce the use of antibiotics, most coun-tries refer to national strategies and programmes involving re-search, the allocation of funds for projects and guidelines. Some ofthese are based on the WHO’s action plan and the future EU council conclusions currently under discussion. Some countriesalso refer to the fact that antimicrobial resistance is a very topicalissue at an EU and global level, and that numerous documents, both legislation and recommendations, are being prepared at the EU level.9 III. Follow-up of the Conference Resolution adopted by the 24th BSPCB. Health Economy(Recommendation 27 – 39)Paragraph 31· improve conditions to support the development of innova-tions in health care, including in the fields of eHealth and telemedicine, whilst ensuring that investments in eHealth support the adoption of standards and drive interoperabili-ty across the health sector to leverage the “eHealth EuropeanInteroperability Framework” (eEIF) and observe the joint European initiatives, such as the “Guidelines under eHealthNetwork” of the responsible member state authoritiesParagraph 34· to improve early intervention to strengthen good publichealth through social investment such as vaccine programs,and take strong measures to reduce consumption of alcohol, tobacco and illicit drugs, and work towards stronger preven-tion of diabetes II and other lifestyle illnessesThe majority of countries are supporting and strengthening the use of eHealth technologies, and have made this an integrated part oftheir modern health services. Several countries report having partic-ipated in a number of innovation projects in the health sector. Tele-medical services are developing. E-prescription, electronic health records and other types of information systems are continuously be-ing implemented. Furthermore, some countries, such as Estoniaand Finland, are working to establish cross-border e-prescriptions and cross-border sharing of patient data. Estonia is currently pre-paring a study on factors affecting cross-border sharing of patientdata, which includes people from across Europe.Most countries also report being members of the European eHealthNetwork and the supporting Joint Action, promoting wide guide-lines and international standards for eHealth.Public health and a reduction in the consumption of alcohol, tobac-co and drugs are on the agenda of all of the countries. They reporthaving launched different types of action programmes and projectsaiming to improve public health and reduce risky behaviour. Some countries have established expert groups on specific health10 III. Follow-up of the Conference Resolution adopted by the 24th BSPCchallenges, launched national awareness campaigns and conductedsurveys in order to identify habits and attitudes of people towardsalcohol, tobacco and drugs. Many projects and campaigns tend tofocus on young people. One example is from Denmark, which has launched an anti-drug campaign – Music Against Drugs – in a va-riety of music festivals and halls.In addition, several countries have adopted new legislation regulat-ing such things as the serving of alcohol, alcohol and tobacco adver-tising, and the sale of electronic cigarettes. The implementation ofEU directives on tobacco products has either been completed or isstill under way.The majority of countries are striving to increase physical activity, inparticular for children and adolescents. Moreover, a healthy diet and the prevention of obesity are other key elements in their nation-al strategies and programmes. Latvia has state funded meals for pu-pils, and legislative efforts have been made to limit the access to food products with high amounts of trans fatty acids in schools, kindergartens and health care institutions.Most countries report that they are continuously considering howto improve and increase the uptake of vaccines in their national vac-cination programme.11 III. Follow-up of the Conference Resolution adopted by the 24th BSPCC. Sustainable and Accessible Socialand Health Care(Recommendation 40 – 57)Paragraph 43· to develop and strengthen strategies addressing demograph-ic change, such as the European Innovation Partnership on Active and Healthy Ageing and especially considering pub-lic services with regard to rural peripheral areasParagraph 49· to carry out studies with the aim of developing preventionstrategies in health care, such as the North Trøndelag HealthStudy (HUNT)Paragraph 52· to create incentives to improve the conditions of the nursingand care professions and to work towards intensified profes-sional and vocational training for people employed in the health sector to significantly facilitate a cost-effective healthsystem in the region and foster understanding of the healthsector as a cross-cutting issueMost countries have launched national strategies for active ageingin order to create an age-friendly society. One example is the Nor-wegian Government’s strategy of focusing on how to give senior citizens the opportunity to participate in work and society so that their life quality and autonomy can be maintained longer.With regard to public services in rural peripheral areas, there aremany examples that could be mentioned. In Lithuania, the deliv-ery of family related services is envisaged through CommunityFamily Houses, which they plan to establish in every municipali-ty. Examples of services that will boe on offer are courses in posi-tive parenting, child care, and assistance to families experiencing various types of crisis.12 III. Follow-up of the Conference Resolution adopted by the 24th BSPCIn Mecklenburg-Vorpommern, the responsible ministry has re-solved to ensure the quality of life in rural areas as a strategic focusin their development programme. In Estonia, a new Social Wel-fare Act was adopted in 2015, which, among other things, sets minimum standards for social services provided by local munici-palities.Some countries have also established working groups to look intothis matter, such as Estonia, where an inter-ministerial task force was set up to put forward measures on this topic.Several countries have conducted national surveys and havelaunched state funded research programmes. Many of them havealso joined international studies, initiated by such organizations as the World Health Organization. Lithuania has conducted period-ical lifestyle surveys for children since 2016. From 2018 an adultlifestyle survey will be carried out. Norway gives financial supportto two population-based health studies, one being HUNT4 and the other being T romsø Health Study number 7. Another example is from Hamburg where the University Medical Centre Eppen-dorf started a similar long-term study called “Hamburg CityHealth Study”, which examined the health of 45,000 people.Most countries have launched competence plans or legislation toimprove the conditions of nursing and care professions. In Esto-nia, a bill was passed in 2015 to grant nurses the authority to write prescriptions, and they are currently working on creating the legalframework to also allow nurses to carry out independent patientvisits. The government of Åland aims to create better working conditions for health and care professions by digitalizing the sec-tor. In Hamburg, a dual course in medical and health care hasbeen created, providing the graduates with a training qualificationas well as a university degree.Some countries also underline the framework for the EuropeanSocial Fund financing for 2014-2020, which aims to support dif-ferent objectives relating to this field . An example of this is the ef-fort to improve access to medical personnel in rural regions, and the training of health care professionals.Baltic Sea Parliamentary Conference Secretariatwww.bspc.netBSPC Secretariatc/o Lennéstraße 119053 SchwerinGermanyPhone (+49) 385 525 2777