Structural Funds and Structural Funds and healthhealth

Cross border health careCross border health careBrussels, 21 March 2006Brussels, 21 March 2006

COHEUR ALAIN

Director european affairs

Some figures :Some figures :- 19 regional federation- 19 regional federation- 2 925 000 beneficiaries – 30% of the - 2 925 000 beneficiaries – 30% of the populationpopulation- 4 500 employees - 4 500 employees - 20 home service units- 20 home service units- 46 optical centres- 46 optical centres- 58 polyclinics- 58 polyclinics- 6 general hospitals offering 1452 beds- 6 general hospitals offering 1452 beds- 23 warehouses loaning out equipment- 23 warehouses loaning out equipment- 17 holiday centres- 17 holiday centres

National Union of Socialist Mutual Health Funds

3

COMMUNITYCOMMUNITYINITIATIVESINITIATIVES

2000 - 2006

• INTERREG 4.9 billion euro• LEADER 2.0 - -• EQUAL 2.8 - -• URBAN 0.7 - -

TOTAL TOTAL 10.3 10.3 -- --

4

General principles :General principles :- Economic and social cohesionEconomic and social cohesion- Balanced and sustainable development of the European Balanced and sustainable development of the European

territoryterritory- TTerritorial integration with candidate and other erritorial integration with candidate and other

neighbouring countriesneighbouring countries

INTERREG III 2000 - 2006INTERREG III 2000 - 2006

Increased budgetIncreased budget : : - 2000-2006: 4.9 billion euro- 2000-2006: 4.9 billion euro- 1994-1999: 3.6 billion euro- 1994-1999: 3.6 billion euro

3 strands :3 strands : - A : - A : Cross-border co-operationCross-border co-operation (67%)(67%)

- B : Trans-national co-operation- B : Trans-national co-operation (27%)(27%)

- C : Interregional co-operation- C : Interregional co-operation (6%)(6%)

5

Cross BorderCross Borderco-operation co-operation

Eligible Eligible regionsregions

INTERREG III - STRAND AINTERREG III - STRAND A

6

Strand BStrand BCo-operationCo-operation

Areas Areas

7

A : Priority actions (not A : Priority actions (not exhaustive) :exhaustive) :

urban, rural (incl. coastal) urban, rural (incl. coastal) developmentdevelopment

entrepreneurship, SMEs, local entrepreneurship, SMEs, local developmentdevelopment

labour market integration & labour market integration & social inclusionsocial inclusion

RTDI, culture, RTDI, culture, info/communications info/communications networks,networks,

environment and energy environment and energy (espc. renewable)(espc. renewable)

transport infrastructuretransport infrastructure institutional capacity buildinginstitutional capacity building

INTERREG III STRAND A - INTERREG III STRAND A - BB

B : Thematic priorities (not B : Thematic priorities (not exhaustive) : exhaustive) :

Spatial development Spatial development strategies strategies

Cities’ and Rural/Urban co-Cities’ and Rural/Urban co-operationoperation

Transport and Transport and communications systemscommunications systems

Management of natural Management of natural resources (e.g. water)resources (e.g. water)

Management of cultural Management of cultural heritageheritage

Small-scale infrastructureSmall-scale infrastructure Maritime and insular co-Maritime and insular co-

operationoperation

8

Origin of the collaboration in health-careOrigin of the collaboration in health-care

European tendencies:European tendencies: growing mobility of the citizens, esp. in growing mobility of the citizens, esp. in

euregions, the first European citizenseuregions, the first European citizens mobility of working, mobility of living and mobility of working, mobility of living and

residing, migration,…residing, migration,… ageing population in Western Europeageing population in Western Europe growing challenges in health-caregrowing challenges in health-care mobility of patients, especially in border-mobility of patients, especially in border-

regions: "health-care in the neighbourhood, regions: "health-care in the neighbourhood, even across borders"even across borders"

freedom of settlement for providers of health-freedom of settlement for providers of health-care, e-health developments, …care, e-health developments, …

9

Eligible zone between France & Belgium Eligible zone between France & Belgium and Belgium – Germany – The and Belgium – Germany – The

NetherlandsNetherlands

VEURNE

IEPERKORTRIJK

MOUSCRON

TOURNAIATH

MONS

THUIN

PHILIPPEVILLEDINANT

NEUFCHATEAU

VIRTON

BELGIQUE

AISNE

ARDENNES

NORD

FRANCE

10

Cross border care Cross border care INTERREG III STRAND AINTERREG III STRAND A

- Forum for cross border matters and groups together people with numerous skills from organisations involved in health domain (sanitary domain and health insurance)

- Permanent arena for discussion, prospective studies and activities. The partners analyse concrete problems which exist in this area with a view to resolving them in the best possible may

- Bring competence and expertise to those who want to improve access to health care for the citizens in the frontier zone by way of cross border co-operation projects.

The Euregio Meuse-Rhin platform

Franco-Belgian Health Observatory (OFBS)

11

Cross border care Cross border care INTERREG III STRAND AINTERREG III STRAND A

The assignments are as follows :- to have a knowledge not only of the expectations of the population but also the health care available in the border zone

- to carry out studies which open up potentials ways of co-operation and complementarities

- to bring help and advice to projects operators

- to follow legal developments in national and Community law

- to be a vector of communication for the people and the health professionals and healthcare establishments settled on the border zone

- to be a catalyser for the cross border co-operation in the areas of public health and health promotion

The Euregio Meuse-Rhin platform

Franco-Belgian Health Observatory

12

Cross border care Cross border care

INTERREG III STRAND AINTERREG III STRAND A

The Euregio Meuse-Rhin platform

Franco-Belgian Health Observatory

The results :

- Creation of areas of access organised for cross border health care

- interhospital co-operation agreements in diverse domains such as urology, radiology, dialysis, infectious illness, pediaetric heart surgery, medical analysis for genetic illness

- evaluation of the cover for the elderly

- emergency services cross border

- accessibility to information for patients and professionnals via a website

13

Trans national border care Trans national border care

INTERREG III STRAND BINTERREG III STRAND B

The transnationalStrasbourg – Liège – Luxembourg hospital co-operation networkWHY :

To optimise the ways of contributing to the development and to the planning of the territory of North-West Europe

14

Trans national border care Trans national border care

INTERREG III STRAND BINTERREG III STRAND B

The objectivesPooling • potential medical – human – technological – scientific - intellectual• respective know-how

in order to - create an example and centres of excellence in the health sector - create a dynamic between professionals and encourage their mobility - promote the co-ordination of action - develop new techniques of communication, data-processing

15

Cross border care Cross border care

INTERREG III STRAND BINTERREG III STRAND B

The new information technologiesCreation of a transnational data-processing communication networkTreatment of patients and technological innovations in the health sectorTransnational development of innovative cognitive methods of treatment for patients with schizophreniaOptimisation of the treatment and rehabilitation of liver transplant patients in North-West EuropeTechnological innovation and transnational development of cell therapy treatment, haematology and oncologyHuman resources and in-service trainingVocational training for nursing care managersJoint transnational action to improve the quality of care in operating theatres

3 fields of action

16

Cooperation obstacles and difficulties

At the macro level- the historical and legal development of social context

- organization and financing of social security and health insurance

- the legislation in the field of public health, the role played by authorities, social partners and private organizations in the decision-making process concerning the projects and their implementation

17

Cooperation obstacles and difficultiesAt the micro level

- language used

- remuneration of doctors and medical demography

- equivalence of medical protocols

- management of the patient in the sense of continuity of care

- impact of the coverage of care on the hospital budget

- noscomial infections

- financial burden for the patient

18

Synergies and potentials for co-operation

Existence of formal structures can occurs :

- role of facilatator (of assistance) by creating working parties

- role of identifier of supply and demand

- role of negociator (of representative) in the contacts with authorities, providers and insurance organizations

- role of catalyst and diffuser of experiences and results with other partners

19

Synergies and potentials for co-operationCross-border cooperation enables :- better access to health infrastructures and can therefore reduce distances of access and possible waiting lists

- better knowledge of regional and cultural differences and constitutes therefore a powerful factor of integration

- better exchange of information and favours therefore the development of exchange and training for the medical hospital staff

- better consideration of deficiencies and insufficiencies of the offer and can therefore lead to reflections on the maintenance of services or installation of common equipment (cross-border planning of health infrastructures

20

Thank you Thank you very much very much

for your attentionfor your attention