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2016 The Future
of Hospitals and Healthcare
Dr Simone Tasso HOPE Italy
WELCOME
Giunta Regionale Area Sanità e Sociale
Rome, Fori Imperiali
Apolozige from
Dr. Domenico Mantoan
Giunta Regionale Area Sanità e Sociale
WELCOME TO ITALY
The Creation of Adam by Michelangelo (Sistine Chapel – Vatican City)
Dr. Domenico Mantoan HOPE Governor for Italy
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Dr. Simone Tasso HOPE Liason Officer for Italy
As Italian representative for HOPE, I’m glad to be here, in the opening session of this International Conference . HOPE was created 50 years ago, exactly in Rome. And we are celebrating this important anniversary
The creation of the sun and moon (detail) by Michelangelo (Sistina Chapel- Vatican City)
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HOPE was founded thanks to the vision of farsighted people when Europe was at the beginning of a new era. The European Economic Community (EEC) was at its beginning, founded by the Treaty of Rome in 1957 .
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Plato and Aristotle- detail from the School of Athens By Raffaello – Vatican City Museum
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It was a different Rome in a different Europe, coming from the Second World War, looking at the future “full of hope”, willing to build a better future, thinking to build a united Europe.
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Roman Holiday (by William Wyler) with Audrey Hepburn and Gregory Peck
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In 1966 HOPE founders had the enlightened idea that, for promoting better health of European citizens, it is necessary to work at European level.
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Rome, Trevi Fountain in 1966
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In the ‘60s Hospitals were the centre of Healthcare Systems, sometimes as large as towns, reaching even 1000-2000 beds. It was natural to create HOPE as an Hospitals Association.
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Hospital in the ‘60s
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Later hospitals became smaller and new Health Services began to develop
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HOPE was prompt to intercept these changes, becoming…
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European Hospital and Healthcare
Federation
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Important work was made during all these years:
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- Creating Networking
- Publishing significant data and studies
- Sharing notable information
- Building valid relationships with European Commission such as…
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MEETING HOPE
and Dr. Vytenis Andriukaitis
26 March 2015
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Dr. Vytenis Andriukaitis EU Commissioner for
Health and Food Safety
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What about HOPE in Italy ?
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General Aspects
ITALY
Rome Population: around 60 millions inhabitants
Regions : 20 which are extremely varied for: size population levels of economy development
Giunta Regionale Area Sanità e Sociale
NHS in Italy National Level states the main rules regarding Planning, Organization and Financing System: -Since 1978: Beveridge System , based on taxation and covering all citizens - It was created in 1978 as “Universal System”
-The total amount of NATIONAL HEALTH FUND (around 111 billions of Euro in 2016)
-The amount for each Region (capitation & age)
Lord William Beveridge
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Rome
VENETO REGION
5 millions inhabitants Territory divided in: 7 counties (province) 579 municipalities
Since 2014, the Veneto Region has been delegated to be the Italian Focus Region for HOPE
It is in the North-Est of Italy The most known town is ...
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VENICE
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Main indicators Veneto Italy
Population 4.9 millions 59.8 millions Gross domestic prod. per capita 30,500 euro 26,700 euro Life expectancy at birth M: 80.7
F: 85.4 M 80.1 F: 84.7
Unemployment 6.6% 12.1% % < 14 years 13.8% 13.7% % > 65 years 22% 22% Net migration -0.3 +0.4 Average age at childbirth 31.9 31.6 Old age ratio 154.8 157.7
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8,3
6,3
3,9 3,4 3,3
3 2,8 2,6 2,9 2,7
2,3
0,7
0
1
2
3
4
5
6
7
8
9
10
Germania Francia Norvegia Italia* VENETO2015
Spagna UK Svezia USA* Canada* Brasile* India*
Hospital beds, Per 1000 population
Year 2013
*ANNO 2012
Rapporto Oasi 2015 su dati OECD 2015 e Who 2015
Following the trend described by W.H.O. , we are decreasing our acute beds …..
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265,5 252,2
185,8 193,3
164,6
132,4 117,2 110,3 108,7
99,7
212,8
125,49 138,6
83,2
55,9
0
50
100
150
200
250
300
Austria Germania Francia* Norvegia Svezia* UK Italia Spagna PortogalloVENETO 2014 Russia USA* Cina Canada* Brasile*
Hospitalization rate per 1.000 population
*ANNO 2012
Rapporto Oasi 2015 su dati OECD 2015
Year 2013
And decreasing hospitalization rate….
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IS IT ENOUGH ?
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Hospitals and Health Services without Walls
Health Promoting Hospitals
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“Hospitals and Health Services without Walls”
In Italy and in Veneto Region we are following this idea We are breaking the walls…
Beside, you can see the poster describing a W.H.O. Conference 2009 :
“BREAKING THE WALL”
Creating Intersectorial actions between hospitals and health services, involving GPs
Sharing Guidelines & Creating Functional Clinical Networks, such as: Stroke Network Oncological Network Diabetes Network Alzhaimer’s Disease Network Rare Diseases Network Emergency Network Pain Therapy Network Transplant Newtwork……
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“BREAKING THE WALL”
Heading to a new role of Primary Care and Health Professions such as nurses and midwives
Empowering Information Technology Sharing Electronic Data Base Putting the patient in the centre
Increasing Intermediate Care: Country Hospitals Rehabilitation Hospitals Palliative Hospitals (=Hospices)
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What about the future ?
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in Europe ?
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Lord William Beveridge
Otto prince of Bismarck
In Europe, Health Systems are part of the Welfare State which was able to produce ….. the longest life expectancy... ….around 80 years…
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0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
80,0
90,0
Main world averages of life expectancy EU Countries: around 80 years
Rapporto OASI from W.H.O. 2015
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Health spending in % Gross Domestic Product (GPD) OECD Countries 2013
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USA Europe (average)
This was achieved with costs not as expensive as other countries… i.e. % GDP : USA 16,4 %, EU around 9,0 %
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Lord William Beveridge
European Health Systems are… treasures
But in a world of Global Crisis Global Economics Global Finance….
Otto prince of Bismarck
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Anti-Hepatitis C - Therapy 71,000 Euro / 84,000 US Dollars per treatment (six months long)
Increasing costs
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There is an increasing problem
that means…
The last Judgment (detail)
by Michelangelo (1534)
Sistine Chapel – Vatican City
SUSTAINABILITY PROBLEM
Will we survive ?
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.
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The USA example
This is Ron Wyden Chairman of the
Committee on finance of USA Senate
He signed the following (famous) letter …
…the letter sent to Gilead Science Inc. (Sovaldi’s Owner)
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Writing …. Why so high prices? $ 84,000 in USA Only $ 900 in Egypt?
Even the USA have a problem of sustainibilty and its Senate asks to the Health Care Industry explanations about the costs!
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What can we learn?
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Facing Global Economy needs to create: International public actions International collaborations
HOPE is a right way to promote international collaborations and to give updated information on key matters
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For instance ?
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T T I P
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HOPE is giving up-dated information on TTIP
In Europe, during the last 2 years, an important discussion has been going on about its impact on Healthcare Systems
In particular the most known discussion was probably between ....
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The discussion on TTIP
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Cecilia Malmstrom European Commissiner on Trade
Ian Livingston, UK Minister (2013-2015) for Trade and Investiment
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The discussion on TTIP
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Ian Livingston, UK Minister (2013-2015) for Trade and Investiment
UK Minister was worried about the possible impact of TTIP on NHS
European Comissioner replied in this letter to UK Minister
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In few words, she replies that there is no reason to be worried because the EU uses a series of reservations……
She concludes inviting to examine the text…
It is important we take under control all the updates of the text of TTIP
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Also for the un-direct impacts TTIP can have on our Health Systems
For instance ….
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The TTIP deals with intellectual property (IP) and on Trade-Related aspects of Intellectual Property Rights (TRIPS) . From the USA part, it seems to push for expanding and extending the duration of patent monopolies.
This could mean, for instance, a longer duration of pharmaceutical patent monopolies, delaying the availability of generic drugs
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Another possible impact?
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The TTIP deals with the Investor to State Dispute Settlement (ISDS) arbitration system. This system allows transnational companies to sue the governements when a policy or law reduce the value of their investiments . How can it work on policy regarding the reduction of alchool / Tobacco consuption ?
(i.e. In 2010, using this ISDS , Philipps Morris International sued Uruguay for placing warnings on tobacco )
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CONCLUSIONS
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CONCLUSIONS
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In Europe there is a growing sentiment of dis-trust and disagregation
Sometime pushing to build walls inside the same EU
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CONCLUSIONS
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Maybe we have to remeber the story of Europe
Its name comes from… Europa
Who was Europa ?
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The abduction of Europa by Francesco Rustici (1474-1554) Victoria and Albert Museum - London
Europa (Princess from Asia)
He transformed himself into a bull to carry her to a new continent…
God Zeus fell in love with her and..
Greek Mithology
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The abduction of Europa
By Titian
By Goya
By Rembrant
And…
in the new continent, Europa brought, as gift, a lot of beauty
And the new continent , in her honour, was called
Europe
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Europe brought to the
world other important gifts….
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CONCLUSIONS
Europe was the home of the ANCIENT DEMOCRACIES
Ancient Athens
Ancient Roman Senate
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CONCLUSIONS ...MODERN DEMOCRACY
Baron de Montesquie
John Locke
Separation of the powers (tria politica principle):
Legislative Executive Judicial
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CONCLUSIONS
Galileo Newton
...MODERN SCIENCE
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CONCLUSIONS
Eisenberg Eistein
...CONTEMPORARY SCIENCE
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BREATH-TAKING ART
Sistine Chapel – Vatican City
58 Sandro Botticelli 1478 “The Spring” Galleria degli Uffizi - Florence
Europe gave its best when it put in the centre the
“Human Kind”
RENASSAINCE PERIOD
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CONCLUSIONS …and when it put in the centre the HUMAN RIGHTS
Voltaire
«I might disagree with your opinion, but I’m willing to
give my life for your right to express it»
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CONCLUSIONS AND IN EUROPE HEALTH IS … A… HUMAN RIGHT !
Lord Beveridge
The European Health Systems
are treasures coming from
this philosophy Otto prince of Bismarck
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The Spring (detail) - Sandro Botticelli 1478 Florence - Galleria degli Uffizi
CONCLUSIONS No separation No disagragation
With Globalization and Economic Crisis we need stronger collaborations in the name of our common roots and of the principles that Europe tought to the world
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The Spring (detail) - Sandro Botticelli 1478 Florence - Galleria degli Uffizi
CONCLUSIONS
More today than in the past, the future of our National Health Systems is also in our capabilities to create international collaborations.
HOPE can be one of the key-actors in this future…
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The Spring (detail) - Sandro Botticelli 1478 Florence - Galleria degli Uffizi
CONCLUSIONS
We need a
New Renassaince And New Bridges
WE COULD CREATE A NEW SPRING !
Giunta Regionale Area Sanità e Sociale
Rome, Fori Imperiali 100 1966-2066
2066 100 ANNIVERSARY
WELCOME TO EUROPE !
