2. The Department of Prevention in the National Health System Maria Grazia Pompa Communicable Diseases Unit Agenzia Sanità Pubblica - Regione Lazio Viral Hepatitis Prevention Board Meeting Catania, November 7- 8. 2002

3. 4 Re-organisation of the National Health System (NHS) 4 Reform of the public administration 4 European Union 4 Federalism The institutional scenario 4 Evolution of the specific laws

4. Only the DP can lay out some services National Health System Open market of services in a settled and controlled system Monopoly of Department of Prevention (DP)

5. Local Health Unit Director General Director AdministrativeDirector Sanitary Social Services Manager Hospital Department of Prevention District Staff Hygiene and Public Health sanità animale Manufacturing hygiene... Breeding hygiene…... Altri servizi…. * nei casi previsti dall'art. 3, comma 3,4 del D.Legisl. 502/92 Prevention and safety in a job place Foods and nutritional hygiene

6. 4 Tutelage of the Public Health 4 Operative module of Local Health Unit 4 Economic and organising autonomy Department of Prevention

7. Garantire la tutela della salute collettiva e fornire risposta unitaria ed efficace alla domanda di salute della popolazione attraverso strategie di : F Health promotion F Prevention of diseases F Quality of life Department of Prevention

8. 8 Liaisons with the other part of LHU and Hospitals 8 Promotion of action at environmental, human, animal level. 8 Objectives for the prevent the diseases and enhancing the quality of life Department of Prevention

9. D. legislativo n. 229/1999, Art. 7- quinquies (coordinamento con le Agenzie regionali per lambiente) …..integrazione tra politiche sanitarie ed ambientali, con particolare riguardo alla sorveglianza epidemiologica e comunicazione del rischio D. legislativo n. 502/1992

10. Department of Prevention Objective Health promotion Social equity Priorities Effectiveness/efficiency EBP RESEARCH

11. Department of Prevention characteristics Risk assessment Evidence-Based Prevention Co-operation with other social subjects Epidemiological knowledge

12. COMMUNICATION Department of Prevention characteristics

13. Department of Prevention characteristics QUALITY ASSURANCE Evaluation of: - outcomes - specialist

14. What kind of prevention??? Ethics/ Equality Benefits versus losses PRIORITY Evidence- -based prevention

15. From control bureaucratic model... …to programming a plan for prevention What kind of prevention???

16. Department of Prevention RE-ORIENTATING EPIDEMIOLOGY COMMUNICATION QUALITY ASSURANCE Preventive medicine Curative medicine

17. Department of Prevention Ministry of Health Co-ordinationIndicatorsFinancing