1. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 Forum 3 European Health Forum Gastein 2005 Dr. Birgit Weihrauch Member of the Board European Public Health Centre (EPHC) NRW INVOLVED CITIZENS: PARTNERS FOR HEALTH INTRODUCTION BY THE CHAIR

2. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 EUROPEAN PUBLIC HEALTH CENTRE (EPHC) NRW WHO ARE WE ? MEMBERS: REPRESENTATIVES OF AUTHORITIES,UNIVERSITIES, ASSOCIATIONS OF THE HEALTH CARE SECTOR PURPOSE AND OBJECTIVES: PROMOTION OF DIALOGUE BETWEEN POLITICS, SCIENCE AND PRACTICE IN EUROPEAN HEALTH POLICY AND PUBLIC HEALTH INFORMATION: www.ephz.de

3. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 NORTH- RHINE WESTPHALIA (NRW) Who are we? NRW – the most populated German state (Land NRW) - 18 million inhabitants NRW – the most populated German state (Land NRW) - 18 million inhabitants Located in the middle of Europe – bordering Belgium and the Netherlands Located in the middle of Europe – bordering Belgium and the Netherlands A European region with numerous initiatives for supporting the European integration process in the field of health care A European region with numerous initiatives for supporting the European integration process in the field of health care

4. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH EXPERT COUNCIL FOR THE CONCERTED ACTION IN THE HEALTH SYSTEM - GERMANY 1992: PARTNERSHIP INSTEAD OF PATERNALISM NEEDED IN THE RELATIONSHIP BETWEEN PHYSICIAN AND PATIENT -

5. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH MESSAGE TODAY: COMPETENT CITIZENS AND PATIENTS AND THEIR ACTIVE INVOLVEMENT STRENGTHEN THE POSSIBILITIES OF SELF-RESPONSIBILITY AND WELLBEING ALSO IN THE CASE OF DISEASE AND CONTRIBUTE TO A FUTURE - ORIENTED HEALTH SYSTEM

6. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH EUROPEWIDE A CHANGE IN UNDERSTANDING: A SOCIETAL PROCESS FOR PATIENTS AND PROVIDERS THAT TAKES IST TIME AND THAT TAKES IST TIME AND THAT IS DIFFERING IN FOCUS AND QUICKNESS THAT IS DIFFERING IN FOCUS AND QUICKNESS

7. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH EXAMPLES OF INTERNATIONAL ACTIVITIES 1979 - CHARTER OF HOSPITAL PATIENT (EU) 1979 - CHARTER OF HOSPITAL PATIENT (EU) 1986 - DECLARATION ON THE PROMOTION OF PATIENTS RIGHTS…(WHO) 1986 - DECLARATION ON THE PROMOTION OF PATIENTS RIGHTS…(WHO) 1994 – DECLARATION ON THE PROMOTION OF PATIENTS´ RIGHTS…(WHO) 1994 – DECLARATION ON THE PROMOTION OF PATIENTS´ RIGHTS…(WHO) 1997 – CONVENTION FOR THE PROTECTION OF HUMAN RIGHTS…(OECD) 1997 – CONVENTION FOR THE PROTECTION OF HUMAN RIGHTS…(OECD) 1997 – GOTHENBURG WORKSHOP: PATIENTS´ RIGHTS IN EUROPE…(WHO) 1997 – GOTHENBURG WORKSHOP: PATIENTS´ RIGHTS IN EUROPE…(WHO) 2000 – RECOMMENDATION REC (2000) 5…(OECD) 2000 – RECOMMENDATION REC (2000) 5…(OECD) Since 2001 – EUROPEAN HEALTH FORUM …(EU) Since 2001 – EUROPEAN HEALTH FORUM …(EU)

8. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH 1990– 2005 IN MANY COUNTRIES PATIENTS‘RIGHTS LAWS : (E.G.: FINLAND, NETHERLANDS, ISRAEL, LITHUANIA, ICELAND, LATVIA, HUNGARY, GREECE,DENMARK, NORWAY, GEORGIA, FRANCE, BELGIUM, SWITZERLAND, RUSSIA, ESTONIA, CYPRUS) (E.G.: FINLAND, NETHERLANDS, ISRAEL, LITHUANIA, ICELAND, LATVIA, HUNGARY, GREECE,DENMARK, NORWAY, GEORGIA, FRANCE, BELGIUM, SWITZERLAND, RUSSIA, ESTONIA, CYPRUS)OR CHARTERS OF THE RIGHTS OF PATIENTS : (E.G.:FRANCE, SAN MARINO, UK, CZECH REPUBLIC, SPAIN, IRELAND, MALAYSIA, SOUTH AFRICA, PORTUGAL, HONG KONG, GERMANY, POLAND, SLOVAKIA, AUSTRIA, CYPRUS, ITALY) (E.G.:FRANCE, SAN MARINO, UK, CZECH REPUBLIC, SPAIN, IRELAND, MALAYSIA, SOUTH AFRICA, PORTUGAL, HONG KONG, GERMANY, POLAND, SLOVAKIA, AUSTRIA, CYPRUS, ITALY) Source: Internet - without guarantee

9. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH WHAT ARE THE MAIN ISSUES? CHANGING ROLE (PARTNERSHIP INSTEAD OF PATERNALISM) CHANGING ROLE (PARTNERSHIP INSTEAD OF PATERNALISM) INFORMATION AND TRANSPARENCY INFORMATION AND TRANSPARENCY ACTIVE INVOLVEMENT OF CITIZENS AND PATIENTS (INDIVIDUAL MATTERS AND MATTERS OF THE SYSTEM ) ACTIVE INVOLVEMENT OF CITIZENS AND PATIENTS (INDIVIDUAL MATTERS AND MATTERS OF THE SYSTEM ) QUALITY, SAFETY, PROTECTION ( STILL PATERNALISTIC APPROACH) QUALITY, SAFETY, PROTECTION ( STILL PATERNALISTIC APPROACH)

10. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH WHAT ARE THE CHALLENGES ? PREDOMINANT CHRONIC DISEASES (PATIENT AS A COPRODUCER) PREDOMINANT CHRONIC DISEASES (PATIENT AS A COPRODUCER) RISING IMPORTANCE OF PREVENTION AND HEALTH PROMOTION RISING IMPORTANCE OF PREVENTION AND HEALTH PROMOTION MORE COMPETITION AND FINANCIAL CONTRIBUTION OF PATIENTS ( HEALTH MARKET) MORE COMPETITION AND FINANCIAL CONTRIBUTION OF PATIENTS ( HEALTH MARKET) NEW ETHICAL QUESTIONS WITH TECHNICAL PROGRESS NEW ETHICAL QUESTIONS WITH TECHNICAL PROGRESS THE MODEL OF A SELF RESPONSIBLE CITIZEN THE MODEL OF A SELF RESPONSIBLE CITIZEN

11. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH TWO MAIN ASPECTS INFORMATION AND TRANSPARENCY INFORMATION AND TRANSPARENCY -HOW AND WHO- ACTIVE INVOLVEMENT ACTIVE INVOLVEMENT PREREQUISITES AND BENEFITS

12. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH INFORMATION AND COMPETENCE PREREQUISITES FOR: SELF- DETERMINED ACTING SELF- DETERMINED ACTING ACTIVE INVOLVEMENT AS A CITIZEN ACTIVE INVOLVEMENT AS A CITIZEN FULL USE OF POSSIBILITIES AND RIGHTS FULL USE OF POSSIBILITIES AND RIGHTS

13. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED PATIENTS: PARTNERS FOR HEALTH THE RIGHT INFORMATION AT THE RIGHT TIME WHAT ARE THE PROBLEMS ? ACCESSIBILITY ACCESSIBILITY UNDERSTANDABLE LANGUAGE UNDERSTANDABLE LANGUAGE QUALITY AND RELIABILITY QUALITY AND RELIABILITY EQUITY- REACH THE LOWER SOCIAL CLASSES EQUITY- REACH THE LOWER SOCIAL CLASSES

14. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH THE RIGHT INFORMATION AT THE RIGHT TIME WHO IS RESPONSIBLE? PHYSICIAN PHYSICIAN HEALTH CARE ORGANISATIONS/PROVIDERS HEALTH CARE ORGANISATIONS/PROVIDERS EDUCATIONAL INSTITUTIONS EDUCATIONAL INSTITUTIONS------------------------------------------------------------------------------- FRAME CONDITIONS THROUGH HEALTH POLICY FRAME CONDITIONS THROUGH HEALTH POLICY

15. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH ACTIVE INVOLVEMENT OF CITIZENS AND PATIENTS IN HEALTH POLITICAL DEVELOPMENT PROCESSES AIMS: MORE ORIENTATION AT INTERESTS AND MATTERS OF THE PATIENTS LEADS TO MORE ORIENTATION AT INTERESTS AND MATTERS OF THE PATIENTS LEADS TO MORE COMPLIANCE AND MORE SATISFACTION OF PATIENTS MORE COMPLIANCE AND MORE SATISFACTION OF PATIENTS MORE QUALITY OF THE HEALTH SYSTEM MORE QUALITY OF THE HEALTH SYSTEM MORE EFFICIENCY OF RESOURCES MORE EFFICIENCY OF RESOURCES

16. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH THE GERMAN EXAMPLE: CHANGES IN SOCIAL CODE V (2003) REPRESENTATIVE OF PATIENTS IN THE GOVERNMENT REPRESENTATIVE OF PATIENTS IN THE GOVERNMENT ACTIVE INVOLVEMENT OF PATIENTS IN DIFFERENT HEALTH COMMITTEES ACTIVE INVOLVEMENT OF PATIENTS IN DIFFERENT HEALTH COMMITTEES NEW INSTITUTE FOR QUALITY AND EFFICIENCY – A.O.WITH THE TASK OF PATIENT INFORMATION NEW INSTITUTE FOR QUALITY AND EFFICIENCY – A.O.WITH THE TASK OF PATIENT INFORMATION

17. Dr. Birgit Weihrauch, EPHC NRW EHFG October 2005 FORUM 3 INVOLVED CITIZENS: PARTNERS FOR HEALTH SOME NRW EXAMPLES: ACTIVE INVOLVEMENT OF PATIENTS IN THE STATE HEALTH CONFERENCE (BY LAW) A.O.COMMITTES ACTIVE INVOLVEMENT OF PATIENTS IN THE STATE HEALTH CONFERENCE (BY LAW) A.O.COMMITTES WWW: GESUNDHEIT. NRW.DE – HEALTH PORTAL BY THE STATE AND THE STATE HEALTH CONFERENCE WWW: GESUNDHEIT. NRW.DE – HEALTH PORTAL BY THE STATE AND THE STATE HEALTH CONFERENCE BREAST CENTRES NRW BREAST CENTRES NRW STANDARDIZED QUALITY STANDARDIZED QUALITY STRUCTURED PATIENT INVOLVEMENT STRUCTURED PATIENT INVOLVEMENT