|Implemented in this survey?|
The Ministry of Health of Slovenia decided to raise the importance of cancer as a public health and health care problem to the level of the European Union. Increasing differences in survival and in quality indicators across the Union speak in favour of integrated and comprehensive programs and in any case evoke the need for a concerted approach that would approach cancer from all of its dimensions. There are four priorities: 1. primary prevention 2. screening 3. integrated care 4. research
Slovenia decided to bring cancer back to the top of the health policy agenda in the European Union. The reasons for that are varied and include:
In order to promote attention to cancer ranging from health promotion and screening to integrated care and comprehensive research, Slovenia launched these as the main four pillars of the project to support its Presidency. The project to support it is called 'FACT-Fighting Against Cancer Today' and is expected to provide evidence, discussion environment and conclusions to serve as an up-to-date base for policymakers to draw future policy options on.
Main objectives of this project:
Incentives of this policy are non-financial and should serve both to the level of the EU as well as to the member states in future defining of cancer-related health policies.
Council of health ministers of the EU, Government, Patients and citizens
|Degree of Innovation||traditional||innovative|
|Degree of Controversy||consensual||highly controversial|
|Structural or Systemic Impact||marginal||fundamental|
|Public Visibility||very low||very high|
Slovenia decided to pick up this topic as a result of the analysis of previous political processes at the EU level and as part of the priorities defined within the 'trio' of presidencies, co-ordinated jointly with Germany and Portugal. Cancer is supposed to integrate both the health in all policies approach focusing on health determinants and the stress on a particular disease, which in turn has important multifaceted implications for health policy at the national and international level.
Revival of some previously adopted policies, such as the European Code against Cancer, and seeking agreement on potential new approaches, especially organised networking in the field of cancer research and health technology assessment, are the two main ambitions of the cancer as the centre of attention during the Slovenian Presidency to the EU. The main expected outputs are going to be: Council conclusions to be adopted at the informal meeting of health ministers and conclusions of the Conference on cancer to be held in Slovenia on 7-8 February 2008.
Seeking consensus at the EU level for intensified and co-ordinated efforts against cancer
|Implemented in this survey?|
The idea was generated by the Ministry of Health (MoH) of Slovenia and the main purpose was to initiate a process in which there would be a heightened interest and effort in the field of cancer launched at the EU level. Joint activities, such as concerted research activities and implementation of previous best policies should represent the core of a new declaration which EU would subscribe to and focus its future activities on. Networking of existing institutions and experts should be enhanced to the benefit of EU citizens and offering benefits to the policymakers of the member states as well.
Challenges presented by the rising incidence of cancer across Europe, in diverging trends in cancer incidence and survival across the continent and in soaring costs for its diagnostic and therapeutic procedures offer enough material for a serious effort to be undertaken at the EU level. Such an endeavour necessarily needs to be based on the previous positive experience and best practices provided by different member states and international organisations. Joining such efforts can produce a range of benefits that could assist in defining future EU activities in the field of cancer.
The approach of the idea is described as:
renewed: Based on previous documents, such as the European Code against Cancer from 2003
amended: Amending existing evidence-based practices and policies at the international and national level with new scientific evidence, also in newer fields such as health technology assessment
Looking from the EU level at the positions of the most important stakeholders one should say that at first there were several stakeholders who were not easily convinced of the need to approach a single group of diseases, such as cancer, once the EU has already subscribed itself to the health in all policies approach, focusing more on horizontal activities in tackling health determinants. Still, a problem of the magnitude such as cancer, posing a range of challenges in front of the policymakers, from the issues related to health promotion and primary prevention to screening and integrated care and finally to all aspects of research into all of cancer's dimensions. Through the first activity of the FACT project, which was a brainstorming meeting of the most important experts and institutions in the field of cancer at the EU level, most of the controversies related to the approach Slovenia was going to take were removed.
Through the next phase which has just been carried out at the time of writing this report (mid-November 2007) the development of the four priorities presented by the Slovenian MoH - primary prevention, screening, integrated care and comprehensive research - has been proposed to the representatives of all member states and the Commission in the format of a policy dialogue. The final output from this consultation will be presented to the conference on cancer as conclusions and as guidance for the council conclusions.
|European Union||very supportive||strongly opposed|
|Patients||very supportive||strongly opposed|
|Scienfic and professional community||very supportive||strongly opposed|
|Industry||very supportive||strongly opposed|
It is expected that there will be three outputs related to health policy decisions:
|European Union||very strong||none|
|Scienfic and professional community||very strong||none|
The process of implementation went through the phases of a brainstorming discussion at the professional level and of a policy dialogue at the expert and political level of the member states. This process will be finalised at the conference on cancer to take place in Slovenia, 7-8 February 2008. As a result of the deliberations prior and at the conference final conclusions and draft council conclusions will be prepared. The latter will then be proposed for adoption by the informal council of ministers, which should convene in the second half of April 2008. We can anticipate some discrepancies around certain solutions and points of view but it is expected that these could be overcome through a process of interchange of views and adjustments prior and at the conference on cancer.
This policy is expected to be regularly monitored and evaluated by the council of ministers as one of its documents, adopted with the purpose of launching some EU-wide action.
It is expected that the results of this policy will be the following:
|Quality of Health Care Services||marginal||fundamental|
|Level of Equity||system less equitable||system more equitable|
|Cost Efficiency||very low||very high|