Family Medicine

More documents

Recommendations

Info

World Book of Family Medicine – European Edition 2015 better education and financial incentives for family doctors. The first concrete achievement occurred in October 2014, with the provision of around 150 Million Euros from specialists’ budget allocated to family doctors. Such an example proves that the mobilization of citizens can influence a national health strategy. Could the Swiss example inspire other countries? Every situation is different… In England in 1996, randomly selected groups of citizens were questioned about their views on the current state of their country’s health strategy and on their ideas for its development compared with the government’s 1995 plan. In conclusion, citizens «should contribute to but not determine health strategy». Citizens may produce fresh ideas but perceive as inadequate the existing arrangements to screen certain types of cancer, although such screening is evidence based (3). This proves that individual points of view without a global perspective do not define a strategy. The increasing complexity of health care organizations combined with the pressure of costs seems to anaesthetize individual initiatives. Or are the health care systems still comfortable enough not to mobilize the population? In Canada in 2002 (4), dialogue sessions with members of the public were used to help define a new health policy. Twelve sessions of a full day of dialogue were held across the country, each with about 40 citizen participants aged 18 years and over, randomly selected to provide a representative cross section of the Canadian population. People working in the healthcare system were excluded. Combining their roles as patients, taxpayers and members of the community, participants reframed the healthcare contract, redefining both individual and collective responsibilities. This had an important impact on the ensuing debate, giving for example a stronger direction for primary care. In conclusion, such engagement of the public may be costly but an essential requirement when opinions are unstable and difficult decisions must be made. An article published in 2004 by De Vos and colleagues (5) analyses the evolution of the European health systems. The authors demonstrate how, since the 1990s, the European Union has built a strict financial and political straitjacket, forcing these systems to carry out privatization and cutbacks. Reform measures can be divided into three interdependent categories: 1) the increasing influence of governments on health care organization, to enable restructuring; 2) measures aimed at reducing public expenses, including higher financial contributions by patients and restrictions on the range of services provided; and, 3) measures that establish competition and hide or open privatization of services and insurance systems. The De Vos et al publication is already 10 years old, during which time the economical crisis of 2008 has taken place , with no change whatsoever to this trend. Is this not a contradiction with the growing collective needs? Is it not a threat to health and social security? The defence of the European welfare state is one of today’s most important challenges. Are citizens aware of the dangers and able to mobilize? Finally as voters, we all have a responsibility to elect or change our authorities if we do not agree with their strategies. Future involvement In a time when social media is creating new ground, can we imagine someone inventing an even more direct democracy than the Swiss model? Groups like Avaaz (6) gather clicks but also voices to get their opinion heard. All forms are probably necessary bearing in mind that humanity has always used both the pioneers and the conservative power brokers in order to maintain the equilibrium in society. Take home messages Individual changes of lifestyle improve health outcomes and can thus indirectly weigh on health policies. A direct democracy system or randomly selected groups of citizens can contribute to health strategy when difficult decisions need to be made. In a moving and increasingly connected world, new ways of mobilization are appearing, from citizen to netizen. For a better humanity? Original abstract http://www.woncaeurope.org/content/6-s-health-their-nation-how-would-citizens-develop-englands-health-strategy References 232
World Book of Family Medicine – European Edition 2015 1. Summerbell CD1, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD001871. http://www.ncbi.nlm.nih.gov/pubmed/16034868 2. IPCC - Intergovernmental Panel on Climate Change www.ipcc.ch 3. Bradley N, Sweeney K, Waterfield M. The health of their nation: how would citizens develop England's health strategy? Br J Gen Pract. 1999 Oct;49(447):801-5. http://www.ncbi.nlm.nih.gov/pubmed/10885084 4. Maxwell J, Rosell S, Forest PG. Giving citizens a voice in healthcare policy in Canada. BMJ. 2003 May 10;326(7397):1031-3. http://www.ncbi.nlm.nih.gov/pubmed/12742930 5. De Vos P1, Dewitte H, Van der Stuyft P. Unhealthy European health policy. Int J Health Serv. 2004;34(2):255-69. http://www.ncbi.nlm.nih.gov/pubmed/15242158 6. The Avaaz community http://www.avaaz.org/en/ 233
Page 1 and 2:
The World Book of Family Medicine -
Page 3 and 4:
World Book of Family Medicine - Eur
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
The WP workshops on Ethics describe
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
References: World Book of Family Me
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Original Abstract World Book of Fam
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Original abstract World Book of Fam
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
References World Book of Family Med
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
References World Book of Family Med
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182: World Book of Family Medicine - Eur
Page 193 and 194: Original abstract World Book of Fam
Page 203 and 204: Take home messages World Book of
Page 215 and 216: References World Book of Family Med
Page 231: World Book of Family Medicine - Eur
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Quaternary Prevention rubric (www.p
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
show all

Family Medicine

Create successful ePaper yourself

Delete template?

Save as template?