presentation

Future
Hospitals
Healthcare
The
2016
of
and
Dr Simone Tasso
HOPE Italy
WELCOME
Rome, Fori Imperiali
Apolozige
from
Dr. Domenico Mantoan
Giunta Regionale
Area Sanità e Sociale
WELCOME TO ITALY
Dr. Domenico Mantoan
HOPE Governor for Italy
Dr. Simone Tasso
HOPE Liason Officer for Italy
The Creation of Adam by Michelangelo
(Sistine Chapel – Vatican City)
Giunta Regionale
Area Sanità e Sociale
3
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)
Direzione Generale
Area Sanità e Sociale
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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 .
Plato and Aristotle- detail from the School of Athens
By Raffaello – Vatican City Museum
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Area Sanità e Sociale
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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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Area Sanità e Sociale
Roman Holiday (by William Wyler)
with Audrey Hepburn and Gregory Peck
6
In 1966 HOPE founders had the
enlightened idea that, for
promoting better health of
European citizens, it is necessary
to work at European level.
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.
Hospital in the ‘60s
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Area Sanità e Sociale
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Later hospitals became smaller and new Health
Services began to develop
9
HOPE was prompt to intercept these changes,
becoming…
European
Hospital and Healthcare
Federation
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Area Sanità e Sociale
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Important work was made during all these years:
- 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
Dr. Vytenis Andriukaitis
EU Commissioner for
Health and Food Safety
Giunta Regionale
Area Sanità e Sociale
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What about
HOPE in Italy ?
13
General Aspects
ITALY
Population: around 60 millions inhabitants
Rome
Regions : 20 which are extremely
varied for:
size
population
levels of economy
development
14
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)
Lord William Beveridge
-The amount for each Region (capitation & age)
Giunta Regionale
Area Sanità e Sociale
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VENETO
REGION
Since 2014, the
Veneto Region has
been delegated to be
the Italian Focus
Region for HOPE
5 millions inhabitants
Territory divided in:
7 counties (province)
579 municipalities
Rome
It is in the North-Est of Italy
The most known town is ...
16
VENICE
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Area Sanità e Sociale
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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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Area Sanità e Sociale
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Hospital beds, Per 1000 population
10
9
Following the trend described
by W.H.O. , we are decreasing
our acute beds …..
8,3
8
7
6,3
6
5
3,9
4
3,4
3,3
3
3
2,8
2,6
2,9
2,7
2,3
2
0,7
1
0
Germania
Year 2013
Francia
Norvegia
Italia*
VENETO
2015
Spagna
UK
Svezia
USA*
Canada*
Brasile*
India*
*ANNO
19 2012
Rapporto Oasi 2015 su dati OECD 2015 e Who 2015
Hospitalization rate per 1.000 population
300
265,5
And decreasing
hospitalization rate….
252,2
250
212,8
200
185,8
193,3
164,6
150
132,4
117,2
100
110,3 108,7
138,6
125,49
99,7
83,2
55,9
50
0
Austria Germania Francia* Norvegia Svezia*
UK
Italia
Spagna Portogallo
VENETO 2014
Russia
USA*
Cina
*ANNO 2012
Canada* Brasile*
20OECD 2015
Rapporto Oasi 2015 su dati
Year 2013
IS IT ENOUGH ?
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Area Sanità e Sociale
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Beside, you can see the
poster describing a
W.H.O. Conference 2009 :
Hospitals and Health Services
without Walls
“Hospitals and Health
Services without Walls”
In Italy and in Veneto
Region we are following
this idea
Health
Promoting
Hospitals
We are breaking the
walls…
22
“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……
23
“BREAKING THE WALL”
Increasing Intermediate Care:
Country Hospitals
Rehabilitation Hospitals
Palliative Hospitals (=Hospices)
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
24
What about the future ?
in Europe ?
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Area Sanità e Sociale
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In Europe,
Health Systems
are part of the
Welfare State
Lord William Beveridge
which was able
to produce …..
the longest life expectancy...
Otto prince of Bismarck
….around 80 years…
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Area Sanità e Sociale
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Main world averages of life expectancy
90,0
EU Countries: around 80 years
80,0
70,0
60,0
50,0
40,0
30,0
20,0
10,0
0,0
Rapporto OASI from W.H.O. 2015
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Area Sanità e Sociale
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This was achieved
with costs not
as expensive as
other countries…
Health spending in % Gross Domestic Product (GPD)
OECD Countries 2013
USA
Europe
(average)
i.e. % GDP :
USA 16,4 %,
EU around 9,0 %
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Area Sanità e Sociale
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European Health Systems
are… treasures
But in a world of
Global Crisis
Otto prince
of Bismarck
Global Economics
Global Finance….
Lord William Beveridge
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Area Sanità e Sociale
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Increasing
costs
There is an increasing
problem
that means…
Anti-Hepatitis C - Therapy
71,000 Euro / 84,000 US Dollars
per treatment (six months long)
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SUSTAINABILITY
PROBLEM
Will we survive ?
The last Judgment (detail)
by Michelangelo (1534)
Sistine Chapel – Vatican City
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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 …
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Area Sanità e Sociale
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…the letter sent to
Gilead Science Inc.
(Sovaldi’s Owner)
Writing ….
Why so high prices?
$ 84,000 in USA
Only $ 900 in Egypt?
33
Even the USA have
a problem of
sustainibilty
and its Senate
asks to the
Health Care
Industry
explanations
about the costs!
34
What can we learn?
Facing Global Economy
needs to create:
International
public actions
International
collaborations
35
HOPE is a right
way to promote
international
collaborations
and to give
updated
information on
key matters
36
For instance ?
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Area Sanità e Sociale
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TTIP
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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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Area Sanità e Sociale
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The discussion on TTIP
Cecilia Malmstrom
European Commissiner on Trade
Ian Livingston, UK Minister (2013-2015)
for Trade and Investiment
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Area Sanità e Sociale
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The discussion on TTIP
UK Minister was worried
about the possible impact
of TTIP on NHS
Ian Livingston, UK Minister (2013-2015)
for Trade and Investiment
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Area Sanità e Sociale
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European Comissioner
replied in this letter to UK
Minister
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…
42
It is important
we take under control all
the updates of the text of
TTIP
Also for the un-direct
impacts TTIP can have on
our Health Systems
For instance ….
43
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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Area Sanità e Sociale
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Another possible impact?
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Area Sanità e Sociale
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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
In Europe there is a
growing sentiment of distrust and disagregation
Sometime pushing to
build walls inside the
same EU
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Area Sanità e Sociale
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CONCLUSIONS
Maybe we have to remeber
the story of Europe
Its name comes from…
Europa
Who was Europa ?
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Area Sanità e Sociale
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Greek Mithology
Europa (Princess from Asia)
God Zeus
fell in love
with her and..
He transformed himself
into a bull to carry her to
a new continent…
The abduction of Europa by Francesco Rustici (1474-1554)
50
Victoria and Albert Museum - London
The abduction of Europa
And…
By Goya
in the new
continent, Europa
brought, as gift,
a lot of beauty
And the new
continent , in her
honour, was called
By Titian
Europe
By Rembrant
51
Europe
brought to the
world other
important gifts….
52
CONCLUSIONS
Europe was the home of the ANCIENT
DEMOCRACIES
Ancient Athens
53
Ancient
Roman Senate
CONCLUSIONS
...MODERN DEMOCRACY
Separation of the powers
(tria politica principle):
Legislative
Executive
Judicial
Baron de
Montesquie
John Locke
54
CONCLUSIONS
...MODERN SCIENCE
Newton
Galileo
55
CONCLUSIONS
...CONTEMPORARY SCIENCE
Eisenberg
Eistein
56
BREATH-TAKING
ART
Sistine Chapel – 57Vatican City
Europe gave its best when
it put in the centre the
“Human Kind”
RENASSAINCE PERIOD
Sandro Botticelli 1478 “The Spring”
Galleria degli Uffizi - Florence
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CONCLUSIONS
…and when it put in the centre the
HUMAN RIGHTS
«I might disagree
with your opinion,
but I’m willing to
give my life for your
right to express it»
Voltaire
59
CONCLUSIONS
AND IN EUROPE
HEALTH IS … A… HUMAN RIGHT !
The European
Health Systems
are treasures
coming from
this philosophy
Otto prince
Lord Beveridge of Bismarck
60
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
The Spring
(detail) Sandro Botticelli 1478 Florence61- 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…
The Spring
(detail) Sandro Botticelli 1478 Florence62- Galleria degli Uffizi
CONCLUSIONS
We need
a
New Renassaince
And New Bridges
WE COULD CREATE
A NEW SPRING !
The Spring
(detail) Sandro Botticelli 1478 Florence63- Galleria degli Uffizi
Rome, Fori Imperiali
2066
100 ANNIVERSARY
WELCOME
TO EUROPE !
Giunta Regionale
Area Sanità e Sociale
100
1966-2066