A roundup of selected health policy news stories from around the world.
International Health News Brief 3x2 952 NoCorrespondent: Sonĵ Hall
For their 50th birthday, all Australians receive a free test kit for bowel cancer from the government, but only four in 10 complete and mail back the test. A new AUD 10 million (USD 6.96 million) advertising blitz is designed to increase this rate to six in 10. If the advertising boost works as predicted, the estimated number of lives saved from the screening program between 2015 and 2040 will rise from 59,000 to 83,000.
Country Correspondent: Sonĵ Hall
The Australian Institute of Health and Welfare’s latest report on potentially preventable hospitalizations revealed that vaccine-preventable conditions such as measles, mumps, and rubella accounted for 8 percent of these admissions. Reporting on 22 acute and chronic conditions, the study also showed substantial disparities in the prevalence of hospitalizations for vaccine-preventable conditions across geographic areas and Primary Healthcare Networks. Overall, 9 percent of hospital bed days were deemed potentially avoidable with appropriate preventive care and early disease management.
Country Correspondents: Danielle Rodin and Roosa Tikkanen
In February, Ontario Health Minister Christine Elliot announced plans to consolidate the province’s six health agencies, including eHealth and Health Quality, with 14 local health integration networks into one central agency, Ontario Health. Elliott also encouraged the creation of 30 to 50 integrated local health teams, comprising hospitals, long-term care agencies, and other providers, to deliver and coordinate care to some 300,000 people. The minister stressed that it’s not the patient’s job to navigate a complicated health system “during what is already one of the most traumatic and stress-filled periods in their lives . . . that is just wrong.” The reforms also will be accompanied by expanded availability of digital health care tools, including virtual consultations.
Country Correspondents: Danielle Rodin and Roosa Tikkanen
The Canadian Partnership Against Cancer and the Canadian Foundation for Healthcare Improvement announced plans to provide up to CAD 5.5 million (USD 4.17 million) to train more than 5,000 paramedics in delivering palliative care. Six of Canada’s 10 provinces and three territories will receive funds over the next four years for the program, which is expected to reduce unnecessary hospital visits.
Country Correspondent: Angèle Malâtre-Lansac
In February, Health Minister Agnès Buzyn introduced the “Ma Santé 2022” (My Health 2022) bill to reshape French health care. The legislation aims to increase the supply of doctors by removing the cap on the number of medical schools; improve access to care and simplify health care transitions by creating 500 local hospitals and 1,000 primary care centers; and promote use of e-health and digital technology by developing a “digital health space” for each patient.
Country Correspondent: Angèle Malâtre-Lansac
Seeking to establish a dynamic platform for the innovative use of health data, the French Ministry of Health and Social Security announced in October 2018 the creation of the Health Data Hub — a one-stop shop for secure access to health data needed for projects in the public interest. In January, the initiative, which aims to make France a leader in the use of health data, issued its first call for projects with the potential to make a significant impact in the areas of research, patient information and follow-up, support for providers, and overall health system improvement. Selected projects will obtain a full year’s worth of technical and financial support.
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Country Correspondent: Michael Laxy
Aiming to connect stakeholders from across politics, nongovernmental organizations, the scientific community, and the health care industry to advance the United Nations' sustainable development goals, German Minister of Health Jens Spahn announced the formation of a new network with seed funding of EUR 1.5 million (USD 1.71 million) over three years. High-priority areas will include fighting tropical diseases, cancer, and antimicrobial resistance and providing universal health care coverage. The network also aims to provide countries with support for digitalization of health care.
Country Correspondent: Michael Laxy
More than a quarter of people enrolled with AOK, one of Germany’s largest statutory insurers, are offered health services that aren’t covered because of their unproven clinical value, according to a study conducted by the insurer’s research arm. These so-called “individual health services” include potentially unnecessary screenings and alternative therapies such as ultrasounds, acupuncture, or leech therapies. Specialists tend to provide the services more readily than general practitioners do, and they are more often offered to higher-earning patients. Patients pay out of pocket anywhere from just a few euros to several hundred for each service.
Country Correspondent: Roosa Tikkanen
According to a working paper from the Organisation for Economic Co-operation and Development (OECD), France, Germany, and the Netherlands are among the many European countries that have experienced a slowdown in life expectancy gains since 2011. In the United States and the United Kingdom, some mortality gains have even reversed, in part because of increasing deaths from accidental drug poisonings. The OECD also reported that diseases of old age, including dementia and respiratory illnesses like pneumonia and influenza, are major contributors to the slowdown.
Country Correspondent: Roosa Tikkanen
In February, the European Union instated new safety rules for prescription drugs in an attempt to reduce the spread of counterfeit medicines. The rules require drug manufacturers to affix a barcode and an antitampering device on medicine containers. In addition, all hospitals and pharmacies, including online dispensaries, will be required to verify the authenticity of medicines before dispensing them to patients.
Country Correspondent: Roosa Tikkanen
An estimated 30 million Europeans are affected by rare illnesses such as cystic fibrosis or Huntington’s disease. On February 28, Rare Disease Day, the E.U. launched a new a web-based knowledge-sharing registration platform to give researchers, policymakers, and patients expanded access to data to support better diagnosis and treatment. Around 600 individual rare disease registries exist in Europe, each managed by individual hospitals, research institutions, pharmaceutical companies, or patient advocacy groups. The new platform aims to promote the interoperability of data across these registries.
Country Correspondent: Roosa Tikkanen
The World Health Organization’s (WHO) first-ever report on the health of refugees and migrants in Europe shows increasing vulnerability to both communicable and noncommunicable diseases such as diabetes, depression, and anxiety once individuals enter their host country. Refugees and migrants also present with cancer at more advanced stages. Although European countries are implementing a strategy and action plan for refugee and migrant health, the report called for greater progress in making health systems responsive to displaced populations, including by ensuring culturally and linguistically appropriate care as well as access to basic preventive care. Migrants make up 10 percent of Europe’s population; 7 percent are refugees.
Country Correspondent: Roosa Tikkanen
As of January this year, patients in Finland have been able to pick up their electronically issued drug prescriptions at an Estonian pharmacy, thanks to the new European Commission–funded eHealth Digital Service Infrastructure, which allows national eHealth services to exchange electronic prescriptions and patient summaries across country borders. By 2021, 22 E.U. member states will be able to exchange prescriptions and other health data through this service.
Country Correspondent: Margje Haverkamp
Bruno Bruins, the Dutch health minister, announced in February the allocation of EUR 10 million (USD 11.4 million) annually toward evaluating medical interventions in an effort to reduce low-value care. A new national collaboration of medical specialists, patients, nurses, hospitals, health plans, and the government will guide medical societies in identifying “grey areas,” or knowledge gaps, and addressing those gaps through systematic studies. Recommendations based on these studies will be integrated into national care guidelines and shared decision-making tools.
Country Correspondent: Margje Haverkamp
National spending on high-cost drugs in the Netherlands increased 9 percent between 2016 and 2017, according to the Dutch National Care Authority. The spike reflected the introduction of a wider variety of high-cost drugs on the market, as well as growth in the number of patients who use these drugs. The rise in spending occurred despite Minister of Health Care Bruno Bruins’ often repeated intentions to limit the power of the pharmaceutical industry and to reduce barriers to pharmaceutical compounding, whereby pharmacists can create their own versions of expensive drugs in a laboratory setting.
Correspondent: Jennifer Schulz Moore
Sixty-eight percent of 800 New Zealand doctors and nurses surveyed by the Choosing Wisely campaign in 2018 consider the provision of unnecessary tests, procedures, or treatments a serious issue for health care in the country, up from 62 percent in 2016. Moreover, twice as many clinicians were familiar with the campaign compared to two years ago — 80 percent versus 41 percent. Choosing Wisely encourages patients to ask their providers such questions as “Do I really need this test?” or “Are there simpler, safer options?”.
Correspondent: Marianne Storm
In his annual hospital speech in January, Norwegian Minister of Health and Care Services Bent Høie announced new wait-time targets for adult and youth mental health services and substance use disorder treatment, among other improvement priorities for 2019. The Norwegian Directorate of Health also has been commissioned to revise provider reimbursement to better incentivize use of telehealth and other digital technologies in medical consultations. Meanwhile, the health ministry is embarking on work to reduce the volume of surgical procedures with limited clinical benefit.
Country Correspondent: Marianne Storm
The Norwegian Institute of Public Health (NIPH), a government agency, has partnered with the International Decision Support Initiative (iDSI) network that helps low- and middle-income countries make evidence-based and equitable health care decisions. The network will aid in building capacity to perform systematic reviews and health technology assessments prior to investments in costly technologies and treatments. First steps for the agency will be to train stakeholders and decision-makers in Ghana and the Palestinian territories. The partnership comes on the heels of a Bill and Melinda Gates Foundation award of USD 14.5 million to iDSI in addition to NOK 27.6 million (USD 3.25 million) from the Norwegian Agency for Development Cooperation to the NIPH.
Country Correspondent: Lars Hemkens
The Swiss Federal Office of Public Health and Swisstransplant, a national foundation for organ donation and transplantation, launched a new public campaign in February to motivate Swiss residents to discuss and sign up to donate their organs. The three-year, CHF 1.17 million (USD 1.2 million) campaign is supported by a website featuring video clips and other informational materials. Switzerland aims to increase the number of organ donors from an average of 18.6 per million in 2018 to 22 per million by 2021.
Country Correspondent: Lars Hemkens
Four in five Swiss residents — and significantly more women than men — die in hospitals and residential homes, according to a new report that summarizes findings from 33 research projects conducted for the National Research Program on “End of Life,” launched in February. The report, which provides a comprehensive overview of current evidence on how people in Switzerland die, also reflects on how society can enable people to die with dignity, as well as how countries can better meet needs for palliative care.
Country Correspondents: Roosa Tikkanen and Adam Briggs
In January, England’s National Health Service (NHS) released its new Long Term Plan, aiming to save nearly half a million more lives over the next five years. The GBP 20.5 billion (USD 26.11 billion) initiative features a historic commitment to community-based care, with a guarantee that investments in primary, community, and mental health care will grow faster than the overall budget for NHS England. It also seeks to expand use of digital health services, genetic screening, and artificial intelligence. Critics call the proposal unrealistic, given workforce shortages.
Correspondent: Roosa Tikkanen and Adam Briggs
In a bid to transform how health services are delivered, NHS England will increase its investment in primary and community care to GBP 4.5 billion (USD 5.73 billion) a year by 2023–24. The NHS Long Term Plan calls for the hiring of 20,000 additional staff to help establish multidisciplinary teams at general practices, comprising pharmacists, physiotherapists, paramedics, and “social prescribing link workers,” who will refer patients to community services and activities such as exercise classes or art groups. A new patient right to web and video consultations also will be introduced by 2021. The reforms are anticipated to particularly benefit people with long-term and complex conditions.
Correspondent: Roosa Tikkanen and Adam Briggs
To help fulfill its goal of halving maternity-related deaths by 2025, the NHS Long Term Plan aims to expand nationwide the Surrey Heartlands Pregnancy Advice Line, which provides new and expectant mothers guidance on labor, breastfeeding, and other pregnancy-related health problems. The 24-hour advice line, staffed by midwives, averages 126 calls per day and has already helped some 20,000 women in the past year. The NHS also plans to provide continuous care to expectant women, enhance mental health services, provide specialist smoking cessation support, and offer mothers access to maternal health records through their smart phones.
Editor: Roosa Tikkanen
Project manager: Aisha Gomez
Australia — Sonĵ Hall
Canada — Danielle Rodin and Roosa Tikkanen
Europe/International — Roosa Tikkanen
France — Angèle Malâtre-Lansac
Germany — Michael Laxy
Netherlands — Marthe Haverkamp
New Zealand — Jennifer Schulz Moore
Norway — Marianne Storm
Switzerland — Lars Hemkens
United Kingdom — Roosa Tikkanen and Adam Briggs
