Country Correspondent: Aisha Gomez

To better serve Australians with two or more chronic illnesses such as diabetes, arthritis, and heart and lung conditions, the government has announced plans to expand the Health Care Homes model to up to 65,000 Australians. The model, currently in trial at 22 clinics, will be offered at an additional 168 general practices and Aboriginal Community Controlled Health Services clinics within the coming year. The Health Care Homes model provides integrated, team-based care focused on patients’ goals and needs. Given that practices receive per capita fees, the model provides incentives to focus on the most complex and highest-cost patients.

• Better health care for people with chronic conditions
• Health Care Homes

Country Correspondent: Aisha Gomez

Rural residents of Australia will soon have better access to mental health services through telehealth. Regional Health Minister David Gillespie, M.D., announced plans for a new Medicare rebate for online videoconferencing for mental health consultations with psychologists, social workers, and occupational therapists. Under the new scheme, up to seven of the 10 sessions currently offered through Medicare mental health plans will be accessible through telehealth. The initiative is expected to cost AUD 9.1 million over four years. The government is also providing AUD 18.6 million in funding for the Rural Junior Doctor Training Innovation Fund that will support 240 accredited intern rotations in primary care in rural general practice settings, in addition to hospital-based rotations.

• Rural Junior Doctor Training Innovation Fund
• Telehealth initiative to improve rural access

Country Correspondent: Aisha Gomez

In association with the international Antibiotic Awareness Week, the Australian Ministry of Health has launched a new website on antimicrobial resistance, one of the tools implemented under the National Antimicrobial Resistance Strategy 2015–2019. The site provides information and education to the public, medical and veterinary professionals, and the agricultural industry. The Australian government has pledged more than AUD 27 million to combat antimicrobial resistance.

• Continuing work to help combat antimicrobial resistance
• Antimicrobial resistance (AMR) is one of the biggest threats to human and animal health today

Country Correspondent: Aisha Gomez

According to figures released by the Canadian Institute for Health Information, health care spending per person grew by nearly 4 percent in 2017, compared with just 2.7 percent in 2016. Although prescription drugs represent only 16 percent of total spending, they have been the fastest-growing type of expense since 2015. In 2017, drug spending is expected to increase by 5.2 percent, compared with 2.9 percent and 4.4 percent for hospital and physician costs, respectively. Prescription drug spending has accelerated in recent years because of expensive drugs such as biologics and hepatitis C drugs entering the market. Canada’s universal health care programs that are run by provinces and territories cover drugs received in the hospital only. States and territories provide publicly funded drug coverage for vulnerable populations such as seniors and low-income individuals, and public spending accounts for two-fifths (42.7%) of total drug spending. In addition, Ontario recently launched a universal prescription drug coverage for children and youth up to 24 years.

• Spending on drugs expected to outpace spending on hospitals and doctors
• Health-care spending projected to jump nearly 4% this year, report finds

Country Correspondent: Aisha Gomez

The number of older adults in the Canadian province of Ontario is expected to double in the next 25 years. To ensure that seniors have access to needed services in the future, Premier Kathleen Wynne released a new plan. “Aging with Confidence: Ontario’s Action Plan for Seniors” aims to enable independent living and empower seniors to make the best choices related to their care, for example through expanding the number of long-term care beds, improving public transportation, and investing in housing. In addition, the province will provide free flu vaccinations to seniors as well as an informational website, Aging Well. Ontario is investing CAD 155 million over three years in the plan.

• Ontario Supporting Seniors to Live Their Best Life
• Aging with Confidence: Ontario's Action Plan for Seniors

Country Correspondent: Roosa Tikkanen

The EU’s Employment, Social Policy, Health, and Consumer Affairs Council has released its latest recommendations on digital health, calling for specific actions by member states and the European Commission. The official statement emphasized that digital tools will maximize opportunities to leverage big data and promote patient-centered and integrated care, transparency, and patient literacy. The council lauded the European eHealth Digital Service Infrastructure, which has enabled cross-border exchange of e-prescriptions and patient summaries; since 2011, Europeans have had the legal right to receive health care in other member countries in addition to their own. The statement also urged member states and the Commission to continue collaborating on the European eHealth Interoperability Framework, disease registries, and other partnerships.

• Employment, Social Policy, Health and Consumer Affairs Council meeting on 8 December 2017
• Employment, Social Policy, Health and Consumer Affairs Council, 07-08/12/2017
• Digital health: Council conclusions

Country Correspondent: Paul Dourgnon

The French Ministry of Solidarity and Health released a new National Health Strategy for the next four years (2018–2022). The strategy outlines four priority areas: promoting health and prevention across all life stages; tackling social inequalities in health and access to care; ensuring the quality, safety, and relevance of care; and identifying innovative approaches to transform the health care system. These areas are further divided into 43 specific goals, and progress will be monitored on an annual basis. The strategy was developed by the government in collaboration with health care experts and public consultation. France has released a national health strategy since 2013. Since then, it has evolved from a roadmap focusing on prevention, primary care, and patient-centered care to the more detailed format it takes on today, with overarching goals and specific objectives.

• Stratégie nationale de santé 2018-2022
• La stratégie nationale de santé 2018-2022

Country Correspondent: Isabelle Scholl

A new website launched by the German Ministry of Health, “Migration and Health,” targets migrants as well as the professionals who help them integrate into German life. The site provides an introduction to the health care system, describes the services available, and offers information about preventive health care. It is currently available in English and Turkish, with plans to launch Arabic and Russian versions soon.

• Neues Internetportal „Migration und Gesundheit“
• Migration and Health

Country Correspondent: Marthe Haverkamp 

Medical marijuana will not be reimbursed under Dutch statutory insurance policies because of a lack of evidence demonstrating its effectiveness for treating chronic pain and the side effects of chemotherapy. The National Health Care Institute submitted these recommendations based on an analysis of the latest scientific evidence. Major Dutch insurers typically follow the Institute’s recommendations, and are therefore not expected to cover medical marijuana in voluntary, supplemental insurance packages, held by 84 percent of Dutch residents. Medical cannabis can be obtained in pharmacies with a doctor’s prescription, with patients responsible for covering the full costs out of pocket.

• Medicinale cannabis niet in basispakket
• Verkoop cannabisolie met 60 procent gestegen
• Medicinale cannabis niet in basispakket

Country Correspondent: Marthe Haverkamp

The Dutch Association for Medical Students has launched a project called "MedGezel" — Dutch for companion — that trains medical students to act as coaches for elderly patients. The coaches accompany clients to appointments, help explain instructions and care options in simple language, and ensure patients play a role in decision-making. The initiative’s goals are to help seniors feel more confident and take an active part in their care, enhance the effectiveness of medical appointments, and enhance medical students’ educational experiences. MedGezel is currently being piloted in three cities.

• Geneeskundestudenten gaan patiënten coachen
• Neem uw eigen medisch student mee op artsenbezoek

Country Correspondent: Aisha Gomez

New Zealand has higher suicide rates than most other industrialized countries, and among the highest teenage suicide rates. Newly appointed Health Minister David Clark, M.D., has announced plans to launch a national inquiry into mental health that will seek input from clinical experts as well as families and individuals affected by suicide. In an interview with the New Zealand Herald, Clark backed Prime Minister Jacinda Ardern’s vision of zero suicides in New Zealand by saying “there is no suicide that is acceptable.” He also noted that funding for mental health services has not kept up with demand. The government is currently updating the national suicide prevention strategy, which was released for public comment in 2017.

• Break The Silence: New Health Minister pledges change on youth suicide
  
• Director of Mental Health’s Annual Report for 2016 released
• Health at a Glance
• Jonathan Coleman says he'll hold new health minister to account over suicide target

Country Correspondent: Aisha Gomez

Many rural communities struggle with a lack of access to specialists. In New Zealand, a life insurance company, Vero Insurance, has partnered with a U.S.-based company, Best Doctors, to offer their rural policyholders free access to health professionals via phone or email. The partnership aims to connect rural communities with more than 50,000 peer-nominated medical experts in over 450 specialties who will provide second opinions on diagnoses and review treatment plans; participants also will have online access to general practitioners. The partnership builds on the success of Best Doctors in Australia; Australians who used this service saw reductions in work absence as well as reduced medical treatment costs.

• Connecting Rural Customers to Global Health Professionals
• Medical specialists from around the world available to farming sector via Best Doctors

Country Correspondent: Birgitte Graverholt

A new report by the Organisation of Economic Co-operation and Development (OECD) has found that relative to other high-income countries, Norway performs very well across various indicators of residents’ well-being. Life expectancy at birth has increased by two years since 2005, and average life expectancy is now two years higher than the average for OECD countries. This position is in contrast to the United States, which ranked in the bottom third of countries for life expectancy. Both countries ranked in the top third of countries for the percentage of adults who perceive themselves as being in “good” or “very good” health.

• How's Life in Norway?
  
• How’s Life in the United States?

Country Correspondent: Birgitte Graverholt

Norway’s national patient safety program, In Safe Hands 24-7, received an award at the World Hospital Congress in Taipei, Taiwan, in November 2017. Ninety organizations were in the competition, representing 24 countries. Since 2011, Norway’s program has sought to reduce patient injuries, build long-lasting organizational structures to promote safety, and instill a culture of safety in the health care sector. Among other steps, the program offers streamlined care packages for specific treatments that lay out guidelines for safe treatments and procedures.

• Pasientsikkerhetsprogrammets arbeidsområder, målsetting, målinger, organisering
• Internasjonal pris til pasientsikkerhetsprogrammet

Country Correspondent: Roosa Tikkanen

A Swedish company, Doktor.se, recently announced it will offer free online health appointments to all Swedes. Similar to other companies, Doktor.se previously charged patients a membership fee to access online health care consultations. However, after purchasing a health clinic in Södermanland County, where all primary care visits are free of charge to patients, the company announced its plans to extend free online appointments to all Swedes. In other counties, patients are typically charged a fee for primary care appointments, including for online appointments. Online consultations are triaged by a nurse, and patients with higher clinical needs are referred to a primary care physician.

• Digitala vårdbesök blir gratis
• Free digital doctor's appointments available to Swedes at new clinic

Country Correspondent: Lars Hemkens

Generic drug prices in Switzerland are 41 percent above the European average, according to the annual report from the Swiss public agency that oversees prices and competition. The report compared prices for 20 generic drugs in Switzerland with those in other European countries, including Germany, France, and the United Kingdom, and found substantial differences in some cases. For example, the price of the cheapest generic drug in the Netherlands is 15 percent of the price in Switzerland. The agency recommended that reference pricing be introduced to reduce variation in drug prices across the country. In addition, the report called for an annual review of medicine prices in Switzerland.

• In der Schweiz kosten Generika doppelt so viel
• Auslandpreisvergleich von Generika und patentabgelaufenen Originalmedikamenten: Weiterhin stark überhöhte Schweizer Preise — Geplante Kostendämpfungsmassnahmen sind konsequent umzusetzen und zusätzliche an die Hand zu nehmen
• Watchdog calls for medicine prices to be slashed

Country Correspondent: Lars Hemkens

More Swiss people than ever are seeking medical assistance to end their lives, according to the Swiss Federal Statistical Office. In 2015, 965 people sought assistance to die compared with just 742 in the previous year and only 86 people in 2000. The vast majority of people seeking assisted suicide were above the age of 65. In Switzerland, health care professionals who help with assisted suicides do so on a volunteer, unpaid basis, since it is illegal for medical professionals to benefit financially from a person’s death.

• Schweizer Senioren wollen ihren Tod selber bestimmen
• Causes of death in 2015 (available in French, German, and Italian)
• Assisted suicide increasingly popular in Switzerland

Country Correspondents: Aisha Gomez and Molly Fitzgerald

The U.K. government has announced plans to launch a fast-track route — up to four years earlier — for patients to receive “breakthrough” therapies and treatments for conditions such as cancer, dementia, and diabetes. Starting in April 2018, the accelerated pathway will classify a number of new medical treatments and devices each year as having breakthrough potential. These treatments will receive fast-track evaluation and financial approval for coverage under the National Health Service (NHS). The program also will establish a new Strategic Commercial Unit tasked with negotiating cost-effective deals with manufacturers. The program will provide £86 million over four years to support fast-track approvals as well as research and development for small and midsized life science firms.

• Accelerated access scheme means patients will get new treatments faster

Country Correspondents: Aisha Gomez and Molly Fitzgerald

England’s National Health Service (NHS) is set to be the first health care system in the world to publish estimates of “avoidable deaths,” or deaths attributed to the fact that patients did not receive available care. Each NHS Trust will be tasked with developing a methodology for counting avoidable deaths, with data to be published quarterly. This means that the numbers will not be comparable between regions. The new initiative aims to build greater trust between NHS trusts and patients, as well as allow trusts to learn from each other and share lessons learned across England. As of December 2017, 171 of the 223 NHS trusts in England have already released or are releasing their first estimates of avoidable deaths.

• NHS becomes first healthcare system in the world to publish numbers of avoidable deaths

Country Correspondents: Aisha Gomez and Molly Fitzgerald

NHS England, Public Health England, and Diabetes UK have partnered with tech developers to tackle diabetes and obesity. More than 5,000 patients across England will test a range of digital products such as apps, devices, and wearable technology aimed at helping them manage their conditions. Over 12 months, patients will be able to access health coaches and online support groups, set personal goals, and monitor their progress through their devices. The pilot aims to provide digital support services similar to those offered through the face-to-face Healthier You program launched in 2016.

• Thousands of people set to access diabetes and obesity prevention services through the touch of a button

Co-editors: Aisha Gomez, Roosa Tikkanen, and Molly Fitzgerald

Country Correspondents: Paul Dourgnon (France), Isabelle Scholl (Germany), Marthe Haverkamp (Netherlands), Birgitte Graverholt (Norway), Lars Hemkens (Switzerland), Aisha Gomez (Australia, Canada, New Zealand, United Kingdom), Roosa Tikkanen (Europe, Sweden), and Molly Fitzgerald (United Kingdom)