dr simone tasso hope italy - hope agora · dr simone tasso hope italy welcome . giunta regionale ....

2016 The Future

of Hospitals and Healthcare

Dr Simone Tasso HOPE Italy

WELCOME

Giunta Regionale Area Sanità e Sociale

Rome, Fori Imperiali

Apolozige from

Dr. Domenico Mantoan

Giunta Regionale Area Sanità e Sociale

WELCOME TO ITALY

The Creation of Adam by Michelangelo (Sistine Chapel – Vatican City)

Dr. Domenico Mantoan HOPE Governor for Italy

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Dr. Simone Tasso HOPE Liason Officer for Italy

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)

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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 .

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Plato and Aristotle- detail from the School of Athens By Raffaello – Vatican City Museum

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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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Roman Holiday (by William Wyler) with Audrey Hepburn and Gregory Peck

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In 1966 HOPE founders had the enlightened idea that, for promoting better health of European citizens, it is necessary to work at European level.

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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.

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Hospital in the ‘60s

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Later hospitals became smaller and new Health Services began to develop

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HOPE was prompt to intercept these changes, becoming…

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European Hospital and Healthcare

Federation

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Important work was made during all these years:

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- 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

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Dr. Vytenis Andriukaitis EU Commissioner for

Health and Food Safety

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What about HOPE in Italy ?

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General Aspects

ITALY

Rome Population: around 60 millions inhabitants

Regions : 20 which are extremely varied for: size population levels of economy development

Giunta Regionale Area Sanità e Sociale

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)

-The amount for each Region (capitation & age)

Lord William Beveridge

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Rome

VENETO REGION

5 millions inhabitants Territory divided in: 7 counties (province) 579 municipalities

Since 2014, the Veneto Region has been delegated to be the Italian Focus Region for HOPE

It is in the North-Est of Italy The most known town is ...

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VENICE

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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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8,3

6,3

3,9 3,4 3,3

3 2,8 2,6 2,9 2,7

2,3

0,7

0

1

2

3

4

5

6

7

8

9

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Germania Francia Norvegia Italia* VENETO2015

Spagna UK Svezia USA* Canada* Brasile* India*

Hospital beds, Per 1000 population

Year 2013

*ANNO 2012

Rapporto Oasi 2015 su dati OECD 2015 e Who 2015

Following the trend described by W.H.O. , we are decreasing our acute beds …..

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265,5 252,2

185,8 193,3

164,6

132,4 117,2 110,3 108,7

99,7

212,8

125,49 138,6

83,2

55,9

0

50

100

150

200

250

300

Austria Germania Francia* Norvegia Svezia* UK Italia Spagna PortogalloVENETO 2014 Russia USA* Cina Canada* Brasile*

Hospitalization rate per 1.000 population

*ANNO 2012

Rapporto Oasi 2015 su dati OECD 2015

Year 2013

And decreasing hospitalization rate….

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IS IT ENOUGH ?

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Hospitals and Health Services without Walls

Health Promoting Hospitals

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“Hospitals and Health Services without Walls”

In Italy and in Veneto Region we are following this idea We are breaking the walls…

Beside, you can see the poster describing a W.H.O. Conference 2009 :

“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……

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“BREAKING THE WALL”

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

Increasing Intermediate Care: Country Hospitals Rehabilitation Hospitals Palliative Hospitals (=Hospices)

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What about the future ?

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in Europe ?

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Lord William Beveridge

Otto prince of Bismarck

In Europe, Health Systems are part of the Welfare State which was able to produce ….. the longest life expectancy... ….around 80 years…

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0,0

10,0

20,0

30,0

40,0

50,0

60,0

70,0

80,0

90,0

Main world averages of life expectancy EU Countries: around 80 years

Rapporto OASI from W.H.O. 2015

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Health spending in % Gross Domestic Product (GPD) OECD Countries 2013

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USA Europe (average)

This was achieved with costs not as expensive as other countries… i.e. % GDP : USA 16,4 %, EU around 9,0 %

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Lord William Beveridge

European Health Systems are… treasures

But in a world of Global Crisis Global Economics Global Finance….

Otto prince of Bismarck

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Anti-Hepatitis C - Therapy 71,000 Euro / 84,000 US Dollars per treatment (six months long)

Increasing costs

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There is an increasing problem

that means…

The last Judgment (detail)

by Michelangelo (1534)

Sistine Chapel – Vatican City

SUSTAINABILITY PROBLEM

Will we survive ?

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.

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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 …

…the letter sent to Gilead Science Inc. (Sovaldi’s Owner)

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Writing …. Why so high prices? $ 84,000 in USA Only $ 900 in Egypt?

Even the USA have a problem of sustainibilty and its Senate asks to the Health Care Industry explanations about the costs!

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What can we learn?

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Facing Global Economy needs to create: International public actions International collaborations

HOPE is a right way to promote international collaborations and to give updated information on key matters

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For instance ?

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T T I P

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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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The discussion on TTIP

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Cecilia Malmstrom European Commissiner on Trade

Ian Livingston, UK Minister (2013-2015) for Trade and Investiment

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The discussion on TTIP

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Ian Livingston, UK Minister (2013-2015) for Trade and Investiment

UK Minister was worried about the possible impact of TTIP on NHS

European Comissioner replied in this letter to UK Minister

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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…

It is important we take under control all the updates of the text of TTIP

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Also for the un-direct impacts TTIP can have on our Health Systems

For instance ….

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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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Another possible impact?

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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

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In Europe there is a growing sentiment of dis-trust and disagregation

Sometime pushing to build walls inside the same EU

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CONCLUSIONS

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Maybe we have to remeber the story of Europe

Its name comes from… Europa

Who was Europa ?

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The abduction of Europa by Francesco Rustici (1474-1554) Victoria and Albert Museum - London

Europa (Princess from Asia)

He transformed himself into a bull to carry her to a new continent…

God Zeus fell in love with her and..

Greek Mithology

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The abduction of Europa

By Titian

By Goya

By Rembrant

And…

in the new continent, Europa brought, as gift, a lot of beauty

And the new continent , in her honour, was called

Europe

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Europe brought to the

world other important gifts….

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CONCLUSIONS

Europe was the home of the ANCIENT DEMOCRACIES

Ancient Athens

Ancient Roman Senate

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CONCLUSIONS ...MODERN DEMOCRACY

Baron de Montesquie

John Locke

Separation of the powers (tria politica principle):

Legislative Executive Judicial

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CONCLUSIONS

Galileo Newton

...MODERN SCIENCE

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CONCLUSIONS

Eisenberg Eistein

...CONTEMPORARY SCIENCE

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BREATH-TAKING ART

Sistine Chapel – Vatican City

58 Sandro Botticelli 1478 “The Spring” Galleria degli Uffizi - Florence

Europe gave its best when it put in the centre the

“Human Kind”

RENASSAINCE PERIOD

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CONCLUSIONS …and when it put in the centre the HUMAN RIGHTS

Voltaire

«I might disagree with your opinion, but I’m willing to

give my life for your right to express it»

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CONCLUSIONS AND IN EUROPE HEALTH IS … A… HUMAN RIGHT !

Lord Beveridge

The European Health Systems

are treasures coming from

this philosophy Otto prince of Bismarck

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The Spring (detail) - Sandro Botticelli 1478 Florence - Galleria degli Uffizi

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

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The Spring (detail) - Sandro Botticelli 1478 Florence - 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…

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The Spring (detail) - Sandro Botticelli 1478 Florence - Galleria degli Uffizi

CONCLUSIONS

We need a

New Renassaince And New Bridges

WE COULD CREATE A NEW SPRING !

Giunta Regionale Area Sanità e Sociale

Rome, Fori Imperiali 100 1966-2066

2066 100 ANNIVERSARY

WELCOME TO EUROPE !