15 March 2011: Lunch debate about EU activities on long-term care
On 15 March 2011, Marina Yannakoudakis, MEP (ECR, UK) and Member of the European Alzheimer’s Alliance, hosted Alzheimer Europe’s 9th lunch debate which was centred around “European activities on long-term care: What implications for people with dementia and their carers?”
Ms Yannakoudakis opened the lunch debate dedicated to long- term care issues by explaining that she had personal experience of dementia as her friend has the disease dementia. She said that she wanted to affirm her support to people with dementia and their carers by hosting today’s debate. The chairperson of Alzheimer Europe, Heike von Lützau-Hohlbein expressed her delight that so many people had taken the time to gather and she said she looked forward to learning how we can develop partnerships with Europe in order to help people with dementia and their carers.
Two representatives from the European Commission informed participants of the work on long-term care which has been, and will be, carried out at European level: Arnaud Senn, Policy Officer, Social Protection, Social Services, European Commission, DG Employment, Social Affairs and Equal Opportunities and Wojciech Dziworski, Senior Economist and Political Analyst, Innovation and Health Ageing, European Commission, DG Health and Consumers.
Long-term care: an EU priority
Mr Senn’s presentation, entitled “Long-term care: An EU priority” gave an overview of the common objectives between healthcare and long-term care since 2006, the recognition of long-term care on the EU agenda and the main policy challenges to be addressed in the field of long-term care. He explained that long-term care is a subject which concerns many European Commission DGs and Departments. Since 2006, the European Commission has worked hard to try to promote long-term health care which is accessible, of a high quality and both sustainable and affordable. Long-term care has been firmly placed on the EU agenda and European commitment was evident in 2008 when a reflection was launched which addressed a whole range of issues regarding care issues. In 2009, both the Swedish Presidency Conference on ageing issues and the Commission report “Access to healthcare and long-term care: Equal for women and men?” reinforced the EU’s commitment to long-term care. In 2010, the Voluntary Quality Framework for Social Services was adopted which aimed to provide guiding principles regarding the quality of social services across Europe. Finally, there is an overriding commitment to the 2020 Strategy, in which long-term care is evident within the aim for inclusive growth, which should be smart, sustainable and inclusive. Issues surrounding long-term care, said Mr Senn, cannot be considered in isolation and he gave the example of access to long-term care, which in turn raises the question of public funding. As such, this long-lasting reflection which has focused on long-term care has raised a whole range of issues, not only from a patient’s viewpoint, but also for Member States and EU institutions.
Mr Senn reiterated the key policy challenges in the field of long-term care which were highlighted during the Swedish Presidency Conference, namely:
- Better integration between health and long-term care
- Improved access to care for dependent old-age people
- Providing choice in public services
- Long-term care workforce policies
- The specificity of Alzheimer’s disease and other dementia
- Quality of services, quality of assessment/control/assurance
- Responsiveness, timeliness, delivery when needed
- Ageing in place and grace, dignity, respect.
All long-term care issues are considered at EU level by the process of the Open Method of Coordination, which is a voluntary process for political cooperation, facilitating an exchange of good and best practices between Member States on specific subjects and includes the social protection committee.
Mr Senn emphasised that the EU commitment to long-term care has also been evident in other initiatives citing the Council conclusions “Promoting health and dignified ageing” of 2009, the EU 2012 Year of Active Ageing, the European Parliament Resolution of 2010 on long-term care for older people, the Social protection Committee’s 2010 voluntary quality framework on Social Services of General Interest SSGI and lastly, the recently launched European Commission Active and Healthy Ageing Innovation Partnership (AHAIP).
Expanding on the AHAIP, Mr Senn explained that the aim of the Partnership is to increase the average number of healthy life years (HLYs) by two by 2020. This can be achieved by improving the sustainability and efficiency of social and healthcare systems and by the creation of an EU and global market for innovative products and services with new opportunities for EU business.
The next step, he said, is for the Commission to write a Staff Working Paper which will map the needs across the EU and identify the challenges faced in different Member States. The Paper should focus both on the needs of the recipient of care and the contribution and role of the carer. This Paper should be issued by the end of 2011.
Marina Yannakoudakis asked whether the Commission would be including the findings from the European Parliament’s own initiative report and Mr Senn confirmed this would be the case as the Commission works closely with all EU institutions and that having them involved and their support is very important.
Nis Peter Nissen, Director of the Danish Alzheimer Association, asked if the Commission had ideas regarding the structures which need to be in place so that better opportunities are really available for the elderly in terms of long-term care as this, he said, required special attention with regards to continuity. Mr Senn acknowledged that continuity had been identified as a problem in terms of the provision of long-term care.
The Chairperson of Alzheimer Europe and of the German Alzheimer Association, Heike von Lützau-Hohlbein, raised the issue of how society sees the ageing population and asked whether this could be something which the EU addresses. Mr Senn said one of the main issues was to change the image of elderly people but also that society has to be ready to consider how the elderly are included. Therefore, Mr Senn said, there needs to be a cultural change to change the image of older people and further involve elderly people within society.
The Active and Healthy Innovation Partnership
Mr Dziworski explained how Alzheimer’s disease fits into the European Commission’s AHAIP and said that DG Sanco is very proud of this Partnership as it is a totally novel concept that involves many actors (from industry, business, research, health professionals, caring and end- users sectors). The Partnership is a major instrument to achieve the EU 2020 Strategy goal, boost innovation and remove bottlenecks at EU level and ageing is seen as an opportunity. The Partnership will pool resources and expertise and build synergies between the different actors. One of the challenges the Partnership will address is that of the current unsustainable health systems within Europe and Mr Dziworski mentioned that aged-related spending is projected to increase by 4.75% points of GDP by the year 2060, whilst at the same time the workforce of the care sector is shrinking with a lack of health specialists being available.
Mr Dziworski reiterated that the partnership has the overall aim of adding two healthy life years to the average life expectancy by 2020 which gives the project a nine-year timeframe. If this can be achieved, he said, there will be a triple win situation whereby the health status and quality of life of the EU older citizens will be improved, the sustainability and efficiency of more integrated care services will be ensured and the elderly will be able to age actively and independently. This should boost EU competitiveness and, at the same time, decrease health costs. Therefore by helping the individual, society also benefits. The Commission hopes this project will make a difference in a very practical way and one way this can be achieved is by recognising the importance of end-users’ involvement. At the moment, Mr Dziworski said, end- users involvement is insufficient. He added that the Partnership is not just about research (which will be continued), but about the identification and development of existing solutions in a coordinated and planned manner resulting in redeployment and prototypes. It will then also be necessary to identify gaps and address them.
The potential action areas of the Partnership which could be focused on with regard to Alzheimer’s disease are: Innovation in: (a) support of people’s health and well being (eg. prevention, early diagnosis, treatment etc), (b) support of collaborative and integrated healthcare systems and services for older people (eg. continuum of care, home and long-term care, training of workforce etc.) and (c) products and services for active and healthy ageing (eg. reduction of unnecessary use of hospital services).
The action areas are extremely wide and will be developed by a Steering Group, which will consist of between 30 and 34 representatives. Whilst the Commission can contribute to the Steering Group’s work by offering guidance, the main advantage of working together is, he said, that a critical mass can be achieved. Consideration will be given to how we can build on projects which already exist. The final element will be to implement standards. In the case of dementia, Mr Dziworski said that it is important that a mapping exercise takes place and that others realise what the growing number of people with dementia actually means to society. Targets can then be set and the Partnership can then identify and develop actions in a given area. He gave the examples of Spain, Germany, the UK, France and Italy as all having already a list of projects on healthy ageing which could, once shared, discussed and adapted, be used by other countries.
Sirpa Pietikäinen, MEP (EPP, Finland) and Alzheimer Europe Board Member, asked whether the procedure could be made stronger by end- users participating in the whole planning process. Both Arnaud Senn and Wojciech Dziworski agreed that it had become clear during the consultation process which groups engage in civil society in an active way (e.g. in Denmark, the Netherlands and the UK). However, the idea was not to ‘see’ the particular person but more to find solutions for the elderly which can be migrated and adapted to particular country’s situations. Such adaption had been done at regional level and now it is hoped to do the same at national level. One way in which action can be effective is to link discussions on healthcare to discussions on reform.
Frieda Breopels, MEP (Green/EFA Belgium) and European Alzheimer’s Alliance Vice-Chair, asked how the Commission will work to ensure that best practices enjoyed in one Member State can benefit all EU patients. Mr Dziworski said the identification and sharing of best practices is a very important part of the Commission’s role. He compared it to speed-dating where you find out the requirements then match up the people allowing a platform to be created where people can share information.
Ms Brepoels also asked about the membership of the Steering Committee and Mr Dziworski highlighted the importance of including the input of Member States, especially as it is the Member States who are responsible for the provision of services. He said that it is also important for MEPs to be involved in the Steering Group and that the President of the Commission will be sending out invitations to participate in the Group.
Nis Pieter Nissen asked how the Commission includes end-users. He said that in Denmark they have a think tank which consists of people with dementia. Once a year they meet to discuss various matters which result in ideas, suggestions and proposals for the Danish Association to carry out. Some of these are taken up and developed into specific programmes. Mr Nissen invited delegates to also use this process.
Jean Georges, Executive Director of Alzheimer Europe, said that it was both refreshing and important to discuss long-term care not only as a challenge of the ageing population, but as an opportunity for EU economies in the context of increasing competitiveness for EU countries. On the subject of innovation, Mr Georges asked the Commission to consider ways in which higher value can be found for people who work in the area of long-term care, such as training and incentives.
Mr Dziworski acknowledged that this is an issue which needs to be addressed and can be challenging when many of the carers are not always health professionals. He raised the issue of migrants working in this area which is often not acknowledged in terms of the migrants receiving financial, legal or specific training.
Annette Dumas, EU Public Affairs Officer, Alzheimer Europe, reminded the two Commission representatives of the wealth of information which national Alzheimer associations have and suggested that the associations forward concrete examples of how to address long-term care to the Commission. Mr Dziworski said they would be grateful to receive such information and that first they need to identify best practices and then share them.
Heike von Lützau-Hohlbein thanked speakers for their presentations and the audience for their interest and participation. She closed the debate by affirming the important role which end- users have when acting as advocates and speaking on behalf of others.
Last Updated: Monday 23 April 2012