De Nederlandse Eerste Lijnszorg Heeft in Het Nabije En Verre Buitenland Een Goede Reputatie

European Forum for Primary Care (EFPC): An update after the Utrecht conference “The Future of Primary Health Care in Europe”

The health care systems in the countries of Europe differ from each other, but all of them are under pressure of similar developments like the need for cost containment, ageing and new technologies. In addition, EU regulations on health (care) impose a host of measures affecting health care delivery. In all European countries health care reforms do take place, in order to cope with these developments.

One striking feature of the health systems in European countries is that Primary Care has taken different shapes and roles, over the years. Analysing these differences may help us to select approaches for reform. However, Primary Care itself also needs reform, there is no static way of offering primary services to the population. There is a lot to learn. With the use of relevant indicators we can identify benchmarks as a support to our learning experience. In this respect it is not only useful to look at our direct neighbours but also further away on the continent where developments do have a different pace because of different historical and cultural background.

Strong Primary Care in countries in Europe does not emerge spontaneously, neither can we take the values and principles of Primary Care for granted, as is shown by the fact that some reforms of the health care system do tend to neglect them, for example, the importance of General Practice as a core function of Primary Care, with its gatekeeper function and direct access.

All these aspects were In particular arguments why the European Forum for Primary Care was founded and is developing it’s activities for the members. During the Utrecht conference, “The Future of Primary Health Care in Europe” the Advisory Committee of the Forum gathered for a special meeting, to discuss the future of the Forum and the next steps to be taken. Because of the growing number of members (from less than 20 in April 2006 to more than 70 at present, originating from a large range of European countries) and the increase of Forum activities (position papers, conference, multi-country study visits, etc) the Advisory Committee recognizes the necessity to establish the Forum as a legal entity – which it isn´t as yet. This process will be finalized in February 2007 at the next meeting of the Advisory Committee. Directly after the Advisory Committee meeting a reception was offered by the Forum to its members. More than 30 members of them from all over Europe attended. This event underscores the growth of the Forum and the expectations that the Forum will become a leading force for Primary Care in Europe.

One of the recent activities of the Forum was the organisation of the Utrecht conference, mentioned above. It did so, in close collaboration with the forum members, the LVG and the NIVEL , the Julius centre of the University of Utrecht and the INIC (International Network of Integrated Care). With this conference Dutch Primary Care showed itself as a player with strong interest in exchanging views and experiences in the national and international arena.

Given the number of conference participants, the conference (first edition) was a great success and the possibilities for enlarging networks have been used by many participants, in particular those from the Central- and Eastern European countries. At the first day of the conference, some Primary Care providers in the region of Utrecht presented themselves to the conference participants through a Study Visit that was organised by the LVG. Further study visits will be organised in future by the Forum which allows the participants to get familiar with Primary Care systems of different countries in one single tour (multi country study visits).

Content wise there was much attention for differences and similarities in Primary Care between North- and South and East- and Western Europe at the conference. Navigation of care for patients and stimulating self care were important topics in these comparisons. The introduction of competition in the provision of care was a knotty theme to which the first key- note speaker, professor Jan de Maeseneer, expressed his doubts as a development that caries the risk of endangering the provision of good care for those who need it most in society. On the contrary, Primary Care as a tool to strengthen the social cohesion was a widely accepted approach during the conference and a theme that will be taken up by the Forum in the next years. During the plenary sessions on the second and third day emphasis was put on the importance of good cooperation between the different professional groups within Primary Care. Multidisciplinary work is a must but has to be learned as well. Educational programmes for Primary Care professionals in many parts of Europe have to be adapted for this reason.

The Forum itself indeed starts from a multidisciplinary set up, with members of the different professions like nurses, occupational therapists, health care managers, general practitioners, psychologists, etc, of which many participated in the conference. Besides the diversity in professional groups a remarkable aspect was the presence at the conference of researchers, policy makers and representatives at implementation level and the information exchange among them. This reflects the Forum´s policy, which tries to bring these different groups together.

The conference has given evidence for the fact that it is useful for European organisations dealing with Primary Care to be internationally active and to share ideas. Through the activities of the Forum (information exchange at the web-site, writing policy documents, organising conferences and shared advocacy towards EU and individual countries) Primary Care organisations have an opportunity to take part in international activities. As more and more health care policy will be influenced by Brussels, it is necessary to jump at this train in time and not to neglect this important initiative.

Author: Diederik Aarendonk, coordinator European Forum for Primary Care Information: [email protected] or the EFPC website: www.euprimarycare.org