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Ministry of Health and Social Solidarity MINISTRY OF HEALTH AND SOCIAL SOLIDARITY Title: «Public Health Action Plan» Study prepared by Γ' Κοινοτικό Πλαίσιο Στήριξης, Επιχειρησιακό Πρόγραμμα "Υγεία-Πρόνοια 2000-2006" 1ST COMMUNITY SUPPORT FRAMEWORK OPERATIONAL PROGRAMME Heallth-Wellfare 2007-2013 ATHENS 2008 MINISTRY OF HEALTH AND SOCIAL SOLIDARITY «Public Health Action Plan» AUTHORS Georgios Braoudakis Christos Zilidis Anastasios Mastroyiannakis Athanasios Adamopoulos Diamantoula Vlantoni Dimitrios Gounglas Mihail Kakouros ΕΥΡΩΠΑΪΚΗ ΕΝΩΣΗ ΕΛΛΗΝΙΚΗ ΔΗΜΟΚΡΑΤΙΑ ΕΡΓΟ ΣΥΝΧΡΗΜΑΤΟΔΟΤΟΥΜΕΝΟ ΑΠΟ ΤΟ ΕΥΡΩΠΑΪΚΟ ΚΟΙΝΩΝΙΚΟ ΤΑΜΕΙΟ ΚΑΙ ΤΟ ΥΠΟΥΡΓΕΙΟ ΥΓΕΙΑΣ ΚΑΙ ΚΟΙΝΩΝΙΚΗΣ ΑΛΛΗΛΕΓΓΥΗΣ Επιχειρησιακό Πρόγραμμα "Υγεία-Πρόνοια 2000-2006" EUROPEAN UNION HELLENIC REPUBLIC PROJECT CO-FINANCED BY THE EUROPEAN SOCIAL FUND AND THE MINISTRY OF HEALTH AND SOCIAL SOLIDARITY OPERATIONAL PROGRAMME Health-Welfare 2007-2013 ΣΧΕΔΙΟ ΔΡΑΣΗΣ ΓΙΑ ΤΗΝ ΔΗΜΟΣΙΑ ΥΓΕΙΑ 5 CONTENTS MINISTRY OF HEALTH AND SOCIAL SOLIDARITY..........................................................4 Title: ........................................................................................................................................4 «Public Health Action Plan» ............................................................................................4 Study prepared by ............................................................................................................4 1SSTT CCOMMUNITYOMMUNITY SSUPPORTUPPORT FFRAMEWORKRAMEWORK......................................................................4 OOPERATIONALPERATIONAL PPROGRAMMEROGRAMME HHealth-Welfareealth-Welfare 22007-2013007-2013 .......................................4 AATHENSTHENS 22008008 ........................................................................................................................4 MINISTRY OF HEALTH AND SOCIAL SOLIDARITY..........................................................5 AUTHORS...............................................................................................................................5 Georgios Braoudakis.........................................................................................................5 Christos Zilidis .......................................................................................................................5 Athanasios Adamopoulos...............................................................................................5 Dimitrios Gounglas.............................................................................................................5 CONTENTS.............................................................................................................................6 CCHAPTERHAPTER 1..........................................................................................................................11 11.. TThehe hhealthealth ooff tthehe GGreekreek ppopulationopulation......................................................................11 1.1 Demographic developments ................................................................. 11 1.2 Epidemiological Developments – Level of Health............................ 14 1.2.1. Mortality..................................................................................................... 14 1.2.2. Premature mortality ............................................................................... 14 1.2.3. Causes of death ..................................................................................... 16 1.2.4. Risk factors ................................................................................................ 18 1.3 Developments according to the socioeconomic level of the population .................................................................................................................... 21 1.3.1 Employment ................................................................................................... 21 1.3.2 Unemployment............................................................................................. 21 1.3.3 Insurance................................................................................................... 23 1.3.4 National income ..................................................................................... 24 1.3.5 Education....................................................................................................... 24 1.4 Evaluation - Conclusions........................................................................... 25 CCHAPTERHAPTER 2..........................................................................................................................27 22.. TThehe ccurrenturrent sstatetate ooff ppublicublic hhealthealth ccareare iinn GGreecereece ...........................................27 2.1 Legal framework for public health ........................................................ 27 2.1.1 Brief historical review of health care legislation in Greece........ 27 2.1.2 Legislation on central public health services ................................. 30 2.1.3 Legislation on regional health services ............................................ 31 2.1.4 Legislation on prefectural health services....................................... 33 2.1.5 Legislation on public health organizations...................................... 34 2.1.6 Legislation on protection of public health ...................................... 41 2.2 Central public health departments ...................................................... 47 2.2.1. General Secretariat for Public Health............................................... 48 2.2.2. National Council for Public Health .................................................... 48 2.2.3. General Directorate for Public Health.............................................. 54 2.3 Regional public health services.............................................................. 62 2.3.1 Regional Public Health Directorates ................................................. 62 ΣΧΕΔΙΟ ΔΡΑΣΗΣ ΓΙΑ ΤΗΝ ΔΗΜΟΣΙΑ ΥΓΕΙΑ 6 2.3.2 Regional Public Health Councils ........................................................ 68 2.4. Prefectural Public Health Services ......................................................... 68 2.4.1 Status within government structure and organizational structure69 2.4.2 Competences................................................................................................ 70 2.4.3 Staffing............................................................................................................ 73 2.4.4 Other public health services at local level........................................... 79 2.5 National Public Health Organizations................................................... 81 2.5.1 Centre for the Control and Prevention of Disease ............................. 81 2.5.2 Central Public Health Laboratory – Regional Public Health Laboratories.............................................................................................................. 92 2.5.3 Institute for Child Health.............................................................................. 94 2.5.4 Greek Pasteur Institute .......................................................................... 97 2.5.5 National School of Public Health ........................................................... 101 2.5.6 Hellenic Food Authority (EFET)........................................................... 103 2.5.7 Foundation for Medical-Biological Research of the Academy of Athens 109 2.5.8 DEMOKRITOS – National Centre of Scientific Research.................. 110 2.5.9 Organization against Drugs (Ο.ΚΑ.ΝΑ.) ............................................... 112 2.5.10 National Pharmaceuticals Organization (Ε.Ο.F.)........................... 118 2.5.11 Greek Centre for Control of Biological Materials (Ε.ΚΕ.V.ΥL.)...... 119 2.5.12 National Diabetes Centre (Ε.ΚΕ.DΙ.) ................................................ 120 2.6 Evaluation of public health services ................................................... 121 2.6.1 Evaluation criteria................................................................................. 121 2.6.2 Staffing of services................................................................................ 124 2.6.3 Policies, programmes and actions ........................................................ 126 2.7 SWOT Analysis - Conclusion ................................................................... 132 2.7.1. Strengths....................................................................................................... 204 2.7.2. Weaknesses of the Public Health system............................................ 206 2.7.3. Opportunities .............................................................................................. 210 2.7.4. Threats........................................................................................................... 212 CCHAPTERHAPTER 33:: ......................................................................................................................215 33.. IINTERNATIONALNTERNATIONAL TTRENDSRENDS AANDND SSTRATEGIESTRATEGIES IINN PPUBLICUBLIC HHEALTHEALTH........................215 3.1 Policy for Public Health in the EUU .......................................................... 215 3.1.1 The strategy of the EU in the public health sector ...................... 216 3.1.2. Priorities of the policy of the 2000-8 period ........................................ 218 3.1.3 Public health policy of the EU for the 2007-2013 period............ 220 3.1.4 The Public Health
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