How much of the care patients receive is determined by their doctor’s decision to provide it as opposed to their need and preference for it? And how much money might be saved if investigations and treatments of limited or no value to patients were stopped? These questions were debated at two recent meetings on practice variation, in the Netherlands, and the Wennberg International Collaborative in London. Both agreed on a fundamental point; if patients aren’t asked what their preferences for care are and their views of its outcome are not solicited then these questions can’t be answered. more…

Given that health is our most precious commodity it is odd that many of us know so little about it. Part of the reason is that we are not used to seeing and thinking about our own health information, for most us don’t get much of it. But things are changing. The NHS has pledged to give everyone online access to their GP medical records by 2015. Controlling your own health record may become an option too. The vision is to turn us all into engaged, active, co producers of health and self managers of disease. If only it were that simple….. more…

To what extent are we sabotaging the future health and wellbeing of our children through ignorance, neglect, and misguided policy? And what can we do to redress this? Discuss.

Discuss? The education and public health experts participating in an international cross-sector meeting convened by the Salzburg Global Seminar in Klingenthal, near Strasbourg last week, scarcely drew breath. But there was a lot to talk about.  Improving the life trajectories of children, particularly disadvantaged ones, through changes in policy and practice across the spectrum of child development and education is a challenging task. more…

Storm clouds hovered above Brussels. Europe’s heads of state battled away, yet again, to try and save the eurozone from collapse. Down the road an international group of clinicians, researchers, and policy makers questioned how Europe’s beleaguered health systems can cope as demand for care soars and workforces shrink.

The European Commission warned member states they would be short of a million skilled healthcare workers by 2020 over a year ago. Over the past three years it’s stumped up several millions of euro’s to support three vast quantitative and qualitative data mapping projects on Europe’s workforce. Information from these provided the backbone for a recent meeting on workforce planning and mobility. more…

Is our increasing life expectancy something to celebrate or despair of? It’s a question that’s exercising several sectors right now and it’s not hard to see why. All societies are ageing, but the fastest population increase is among the “oldest old,” and their projected need for health and long term care is daunting.

Currently around 1.4 million UK citizens are over 85. By 2035 the UK Office for National Statistics estimates it will be 3.6 million. Data from the Organisation for Economic Co-operation and Development (OECD) paint a similar picture and in its recent report, entitled Help Wanted, it estimates that the proportion of people over 80 will increase from a current  4% to 10% by 2050. more…

What will it take to persuade monolithic health systems to put patient’s priorities at the heart of what they do? As researchers, health professionals, and patients debated this question at the sixth international “shared decision making” meeting in Maastricht last week, the frustration was tangible. A survey to inform the meeting *reveals that while many countries are nominally signed up to initiatives to provide patients with the opportunity to participate in shaping services and making informed and shared decisions about their care. In practice, care on the ground is far from patient centred. Medical paternalism is alive and well. more…

Might patients hold the key to putting the brake on spiralling healthcare costs?  If you had asked me that question a few days ago I’d have said no. We all know about the problem of spiralling demand for healthcare and rising patients’ expectations. But after participating in the Salzburg  Global Seminar,  where the  thesis that” better decision making by patients will result in better and cheaper healthcare” was debated,  my views have shifted. more…

In the mountain resort of Bad Hofgastein in Austria, exercise is King. In early October the power walkers head for the mountains and noticeably less fit conference goers head for the European Health Forum Gastein.

Attending conferences which start early, finish late, and include lunchtime workshops as well as a smorgasbord of parallel sessions, can be hard work. But good speakers make the going easier and this year an optimistic one cheered the horses. more…

British doctors worrying about the impact of the chilly financial climate should spare a thought for their European colleagues. In Greece, the Baltic states, Spain, and Ireland, doctors, along with other public sector workers, have had their salaries and pensions cut by up to 15%, drug budgets have been reduced, and some services put on hold. Several poorer countries are also having to cope with an exodus of health professionals, exercising their right, courtesy of EU law, to quadruple their salaries by moving to work in a richer member state. more…

Iceland’s unpronounceable volcano has much to answer for. The  economic impact of its ash cloud has been immense and its growing. Thousands of  airline  passengers are still stranded. Quiet skies may be a treat and  politicians’ Dunkerque gestures a diversion, but lives are being disrupted, and attendance at international medical conferences decimated….. more…