EFPC: EUROPEAN FORUM FOR PRIMARY CARE

Policy brief on integration of public health and primary care in Europe

There is more than one reason to provide European policy makers with a clear description of what is lacking in the integration of Public Health and Primary Care. Recently, there has been a rapid increase in the number of member countries of both the European Union and the WHO European Region. Furthermore, there is the growing need to understand more clearly the overall impact of new clinical approaches and service delivery models on health and public service systems in contemporary primary health care. When policy makers want to integrate Public Health and Primary Care, possible policy options for this integration process should be characterized and key implementation considerations should be delineated (1).

While the organization scale of primary care and public health ranges internationally from small general medical solo-practice to multi-specialist polyclinics, and from community health centres to public health services with large health promotion programmes, all national health care systems share similar pressures for change and development. The scope and range of activities to respond to has gradually increased and now covers many aspects of individual lifestyle and risk. However, our understanding of the activities that are undertaken is very limited. Moreover, the evidence base underpinning many public health activities in primary care can be questioned. The introduction of new health check programmes raises particular concerns about how individual risk is calculated and applied to patient populations. At the same time—as a key health care service located in the community and supporting individuals and families—primary care services play an important part in supporting people who are unwell as well as those who are well.

Collaboration in understanding the pressures and the responses is essential in a modern Europe taking forward its economic and social development, to enhance the overall health status of its divergent but increasingly interdependent communities. As stated by the WHO Europe Region prior to the Andorra March European Health Policy Forum: ‘Disease prevention and health promotion are particularly important elements of public health.’ In several countries of the European Region these have become institutionally and functionally lacking because of weaknesses inherited from the past as well as recent reforms and structural changes, such as decentralization and privatization of health care services, conducted without appropriate planning and investment in preventive services. The development of primary health care services will enable these elements to function more effectively (2).

For this reason, the European Forum for Primary Care, together with the European Observatory, has started to write an authoritative Policy Brief on this topic. In the next half year a group of key-experts identified by both organizations will issue this document, to meet policy-makers’ requirements. The document will be a rigorous review of the available research evidence, written in a language accessible to non-specialist policy-makers.

Invitation to the EFPC Conference in Graz, 16 September 2011

The EFPC conference in Graz will be used to reflect on and to discuss the increasing emphasis on the role of primary care in identifying and managing health problems. Good practices of integration of Public Health and Primary Care that can be found everywhere in Europe will be presented, including examples from Sweden and hosting country Austria. These examples will be underlined by high level keynote speeches from different European Universities and the OECD.

We invite you to participate in this discussion and hope to receive your contribution on the integration of Public Health activities and Primary Care in Europe as an example to the rest of the world. See you in Graz! (Visit: http://www.euprimarycare.org/).