Sunday, September 21, 2008

25-27th June, 2008, Tallinn
At last, the culmination of over two years’ work. Health ministers and their representatives from the 53 Member States of the European Region of WHO have come together in a major
conference to discuss the links between health systems, health, and wealth. I’ve been involved in many aspects of this process, including writing some of the background reports, but here my task is to give one of the opening speeches, along with Mary Robinson, former UN High Commissioner for Human Rights and President of Ireland, and Uwe Reinhardt, from Princeton University. Both extremely hard acts to follow. If you want to see whether I succeeded you can watch a webcast of the speech on the conference website.
The framework underpinning the conference is a series of reciprocal relationships between health systems, health, and wealth. The first set of relationships are between health and wealth. It is obvious the greater wealth, whether at the level of the individual or a country, provides greater opportunities for health. People with more economic resources can make healthier choices in terms of what they eat, where they live, and how they spend their leisure. Countries with more economic resources can provide healthier environments. However, there is now a large body of evidence that healthier individuals and healthier populations contribute to greater economic growth. Healthy individuals are more productive and more likely to remain in the labour force. Historical studies show that much of the wealth of countries today is due to improvements in health over the last 200 years.
Health systems contribute to health, by preventing death and alleviating suffering. We can I quantify this through research using the concept of avoidable mortality, which measures the number of deaths that should not occur in the presence of timely and effective care. However better health also contributes to health systems, as healthier people have less requirement to use health care. This was the basis for at the analysis conducted by Sir Derek Wanless in his report to the UK Treasury, when he was asked to look at future expenditure on the National Health Service.
Wealth can contribute to health care as wealthier countries clearly have more resources to spend on modern medicine. On the other hand, health care systems can contribute to economic growth, especially at a regional level, where the provision of high-quality health care and support inward investment. Investment in health facilities can benefit the local economy, reducing unemployment, and thereby improving the health of the population, but only if it is structured in a way that enables local companies to bid for tenders on a level playing field with multinational corporations.
What we were trying to convey at the conference was not the detailed prescription for action, but rather a vision of where policy should be heading. We believe that it is possible to create a virtuous circle, with benefits for everyone.
Although there was a large attendance at the conference, and the background material is available on the Internet, we had recognized that there was a need to reach out to a much wider audience. Fortunately, as at the
Oxford Health Alliance meeting in Sydney in February, we were able to enlist the invaluable support of Eddie McCaffrey and his team at JooseTV, who not only webcast the entire conference, but also produced a series of news bulletins at the end of each session and in-depth interviews with some of the key individuals who were at the conference. If you watch nothing else, check out the film shown at the end of the conference that really captures the atmosphere of excitement and enthusiasm there. Once again, I conducted many of the interviews and you can watch them on the conference website. The opportunities provided by webcasting also allowed us to connect with the European Health Management Association conference, taking place at the same time in Athens, with a specially tailored interview. If we really want to communicate messages to a wider world, this is definitely the way to go forward.

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