In its health policy the European Union should focus on the patient. This wide consensus emerged at the European Health Forum Gastein, an annual Conference held at Bad Hofgastein / Salzburg. At the beginning of October 1999, more than 300 European experts representing all groups participating in health policy decisions - science, business, industry, public administration, politics and patient representatives - elaborated joint proposals and guidelines on current health political topics. The scientifically elaborated results are available now.

At the presentation of the 1st Gastein Health Declaration on January 4, 2000 at RadioCafé in Vienna, the President of the Forum and Member of the National Council, Dr. Günter Leiner, defined the promotion of more self-responsibility, an intensive information campaign on medical risks among citizens, equal opportunities in access to medical care, and the integration of social fringe groups as priority health objectives.

Apart from the member states, the European Union is called upon to use new information technologies in medicine and when introducing new kinds of drugs to fight rare diseases.

"Costs in the pharmaceutical sector should not be permitted to rise even more", underscores Leiner. His special interest goes to the dialogue between industry and society which is a special focus of Forum Gastein and has not existed as such hitherto.

In Europe there are considerable life expectancy differences between the countries, for men from 61 years in Russia to 74 years in France and even higher. Even within countries of Western Europe there are big disparities between the life expectancy of higher and that of lower social strata. "It is very difficult to eliminate the injustices in health care", Leiner complains, "such as poverty, unemployment, inadequate education, nutrition, and housing." The Gastein Health Declaration calls for a definition of regional poverty limits and problem zones to make targeted local assistance in the regions concerned possible. The creation of work must have absolute priority in all countries to avoid misery and secure a life in dignity. According to Dr. Leiner, work is a determining factor for health.

With regard to preventive medicine, industry is also summoned to comply in the choice of its advertisement methods. Dr. Leiner strongly criticized the custom of the tobacco industry to specifically target socially weak groups with its advertisement.

The right to health for all must be enshrined in the European Civil Rights Charta, Dr. Leiner say, quoting another demand of the Gastein Declaration. In future, patients should be able to define the criteria for quality improvement in health care and evaluate the quality of medical care themselves.

The European Union is called upon to formulate the necessary standards and objectives and to promote high-level quality. Furthermore, the Union is summoned to promote patient and consumer groups so that these become involved in the process of quality improvement.

The Essential Demands of the First Gastein Health Declaration:

1. Improving the Quality of Care
The Patient Decides / EU for Mediation and Exchange

* Access to good health quality for all (in care, treatment, and services) within reasonable time.
* Develop quality standards and quality targets for health care

2. Equity: Create Employment and Define Regional Poverty Limits

* The existing gap in access, scope, and quality of health must be studied and gradually abolished, whereas certain groups of persons (e.g. migrants and refugees), the adjustment of the membership candidates, and certain areas (e.g. employment possibilities, alcohol, and drugs) require particular attention.
* The creation of employment and the establishment of dignified living conditions constitute political and social priorities.
* Health regions with comparable health-related situations must be defined as well as poverty limits.
* Improve health information, science transfer, and data exchange.

3. Public Health and Health Promotion: Health as a Citizen's Right

* The proposed EU declaration of the rights of citizens must include references to health and public health measures.
* Public health research must be integrated more efficiently into existing structures, both within the EU and in the member states.

4. Information Technology: Has been Previously Left to Technicians

* A system for the certification of HC Telematic products at the European level should be set up. Certification should be carried out by independent neutral bodies.
* The system shall ensure that these products are medically cost beneficial, technically interoperable and reliable as well as beneficial to the patient (directly or indirectly). 5. Rare Disorders and Orphan Drugs: Release Entire Budget.
* The original budget for the Rare Disease Programme of 30 million Euro should be restored, because the current reduction to 6.5 million Euro threatens the success of the programme.
* The European Agency for the Evaluation of Medical Products (EMEA) should be given a dedicated budget of 1 million Euro to enable it to operate the Orphan Medicinal Products regulations effectively and ensure the speedy release of orphan drugs on the market.

6. Biotechnology: Politics Need to Create Rules and Limits

Basic biotechnological research will lead to the development of new drugs, vaccinations, diagnostic methods, and medical procedures. In order to derive practical benefits from these achievements for those affected, it is necessary to establish an open dialog and a functioning communication between researchers in biotechnology, other experts, and the general public.

* Both basic and problem oriented research need to be increasingly funded. There will be no applied research without continuing basic research.
* Nations ought to have clear ethical and legal guidelines on research. A common European standard is necessary.

The entire catalogue of demands and tasks drawn up by the workgroups of the European Health Forum has been published as the first Gastein Health Declaration to serve as guide and basis for decisions for European health policy. The paper will be sent to all Directorate Generals of the European Commission concerned, the World Health Organization, the European Parliament, to all European health ministries, European patient organisations, universities, companies, specialised associations, and the media.

The paper shall serve as basis for further discussions in the framework of the European Health Forum Gastein 2000 which will take place from Septemeber 27 - 30, 2000 in Bad Hofgastein and will be organised in cooperation with the Austrian Broadcasting Company and the Federal Ministry of Labour, Health, and Social Affairs under the motto "Communication in Health Care".