Interview with Guntis Belēvičs: Latvian Presidency of the European Union puts the focus on patient-centred healthcare

3rd June 2015

The future sustainability and equity of Europe’s healthcare systems depends on placing the needs of patients first. From this perspective, it becomes possible to improve coordination and quality at every level of care, strengthening services and increasing the healthy life span of all, says Guntis Belēvičs, Latvia’s Minister for Health  

While the Riga conference on ‘Universal Health’ comes at the end of its term, the Latvian Government has made healthcare one of the priorities across its Presidency of the EU, addressing issues including eHealth, child health and alcohol-related harm reduction.

The range of topics illustrates there are many strands to the provision of high quality health care. But says Guntis Belēvičs, Latvia’s Minister of Health, there should be a single focus. “In the long term, health care systems must be developed in such way that the patient is at the centre, and medicines and medical devices must be accessible, high quality and cost-effective.”

Changes in the needs of the patient population that are occurring as a result of the demographic shift and the increasing incidence of non-communicable chronic diseases, also change what is required of health care systems. “It is a major challenge to ensure the increasing demand for health care services [is met], whilst balancing the increase in costs of new treatment methods and technologies, with the financial [resources] of the society,” Dr Belēvičs says.

To achieve the objectives of ensuring safe and high quality health care services and enhancing health promotion and disease prevention, it is important to, “focus on the needs of patients” and “not so much on treatment of each specific disease,” Dr Belēvičs believes. “It means achieving – and improving – the coordination of health services at all levels of care, patient involvement, and strengthening accountability at all levels, from policy makers to health care providers, society and patients.”

This is the only way to achieve a substantial increase in healthy life years for each individual, and for society as a whole to reduce poverty and the risk of social exclusion.

In this context, Dr Belēvičs points to the work started by the World Health Organization Regional Office for Europe on a Framework for Action towards Coordinated/Integrated Health Services Delivery. “The aim of reinforcing people-centred health systems in the European region of WHO, is recognised as being very important,” he says.

Increasing the emphasis on promotion and prevention

That life expectancy is increasing across Europe is a great achievement and should be celebrated. However, it also poses challenges for individuals and society. The ageing population is associated with a greater incidence of non-communicable diseases, placing an additional burden on health care systems. “Therefore health promotion and prevention become more and more important,” Dr Belēvičs notes. It is crucial that all EU member states share examples of their best practices and work together towards more effective, inclusive and integrated health approaches.

To support such cooperation it is necessary to evaluate the effectiveness of particular health policies. “For this reason it is important that the EU works on the development of common tools for assessing performance and quality of various interventions and policies, whilst keeping in mind that interventions should be country context-specific and cannot be used as a “one-size-fits-all” approach,” says Dr Belēvičs.

Health in all policies

It has become evident over the last few decades that in order to really improve the health and wellbeing of nations it is crucial to engage stakeholders across the health sector and beyond – in a “whole-of-government” and “whole-of-society” approach – in which the individual is actively involved.

“We have to improve urban planning, work with ministries of environment, traffic, finance, education, and with the private sector and employers,” Dr Belēvičs says. “We know that each euro spent on prevention and health promotion is paid back in the long term: populations are healthier; the burden of non-communicable diseases is reduced; we can contribute to sustainable economic growth in Europe.”

One case in point is what Dr Belēvičs refers to as “a very alarming situation” in terms of childhood obesity and its long-term consequences. To highlight this issue, the Latvian Presidency organised the High Level Conference on Healthy Lifestyle in Riga, to discuss how to tackle the obesity epidemic, with the outcomes presented at the Informal Meeting of Health Ministers in April.

Experts at the conference discussed the best school–based approaches for promoting healthy nutrition and physical activity. “I believe that the discussions will help us to work on the next steps to reduce obesity among children and young people at the EU level,” says Dr Belēvičs

The experts agreed it is crucial to make sure policies do not inadvertently increase health and social inequalities, and to implement policies that ensure a healthy environment in schools, which encourage healthy eating and physical activity.

The Latvian Presidency has also put the issue of alcohol-related harm high on the agenda of health ministers and the Commission. Dr Belēvičs points to the enormous cost, not only in financial terms, but also because people are dying prematurely. “We lose the most important resource, [people] that can strengthen the productivity of European Union,” he says.

Ministers from member states and WHO, clearly identified the main issues that should be taken into account in developing a new EU Alcohol Strategy. Ministers are in favour of a new strategy with an emphasis on cross-border issues, like alcohol marketing restrictions, pricing policies, cross-border sales regulations, and others.

Following their informal meeting in Riga, health ministers wrote to Commissioner Andriukaitis, asking the Commission to work on the new EU Alcohol Strategy, putting the focus on issues outside the competency of member states. “The European Parliament has defined its opinion regarding this issue as well, so I’m quite sure that our discussion has been an important step,” says Dr Belēvičs. This will open the way for the Commission to work more actively to help member states to tackle the alcohol problem.

The role of digital technologies in shaping patient-centred health care

Information and communication technologies have a central role to play in the provision of the high quality and efficient health care delivery in Europe. “ehealth issues are essential priorities for Latvia in the context of the Presidency,” Dr Belēvičs says. “eHealth and mHealth will not only contribute to the wider involvement of society and patients in health care processes – thus promoting public health and a healthier lifestyle – but they will also develop the e-skills of the population and the growth of the digital sphere as a whole.”

Within the framework of the eHealth programme in Latvia, the National Health Service is introducing a single electronic information system, with the central objectives of promoting citizens’ control of their own health by providing access to their health data, and of strengthening health promotion by making more information available and promoting healthy lifestyles.