Equality in health care is looked upon as a European value. It sounds good but in real life - and death – the conditions for prevention, treatment and survival shift strongly around the European Union:

• Waiting times for critical procedures like cancer treatment varies. In two out of three EU member countries you must wait more than thee weeks to have a treatment.
• The survival rate among breast cancer or heart infarct patients relates to which country you live in, and to a large extent is not dependent on what healthcare resources different member states can afford (i.e. level of national wealth). Breast cancer champions are the Netherlands, Poland, Spain and Sweden while infarct patient in average have the best odds in the UK, the Netherlands and Sweden.
• Still key procedures too often are implemented at random. In some countries and hospitals 90 percent of the patients suffering from cardiovascular diseases and a high blood pressure are put on beta blockers while maybe just in the next city only half of them get this kind of medication. Statins to reduce the harmful blood lipids are becoming more common but again what in many clinics is standard procedure is rare in others. Regular eye screening to control diabetes is another guideline actively implemented by many hospitals but meeting resistance among others.

Looking into these examples the problem is hardly the lack of guidelines or insights of what is the best medicine. What it takes is rather a critical mass regarding media coverage and patient/consumer action enough to make the prize for systems negligence too high.

A good example of how to highlight critical needs was the Women´s at Heart conference in Brussels the other week. Here the European Heart Network and the European Society of Cardiology called upon the Council of Ministers to adopt a EU recommendation on a concrete EU-wide cardiovascular strategy including health promotion, support of the member states strategies and activities and guidelines on risk assessment, optimal preventive methods, treatment, rehabilitation and screening. As cardiovascular diseases prematurely kill two million EU citizens every year the gravity of the problem is hard to argue about.

What you might add to the shopping list is better evaluation of medical outcomes – key to improvement but where the European Commission for some perverse reasons still prefer to talk about resource input. Survival rates vs. the number of bed-days – judge yourself which data is of concern to you…

Johan Hjertqvist
President