Press release                                                                      Brussels, April 11^th 2011

Health patients right in Europe: right of respect of patient time, right to free choice and right to access to care are the three less respected

Presented in Brussels the second Active Citizenship Network report on patients' rights assessment.

Patients' time, free choiche and access to the cares are the three of the health rights less respected in Europe between the 14 rights enshrined in the "European Charter of Patients' rights".

These are the main results underlined by the report “The Eu Charter of Patients' Rights – A civic Assessment”, presented today in Brussels by Active Citizenship Network, a european civic network promoted by the italian no profit organization Cittadinanzattiva.

The research covered 20 european countries, 56 hospitals, 23 Ministries of health and 70 civic organizations, and is based on the method od “civic information”, defined as the capacity for organised people to produce and use information to promote their own policies, and participate in public policymaking. In particular, “Audit civico”, an application well established in Italy.

Patients' Rights Euro Scores

*Only considering Civic Partner Organizations answers.                                                        Source: Active Citizenship Network.

No single right is fully implemented and thus respected. “As already observed previously”, declared Teresa Petrangolini, Active Citizenship Network Director “the results are connected to the crisis of the "European Social Model" insofar as concerns the universal right to health care and the consequential reduction of levels of protection”.

Too low is also the score of the right to avoid unnecessary suffering and pain.

The Situation in the different countries. The calculation of the PRES indexes measures the attention to the rights of the European Charter and cannot be used as a basis for a classification of the health systems. Even the best countries do not attain excellent scores. More generally, the comparison of countries highlights a decidedly broad field of variability, with a gap equal to around 40% separating the best situation from the worst. This confirms that residence is still a powerfully discriminating factor.

Good news: development of a European framework. The Civic Audit methodology adopted in this assessment work has also underlined the existence of important common characteristics:

• a good physical accessibility of hospitals, nearly always reachable by public transport;
• a fair implementation of the right to privacy and confidentiality, supported by national guidelines;
• a good protection of the right to preventive measures, with vaccinations and screening programs;
• the spread presence of legislative indications regarding non discrimination and personalized care that take into account culture and religion, gender and age.

Other twelve indicators regarding safety, quality and care personalization are present and complied in almost all the countries, so that it is possible to talk about a common European culture in health care.

An active citizenship in Europe: in progress, but not enough. Many countries, in the last years, have recognized rights - to informed consent, to free choice, to complaint, and to compensation - which can contribute to the training of an “empowered user”. The process, nevertheless, is still widely incomplete: indeed these same rights have unsatisfactory scores; informative means are scarce and the active citizenship is not favoured.

It is possible to assert that, in general, citizens can be, in the best situations, the main object of the attention, but they are not yet recognized as subjects able to participate in the governance.

CITIZENS’ RECOMMENDATIONS

The stake - the protection of the universality of health care systems – requires a general effort in order to avoid that illness causes social exclusion, with adequate resources and guarantees of protection of weak people and with proper supporting policies in five ambits.

1. Adoption of the European Charter of Patients’ Rights as a common standard and tool for the assessment of quality and accessibility of Health services.
2. Time, free choice and access to care must be declared as a priority to achieve an acceptable Health policy in Europe.
3. Disparities in treatment among European citizens must be reduced. The implementation of the European Directive on cross-border care must be supported through the spread of shared quality standards, information and safety, through the removal of impediments to the exercise of free choice, through a better management of the waiting lists.
4. The development and the training of “empowered users” must go on, as a contrast with the reductions of levels of protection caused by the crisis of the social model, by promoting active citizenship all over Europe, by implementing the right to information and by spreading the patient centred care.
5. Local communities must be in conditions of freely make use of their own resources, in the framework of subsidiarity, with adequate and certain flows of financial resources as well as with  actions for the support and training of local leadership.