An EU Health Emergency Preparedness and Response Authority

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The creation of a new authority, the Health Emergency Preparedness and Response Authority (HERA) which could mobilize resources quickly in emergencies, was the next major initiative of the European Health Union, Valérie Friot, Deputy, held by the European Association of Hospital Managers (EAHM). Director of  Hôpitaux Champagne Sud  (HCS) told a webinar on  November 24.  Maureen Browne reports.

The webinar was moderated by Lucy Nugent, HMI Council Member and Chief Executive of Tallaght University Hospital, Dublin.

The Deputy Director said national health policy  was the responsibility of the individual EU states.  The European Union  complemented and supported this and wanted to improve and foster health in the Union.

The objective of HERA) is to anticipate threats and potential health crises, through intelligence gathering and building the necessary response capacities. When an emergency occurs, it should ensure the development, production and distribution of medicines, vaccines and other medical countermeasures.  Its creation showed the will of the EU to integrate health and social responsibility

Speaking on “Social Responsibility in health systems in Europe,”  she said we should look at how health systems could  be managed in an “optimal” way, what should be prioritises in the future and the lessons that could be learned from the pandemic.

Hospitals, she said, had to do their best for their patients, for those who worked in the hospitals and for their community.

This is about giving patients more authority and getting them to be a part of the decision making process

There were heavy responsibilities on hospitals and hospital managers and they had many different stakeholders.

They had to provide services for the public, ensure quality patient care, emergency care, preventative care and also to be responsible for their employees. 

“We have to ensure doctors and other health professionals can deliver the best possible care.

“We have to emphasise the patients’ responsibility  and encourage them to behave responsibly, engage with them and  influence them to actually modify their own behaviours and take more responsibility for their own health.  We have to encourage doctors and nurses to speak to them and to listen to them.  We are members of our community and we have to work with many institutions, including medical schools and local authorities. 

“We also have a wider responsibility to chart a path to a better tomorrow.

Paul Bomke, Director Pfalzklinikum in Klingenmunster, in the southwest of Germany spoke on  “Mental health effects of the COVID-19 pandemic.”  He said the pandemic was not really a pandemic but rather a syndemic, as it  had resulted in an increase in a number of other health problems, including mental health.

“When it comes to mental health,  we have to think about suicide rates and prevention during the crisis.  Then there were the financial stressors, domestic violence, alcohol consumption and all that went with it.  There was isolation,  entrapment, loneliness.  So, when we talk about the effect of COVID on mental health, we always have to talk about the general effect of policymaking on mental health.

There was also the need to manage people with COVID who had acute confusional states and the psychological distress caused by restricted visits to patients in hospital and homes.

There were a lot of socio economic problems and anger and fear as a result of the pandemic and some people brought this to the service providers.  They were afraid to go to the health services because of fear of infection. so the level of service provision was decreasing at the moment, despite all the problems patients were experiencing.

When it came to mental health it involved not just the mental health sector but other sectors, so it was a good strategy to  find local champions and relevant local stakeholders to get across the message that the mental health services were there.

He said there was a European campaign to bring all the ideas around mental health in Europe together and to find a good strategy and structure for digital services around mental health. MoodGYM, which started in Australia and was adapted in Germany, helped people to cope with depression on line.  It was  an interactive self-help book which helped people to learn and practise skills which could help to prevent and manage symptoms of depression and anxiety.

“Improving the engagement of patients is one important area. Another is seeing how we can bring the patient into the decision-making process.  This is about giving them more authority and getting them to be a part of the decision making process.

He said it was also very important to improve integrative care treatment systems. “We have strict silos around ambulatory services and inpatient services. But we realized when we started our integrative model during the crisis that it was very helpful and post pandemic it will be a  very important step to integrate inpatient and outpatient services under one management.

“We realized that we can create a new model where we can try to find the effects of engagement on the outcome and quality of care .”

Guillaume Pradalié, Director of medical affairs and healthcare supply – Centre hospitalier de Troyes (Troyes), said there were eight hospitals (seven pubic and one private) in the Group, which was situated not far from Paris.

He said during the pandemic. they left aside every other conditions, such as cancer, diabetes and long term illnesses which was now leading to issues, but was one of the ways they managed to get through. Then, for many months there were never talks about  budgets, which was very unusual.  They were always in a difficult but not in the worst situation.

“There was huge solidarity in our hospitals and in the local community.  Restaurants, shops and other companies brought us exotic food, chocolate and wine to the extent that we had one manager working full time on donations.  We also worked well with local authorities, especially local elected officials, and local doctors. We knew we could rely on each other which was very useful during the crisis.  Collective decision-making  was truly fundamental We also  tried to make room for ethical questioning.”

He said they  appreciated that the medical units which were most engaged in the fight against COVID had integrated  ethical questioning into their daily routine. This was especially so in how decisions were made, which were also collective.

“We also felt we were accountable for what happened to others and we tried, maybe a little bit more than usual, to understand what other people were going through and to begin to make collective decisions with the other partners.  Hospital governance had changed  with decision-making centering more on doctors.

“Today, we try to continue to  try and take care of the staff and the carers and sometimes of ourselves.”

Hospital workers in France  got a pay increase of €186 per month in recognition of their work during the pandemic.