Press Release

Major Health initiatives to be promoted during the Irish Presidency of the EU

Ireland will have the opportunity to make major advances on health issues during the Presidency of the European Union next year. The Department of Health and Children are now developing initiatives which could affect the cardiovascular health of all Member States. For the first time, agreement will be sought on strategies for promoting Cardiovascular Health.

The second major Irish initiative will be in the area of E-Health and will aim to co-ordinate the collection of data on the care of patients with coronary heart disease by health care professionals across the EU.

The Minister for Health, Micheal Martin T.D., will chair a Ministerial meeting as part of the ongoing EU work on health issues such as food, medicines and access to healthcare across EU Member States. The Department of Health and Children will also host two expert meetings with input from Member States, at which Ireland will put forward new health initiatives.

Cardiovascular Health

The first expert meeting is a European consensus conference on cardiovascular health, which is planned for Cork in February 2004. The focus of the conference is the maintenance of cardiovascular health through lifestyle and prevention measures. Ireland´s experience in addressing cardiovascular health affords a clear opportunity: to advance this issue. At one stage, Ireland´s death rates from cardiovascular disease were twice the European average. Over the past four years €54 million has been invested in cardiovascular treatment and rehabilitation and significant gains have been made in preventing cardiovascular disease by putting structures and systems into place across the country. The Department of Health have emphasised evidence-based interventions and this experience can be used in a European context and help to promote agreement on how Europe can prevent cardiovascular disease, both through primary prevention with those who are well and secondary prevention in those who have already developed heart disease and related conditions.

While Ireland has had success in reducing the cardiovascular disease toll, death rates in many of the new member states have been on the increase. Within the union of 15, Ireland currently has the highest rates of death from cardiovascular disease When the accession countries are taken into the equation, this will change. Ireland has a lot of experience to share with new EU members arising from our actions to address cardiovascular disease to date. Ireland developed the Cardiovascular Health Strategy to address disease prevention but also to improve services for the treatment and rehabilitation of those who already suffer from coronary heart disease and related conditions. Implementation of this strategy has had a major impact on the delivery of health services.

Ireland will not just be “advising” Member States on how to handle cardiovascular disease, but will be well placed to lead the discussion at European level on what sort of supports and structures Member States could adopt for themselves to ensure or enhance approaches to cardiovascular disease. There are risk factors associated with cardiovascular disease; to avoid it people should not smoke, eat healthily, be active for at least 30 minutes a day, blood pressure should be less than 140 over 90 (mms mercury), and cholesterol should be less than five (mmol/L). Ireland will be acknowledging the agreement among European professionals on the factors which increase risk and on the health behaviours and physical parameters which reduce risk.

Arising from that, consensus will be sought on strategies for individuals, health services, communities, governments and the EU to agree strategies on how governments can support the promotion of cardiovascular health. There are challenges for Member States to work with the various sectors of society to create environments which support healthy lifestyles. An overall environment needs to be created which encourages healthier choices. The aim is to arrive at a European consensus on what risk factors are associated with cardiovascular disease, and how Europe can agree to tackle that on an individual, governmental and European basis for the future.”

National Heart Health Advisor, Emer Shelley, describes the work already under way in Europe to enable informed discussion when the expert groupings arrive in Ireland early next year. “In September of this year, 2003, the report of the Third Joint Task Force on the Prevention of Cardiovascular Disease in Clinical Practice will be published. That’s a process which has been led by the European Society of Cardiology and the ESC are our main partners in the Prevention Conference planned for the Irish Presidency. We will review that document, which has been written from the perspective of the health services. We will examine what it means for individuals, populations, for governments and for other relevant sectors. The expert groups will review the available information and will draw up proposals for strategies that could be agreed at European level. The Irish leadership will also draw up a supporting document detailing relevant research – for instance, the research which is available on smoking, or successes in how to encourage young populations to quit the habit. These findings and conclusions will form the basis of a discussion document to be distributed among Member States prior to the expert meeting planned for Cork during the Irish EU Presidency. In this way all those taking part in the process will be informed and consulted.”

E-Health Cardiovascular Audit and Registration Data Standards (CARDS)

The second expert meeting is to be a conference on Cardiovascular Audit and Registration Data Standards (CARDS) planned for Dublin in May 2004. The initiative involves a partnership with the European Society of Cardiology to agree the type of information to be collected in databases on coronary heart disease, which could be used by all Member States. Dr. Shelley explains, it is again, an initiative which has not been attempted before in a European context, and which should make a major contribution to European health planning. “Analysis of the data could allow each region or country to identify trends in the treatment of heart attack and in procedures to treat coronary artery disease.

The findings can then be validly compared with data collected in other European settings. The information will also be useful to software or equipment manufacturers to ensure uniform standards across the EU.”

Three separate data sets will be developed:

  1. Acute coronary syndromes {heart-attack}
  2. Coronary interventions {where there are treatments to coronary arteries}
  3. Electrophysiology {to either diagnose or treat rhythm disturbances of the heart}

A data set will be created for each of these topics, with an accompanying manual to indicate the types of people whose information should be recorded in the database. Each data item will be carefully defined, so that there will be comparability across different care locations. As Emer Shelley outlines, “Our first task will be to agree the types of information that would be most useful to compile, and then we will address the specifics. There are existing information systems in a number of countries, and indeed in a number of locations in this country. We are collecting as many of these as possible, and are compiling them all into a matrix. An Expert Committee will advise on the content for each of the data sets, identifying which data items are high, medium or lower priority. The proposed data sets will be reviewed, amended and adopted at an expert conference in May 2004.”

From a European health professional´s point of view, CARDS will identify the top 100 pieces of data to be collected about patients in relation to them being admitted to a coronary care unit, having an electrophysiology test, or intervention to treat coronary artery disease. From a European patient’s point of view, for these three strands it will set the scene for examining the outcome of treatments, to encourage improved quality, in accordance with best evidence and research. Meanwhile, the European consensus conference on cardiovascular health could lead to reduced death tolls from cardiovascular disease across Europe. Ireland has the experience to facilitate this, based on our own national programme which has been in operation for the past 4 years. With co-operation from many players, a wonderful legacy can be associated with Ireland’s EU Presidency in 2004.

The Minister for Health and Children, Mr. Micheál Martin, will chair the EU Health Council and preside over EU health matters for the six months of the Presidency. Ireland and the Minister will be taking the lead on all health matters in the European context. In doing that, the Department of Health and Children will work with other Member States, and the EU Commission, and other partners such as European professional bodies and voluntary organisations.