Gaining health : analysis of policy development in European ...

Chapter 4
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telecommunications, human resources, and research and
development.
The European Commission’s proposal to establish a
programme of action in the field of health and consumer
protection for 2007–2013 (13) states that the main aims are
to: protect citizens against health threats; promote policies
that lead to a healthier way of life; contribute to reducing
the incidence of major diseases; and improve the efficiency
and effectiveness of health systems. Among the common
actions proposed are improved communication with the
general public, improved participation in policy-making, and
the development of HIA and enhanced risk assessment.
The need to tackle the determinants of health, address inequalities,
improve information and involve stakeholders in
policy-making is stressed, as is the need for more resources.
Changes in healthy life years are to be closely monitored.
The proposal makes clear reference to the need to tackle
lifestyle issues (tobacco, alcohol and drug use and nutrition)
and proposes that the health determinants strand of the
programme be reinforced and complemented by a new
strand on disease prevention. Socioeconomic factors such
as poverty and working conditions are to be addressed
and health inequality issues are to be integrated into other
policies.
It was within this framework, therefore, that early in 2005,
the MHSS published its proposal for formulating a national
development plan for 2007–2013 (14) and placed it on the
Internet. This refers, in its opening section, to the WHO
definition of health and to the need to deal with socioeconomic
inequalities in health.
As will be seen below, Greece is also to develop, by early
2008, a strategy for public health. Since it is still in the early
stages of development, it was not possible to do it justice
in this section. To present as complete a picture as possible,
therefore, we focus mainly on the available strategy
documents developed in relation to EU programmes, with
reference to other strategies being initiated.
The above-mentioned development strategy document
does not offer background information on the health status
of the Greek population. With reference to international
experience, it refers to the need for intersectoral action,
defined mainly in terms of dealing with poverty and social
exclusion, adequate funding of health care, improvements
in the quality of care, particularly for mental health, and
improving human resources for the health and social services.
Cooperation with sectors such as education, tourism
and labour are mentioned briefly, from the point of view of
delivering health and social services.
Later in 2005, a private company was commissioned by
the MHSS to expand on the investment programme for
development in the field of health and social cohesion (15),
within the framework of the national development plan for
2007–2013.
2.3.1. Awareness building and the consultation process
The document containing proposals on health for the
2007–2013 development strategy (14) appears to have
been formulated by staff of the strategic planning unit of
the MHSS. As mentioned above, an expansion of this, with
specific investment proposals, was carried out by a private
consulting firm. The consulting firm sent questionnaires to
or interviewed more than 50 people in the MHSS, the ESY,
the health professions and NGOs, collaborating with staff
of the School of Public Health and the Special Service for
the Administration of the EU Operational Programme. A
conference was organized in Athens in November 2005 to
discuss the first draft. The second draft was discussed at a
National Development Conference organized by the MHSS
in Salonica in January 2006.
The background report for the strategy makes brief mention
of life expectancy and infant mortality but does not
Case studies: policy development in countries for tackling noncommunicable diseases