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

Chapter 4
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2.8. Policies for specific population groups – older
people
Interest in self-help groups has been growing in Greece and
there are now active NGOs addressing, for example, breast
cancer, diabetes and the need for dialysis. In some cases,
their pressure has been extremely effective: for example,
the Association of People with Cooley’s Anaemia managed
not only to secure proper medical care but also social and
economic provisions that are now law. Although there is no
national council or committee for older people, there are
a number of quite vociferous pensioners’ organizations and
an NGO for healthy ageing, Ellas50plus, which represents
Greece on the European Older People’s Platform (AGE).
We were unable to locate published policy documents for
specific population groups, including older people. However,
as seen above, the necessity of reporting to the EU provides
a valuable source of policy information in Greece. The
Annual report on health, health care and care for the elderly
(37) is one such source. The report does not refer to the
health challenges faced by older people but outlines efforts
made to improve the quality of and access to hospital care,
including the improved computerization of information and
proposals to expand PHC.
The success of the community centres for the elderly
(KAPI) introduced during the 1980s, and particularly of
the home-help services they provide, is highlighted in the
report. In view of their success, the Government intends to
further expand these services, which can be expected to
support older people suffering from NCD.
In relation to older people and nutrition, in the context of
the WHO/EU research project (EPIC) referred to above,
nine countries, including Greece, are examining the role of
diet on the etiology of cancer and other chronic diseases
among older people.
2.9. Broad intersectoral policies with a health
component
In the framework of the EU agreements, Greece develops
national action plans for social inclusion (NAPs). The
2003–2005 NAP (38) included, as its tenth target, “Promoting
better health. Increase of two years in average
life expectancy at birth”. The NAP did not relate this to
tackling NCD. The main issues presented were ensuring
access to health care in geographical and financial terms and
expanding community services for mental health. Disease
prevention was seen in terms of advice on quitting smoking,
diet, etc. offered by the hospital services.
An intersectoral Commission for Social Protection was set
up in 2003, chaired by the Minister for Labour and including
among others the Deputy Minister for Health, the general
secretaries of a number of ministries, and representatives
of local authorities, trade unions, entrepreneurs, the church
and voluntary organizations.
The 2006–2008 NAP (39) is aimed at three policy areas:
social inclusion, the social security system, and health and
long-term care. Employment is seen as the key to lifting
people out of poverty. Health is seen, however, in terms
of access to health services and the document states that
“although health care expenditure has risen importantly,
there has been no improvement as to the basic indicators
on life expectancy, morbidity or potential morbidity of the
population” (39). There is no reference to the concept of
dealing with the determinants of health and the main causes
of death and morbidity.
3. Infrastructure and resources for policies
to tackle NCD
3.1. Human resources
“In Greece, only the University of Crete has recognized
family medicine as an academic discipline; only one chair
is available in this country, and GPs are seeking recogni-
Case studies: policy development in countries for tackling noncommunicable diseases