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

tics are based on close cooperation between specialists
(a cancer care team) and on organized consultations – in
other words, on multidisciplinary communication.
To ensure that standardized principles of treatment are
applied, treatment and financing protocols were defined
as early as December 2005. A decision was also taken that
certain types of cancer were to be treated not in oncology
centres but in separate units in specialist facilities, partly
because of their specific nature and partly because of Hungarian
practice. A multidisciplinary programme is needed
for the modern treatment of malignancy. Concerning the
rehabilitation of cancer patients, physical and emotional
rehabilitation is available at county oncology centres and a
mobile team offers palliative care.
There are currently 1700 beds for cancer patients undergoing
chemotherapy and radiotherapy and for the care of those
with chronic disease, an insufficient number for the proper
management of the tasks in hand. Cancer care facilities are
organized and operated hierarchically, managed by a network
of GPs, the oncology departments of the municipal and
county hospitals, the clinical oncology departments of universities
and, at the top, the National Institute of Oncology.
In recent years, the transfer of research results to oncology
practice has accelerated, which is a huge challenge to
the profession. It is essential that this research be included
as a key component of the National Cancer Control
Programme, in conformity with international practice. A
sufficient number of appropriately trained specialist physicians
are fundamental to cancer treatment. The schools of
medicine and the National Institute of Oncology play the
defining role in training specialist physicians.
The cancer programme includes 16 objectives covering the
three pillars of primary prevention, secondary prevention
and treatment. The list of objectives includes neither baseline
measures nor clear, measurable indicators. It is noteworthy
that the planning group expects substantial support
from the EU structural funds in the forthcoming years, but
there is great uncertainty as to the prospects of implementation.
It is too early to forecast the chances of its success.
2.6.2. Heart health
In spring 2006, the Prime Minister requested the Hungarian
Alliance of Associations in Medicine and Natural
Sciences (having among its members various cardiological
associations) to draft a National Heart Health Programme.
Hungarian CVD mortality and morbidity are very high
compared to the EU average, especially in middle-aged
men. Despite some favourable trends in the last few years
(the decline in mortality from acute myocardial infarction),
Hungary still faces great challenges in reducing CVD
mortality and morbidity. In addition, the social and regional
inequalities in CVD are striking. The draft Heart Health
Programme was discussed at different national conferences
and technical meetings and the document was published on
the Internet with a call for comments.
According to the Programme, the main aim is to improve
significantly the health status of the population, and in particular
life expectancy at birth should approach the average
of the 27 EU Member States by the year 2013. To achieve
this and to develop an efficient level of health promotion it
is crucial to develop health communication and ensure the
quality and effectiveness of care while reducing inequalities
and joining the “information society”. As far as we can see,
this list of key components is rather eclectic.
Instead of clear objectives, the document uses the terminology
of expected results. Only one objective is quantified,
which is the increase in life expectancy at birth by three
additional years by 2013 for both males and females. Among
the expected results, the following are explicitly mentioned:
• declining cardiovascular morbidity and mortality;
• decreasing inequality;
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Case studies: policy development in countries for tackling noncommunicable diseases