2017 Health Ministerial Meeting: The Next Generation of Health Reforms - opening remarks
Opening remarks by Angel Gurría,
OECD, Paris, 17 January 2017
Dear Secretary Hunt, Ministers, Ambassadors, Ladies and Gentlemen:
Welcome to the 2017 OECD Health Ministerial Meeting. Let me begin by thanking Mr. Jeremy Hunt, Secretary of State for Health of the United Kingdom, for chairing this meeting. I would also like to recognise our co-vice chairs ─ Minister Castillo Taucher (Chile), Minister Gröhe (Germany), and Minister Berset (Switzerland) ─ who will lead this afternoon’s break‑out sessions on tackling high-cost treatments; reforming the roles of health professionals; and governing big data in healthcare.
This Ministerial will focus on the Next Generation of Health Reforms and the future of health, but it is worth taking a moment to look at where we are now.
Health systems today are broadly in good shape
Broadly speaking, the vital signs are good. Most OECD countries have achieved universal or near universal health coverage, and emerging economies are making good progress. Life expectancy in OECD countries has increased by more than a decade since the 1970s. Improved treatments, better prevention, and healthier lifestyles have resulted in a 50% reduction in mortality from cardiovascular disease.
There is global momentum to build on these impressive achievements. Health is a pillar of the 2030 Agenda for Sustainable Development, in particular Sustainable Development Goal 3 to “Ensure Healthy Lives and Promote Well-being for All at All Ages”. It also goes to the heart of the G20 and G7 agendas, and the OECD’s Inclusive Growth Initiative. This is because the inclusive, prosperous societies that we are striving to create depend upon a healthy population.
The OECD is working closely with policymakers in many emerging and developing countries ─ including China, India, South Africa and Kazakhstan, to name a few ─ to help build the strong and sustainable health systems their fast-growing economies need.
Despite significant progress, challenges remain
But despite undeniable progress on many fronts, good health remains out of reach for many. Large health inequalities persist within and across countries. For example, Health at a Glance: Europe 2016 ─ which I launched with European Health Commissioner Andriukaitis last November ─ shows that people in Western European countries live, on average, five years longer than those in Central and Eastern Europe. And in all countries, the richest and the most educated benefit from better health than the rest of the population: at age 30, people with the highest levels of education can expect to live six years longer than those with the lowest levels of education. Differences in smoking habits and rising obesity across different social groups mean that these differences will persist into the future, and may even get worse.
At the same time, health systems are facing new challenges.
Recent health technologies ─ including personalised medicine and monitoring and communication technologies ─ can improve treatment, but they also raise difficult questions about how to manage costs and ensure fair access to all. Similarly, the previously unimaginable abundance of health data creates new opportunities to coordinate care; to improve patient experiences and outcomes; and to advance medical science. But privacy is critical. We must make sure that sensitive personal data is protected, and never falls into the wrong hands.
Global threats, such as the rise in resistance to antimicrobials, are also daunting issues. To make sure we have antibiotics to treat future generations effectively, we need to improve access to medicines, and increase the coordination of measures tackling antimicrobial resistance between sectors ─ medical and animal ─ and across national boundaries. Finally, we need to promote innovation in the pharmaceutical sector. The OECD is supporting the efforts of the G7, G20 and other global fora in these areas.
And these challenges must be addressed while balancing ever-tightening budgets. Although the growth in health spending across the OECD at 1-2% is roughly keeping pace with GDP growth, it is under pressure from the need to pay for new technologies. What is clear is that we not only need to do more, but we need to do more with less.
A new vision: The Future of Health
To deliver more effective, accessible and resilient health systems that are capable of tackling new and existing challenges, we need a new vision for the future of health. Setting the scope of this vision is what we are doing here today. But to launch the discussions, I’d like to highlight action on four fronts, from which all countries would stand to gain:
- First, we must step up our efforts to tackle waste and promote high value care. According to an OECD report published last week, Tackling Wasteful Spending on Health, around one-fifth of health expenditure makes no or minimal contribution to good health outcomes. This is shocking! Led by better information, we must change habits and incentives across the entire system, from patients and providers to executives and decision‑makers. We also need urgent investments to make our health workforce fit for purpose, drawing on the recommendations of the UN High-Level Commission on Health Employment and Economic Growth, and the OECD report, Health Workforce Policies in OECD Countries. We need the right health care jobs, and the right skills, in the right places!
- Second, our health systems must manage better the costs and opportunities of new technologies, including personalised treatments and extremely expensive new drugs. This will require new regulatory, funding and innovation models for health care and industry. These issues are explored in our new report, New Health Technologies: Managing Access, Value and Sustainability.
- Third, we need to harness the capacity of big data to improve research, innovation and health system management, while ensuring that privacy is protected at all costs. The OECD Council Recommendation that you will launch today sets out ways to make these needs compatible rather than mutually exclusive and to build public trust in health data use. I hope it will serve as a powerful tool to support health reforms in your own countries.
- Finally, we need to make health systems more people-centred. This is the thread that needs to run through the next generation of health reforms. As Professor Berwick said at yesterday’s OECD Policy Forum, “Person-centeredness is not just one of the dimensions of healthcare quality, it is the doorway to all qualities.” This ambition cannot become a reality unless we start asking patients to identify outcomes that matter to them, such as their quality of life and functionality after medical care. The OECD will be working with all of you to develop the Patient-Reported Indicators Survey ─ PaRIS ─ and publish internationally comparable indicators of patient experiences and outcomes that illustrate the real value of health spending.
Ladies and Gentlemen: Winston Churchill once said "healthy citizens are the greatest asset any country can have". Good health is the foundation for well-being, for labour-markets, and for inclusive societies. We cannot afford to get health policy wrong. The lives of citizens depend on it. To build the health systems of tomorrow, the hard work must start today. Together, we can build the evidence, identify the best practices, and set the vision that we need for stronger health systems, better health policies, and better, healthier, lives.
Secretary Hunt, the floor is yours.