Health Ministers from OECD countries met in Paris on 13-14 May 2004 to debate ways in which they can improve the quality and efficiency of their health systems.  In a joint session with Finance/Economics Ministers, they also discussed the challenges of ensuring the financial sustainability of health systems.  Rapid growth in health spending, together with a growing awareness of problems of quality in health care and opportunities to prevent illness and disability, raises the urgency of addressing these issues.    

Theme 1:  Better health through prevention and high-quality care

Initiatives to improve public health – to cut tobacco and alcohol use, reduce road accidents, change sedentary lifestyles and reverse the growth in obesity – may well do more to improve health status than providing care for those who become ill.  However, where prevention does involve higher outlays, there is a tendency to under-invest.  Moreover, while the costs come now, the benefits generally come much later.  Ministers discussed which prevention strategies have been shown to be cost-effective and might be extended.

Ensuring delivery of the right type of care at the right moment also needs to be an important focus of today’s health systems.  Substantial differences in performance between providers, within as well as across countries, show that there is much room for quality improvement.  Many OECD countries now monitor indicators of health-care quality, but their efforts can be strengthened by investments in tools like clinical practice guidelines and performance standards that promote the practice of evidence-based medicine.  Ministers exchanged views on ways to encourage improved quality-of-care standards and implementation of best practices.  

Joint session with Finance/Economics Ministers:  Ensuring the financial sustainability of health systems

OECD countries spend considerable amounts on health care:  the average across OECD countries is now almost 9% of GDP, and above 11% in several of the large economies.  After a pause in the late 1990s, the proportion of GDP devoted to health is now rising again in many countries.  Advances in the capability of medicine to treat and prevent health conditions is a major factor driving health cost growth.  Population ageing is also expected to play an important role in driving future growth in health spending.  In view of the significant and often predominant role of the public purse in financing health care, the financial sustainability of health systems looms large on the political agenda. OECD countries have experimented a wide range of measures to offset cost pressures in the health sector, but none offers a panacea.

Theme 2:  Improving value for money in health systems

Health systems across the OECD are striving to increase value for money.  In recent years, OECD health systems have done much to reduce inefficiencies, such as excess hospital capacity and excessive lengths of stay.  Yet much could still be done to encourage cost-effective innovation in health-care delivery and management.  In many areas of the economy, competition through informed consumer choice works best to improve the quality of services.  However, in health care it is technically difficult to inform patients about outcomes adequately.  What role should competition play in improving efficiency in health care systems?  How can the public debate about health care performance be better informed?  These are some of the questions that Ministers addressed.    

The Health Ministerial Meeting was preceded by a Health Ministers Round-Table at the OECD Forum 2004 on 13 May in the morning (daily summaries and speeches).  This Round-Table provided an opportunity for Ministers to exchange views on the contribution of research and innovation systems to improving the performance of health systems.