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Observatory on Health Care Systems is launched
Israeli ministries debate medical-waste problem ntreated medical waste dumped into a landfill site without permission has left the Israeli ministries of Health and Environment in a dilemma. The problems began after the Environment Ministry threatened
U
Who should supervise?
to withdraw the licence of Israel’s only waste disposal company, Admon, after it was reported that the company had dumped waste in the Modi’in landfill site without the correct permits. The two ministries have
been arguing over how to hold Admon responsible without shutting the company down. Now, both ministries have agreed to allow Admon to continue its work under a 3-month interim agreement requiring continuous supervision and monitoring by the Health Ministry of all Admon’s operations from collection of waste through treatment to final disposal. “Within a decade there will be nowhere to dump any solid waste in Israel—a public-health disaster is impending”, said Yossi Inbar, deputy managing director of the Environment Ministry. Inbar also noted that there is a lack of development plans for practical alternatives to limited landfill space such as recycling, composting, and controlled incineration.
o curb pharmaceutical expenses, the Catalonian Health Department announced a “prescription pact” this week. This pact, which is already working in 21 primary-care centres, will allow doctors to increase their salaries by about US$ 3100 per year. The objective is that growth in drug expenses in Catalonia, which was 9·85% last year, will reach no more than 8% this year. The pact consists of prescribing only drugs that are considered to have a high therapeutic value. Agents with a low effectiveness will be restricted to 15% of all prescriptions. 5–10% of all presciptions must be generic drugs, and doctors will be obliged not to prescribe new drugs until experts give them the go-ahead. The increase in doctors’ salaries is, therefore, linked to a budgetary matter and to the quality of prescriptions.
Rachelle H B Fishman
Xavier Bosch
Observatory on Health Care Systems is launched “
e are at the start of a fascinating development”, said Josep Figueras, head of the European Observatory’s secretariat at the launch of the European Observatory on Health Care Systems in London on Feb 11. The new observatory was officially established in Jun 1998 as a partnership between seven organisations (see panel). One of its main objectives is to provide high-quality knowledge about the healthcare systems in the 51 countries of the European region and to assess the impact of development and reform strategies. Harrison Spencer, Dean of the London School of Hygiene and Tropical Medicine, pointed out that “objective evidence is sorely needed on key questions such as how best to provide sustainable financing for healthcare, how the hospital of the future should look, and how to
W
The Observatory partners
• WHO Regional Office for Europe • Government of Norway • Government of Spain • European Investment Bank • World Bank • London School of Economics and Political Science
• London School of Hygiene and
Catalonia puts a brake on drug expenses
promote equitable access to care; especially where resources are scarce”. “Many decisions in health policy have to be taken in the knowledge that scientific evidence does not rule out uncertainty, since other elements, such as the cultural context, individual preferences, and different social factors, may have a decisive influence on the success or failure of public-health interventions”, added Enrique Castellon-Leal, UnderSecretary of Health and Consumer Affairs, Spain. Haik Nikogosian, Minister of Health, Armenia, illustrated how such comparative knowledge could be useful in future by explaining the problems, mistakes, and achievements of his country in its search for a new healthcare system since the break-up of the former Soviet Union. The Observatory’s work programme will centre around four basic functions: monitoring, analysis, dissemination of information, and training. Its activities are divided into three working hubs: the WHO Regional Office for Europe in Copenhagen; the London School of Economics and Political Science with the London School of Hygiene and Tropical Medicine; and the National School of Public Health in Madrid.
Tropical Medicine
T
News in brief In memory of King Hussein The Texas Hadassah Medical Research Foundation—a US-Jewish organisation—delivered US$3·3 million worth of medical supplies to Gaza this week, in memory of Jordan’s King Hussein. The gift of antibiotics, nutritional and surgical supplies, and pain killers was arranged with a donation from MediCares, a private interbational disaster-relief organisation. Handwashing advice for doctors The College of Physicians and Surgeons of Ontario sent doctors an instructional booklet telling them how and when to wash their hands, last week. Among the booklet’s warnings is a reminder to wash after going to the bathroom, as well as “before and after body-contact with patients, body substances, or specimens”. Chest physiotherpy examined Chest physiotherapy practises are being investigated (See Lancet 345: 510) at the National’s Women’s Hospital (New Zealand). The inquiry follows a report into the death of five babies with low birthweights and the brain damage of eight others.
Sabine Kleinert
654
THE LANCET • Vol 353 • February 20, 1999
U
Who should supervise?
to withdraw the licence of Israel’s only waste disposal company, Admon, after it was reported that the company had dumped waste in the Modi’in landfill site without the correct permits. The two ministries have
been arguing over how to hold Admon responsible without shutting the company down. Now, both ministries have agreed to allow Admon to continue its work under a 3-month interim agreement requiring continuous supervision and monitoring by the Health Ministry of all Admon’s operations from collection of waste through treatment to final disposal. “Within a decade there will be nowhere to dump any solid waste in Israel—a public-health disaster is impending”, said Yossi Inbar, deputy managing director of the Environment Ministry. Inbar also noted that there is a lack of development plans for practical alternatives to limited landfill space such as recycling, composting, and controlled incineration.
o curb pharmaceutical expenses, the Catalonian Health Department announced a “prescription pact” this week. This pact, which is already working in 21 primary-care centres, will allow doctors to increase their salaries by about US$ 3100 per year. The objective is that growth in drug expenses in Catalonia, which was 9·85% last year, will reach no more than 8% this year. The pact consists of prescribing only drugs that are considered to have a high therapeutic value. Agents with a low effectiveness will be restricted to 15% of all prescriptions. 5–10% of all presciptions must be generic drugs, and doctors will be obliged not to prescribe new drugs until experts give them the go-ahead. The increase in doctors’ salaries is, therefore, linked to a budgetary matter and to the quality of prescriptions.
Rachelle H B Fishman
Xavier Bosch
Observatory on Health Care Systems is launched “
e are at the start of a fascinating development”, said Josep Figueras, head of the European Observatory’s secretariat at the launch of the European Observatory on Health Care Systems in London on Feb 11. The new observatory was officially established in Jun 1998 as a partnership between seven organisations (see panel). One of its main objectives is to provide high-quality knowledge about the healthcare systems in the 51 countries of the European region and to assess the impact of development and reform strategies. Harrison Spencer, Dean of the London School of Hygiene and Tropical Medicine, pointed out that “objective evidence is sorely needed on key questions such as how best to provide sustainable financing for healthcare, how the hospital of the future should look, and how to
W
The Observatory partners
• WHO Regional Office for Europe • Government of Norway • Government of Spain • European Investment Bank • World Bank • London School of Economics and Political Science
• London School of Hygiene and
Catalonia puts a brake on drug expenses
promote equitable access to care; especially where resources are scarce”. “Many decisions in health policy have to be taken in the knowledge that scientific evidence does not rule out uncertainty, since other elements, such as the cultural context, individual preferences, and different social factors, may have a decisive influence on the success or failure of public-health interventions”, added Enrique Castellon-Leal, UnderSecretary of Health and Consumer Affairs, Spain. Haik Nikogosian, Minister of Health, Armenia, illustrated how such comparative knowledge could be useful in future by explaining the problems, mistakes, and achievements of his country in its search for a new healthcare system since the break-up of the former Soviet Union. The Observatory’s work programme will centre around four basic functions: monitoring, analysis, dissemination of information, and training. Its activities are divided into three working hubs: the WHO Regional Office for Europe in Copenhagen; the London School of Economics and Political Science with the London School of Hygiene and Tropical Medicine; and the National School of Public Health in Madrid.
Tropical Medicine
T
News in brief In memory of King Hussein The Texas Hadassah Medical Research Foundation—a US-Jewish organisation—delivered US$3·3 million worth of medical supplies to Gaza this week, in memory of Jordan’s King Hussein. The gift of antibiotics, nutritional and surgical supplies, and pain killers was arranged with a donation from MediCares, a private interbational disaster-relief organisation. Handwashing advice for doctors The College of Physicians and Surgeons of Ontario sent doctors an instructional booklet telling them how and when to wash their hands, last week. Among the booklet’s warnings is a reminder to wash after going to the bathroom, as well as “before and after body-contact with patients, body substances, or specimens”. Chest physiotherpy examined Chest physiotherapy practises are being investigated (See Lancet 345: 510) at the National’s Women’s Hospital (New Zealand). The inquiry follows a report into the death of five babies with low birthweights and the brain damage of eight others.
Sabine Kleinert
654
THE LANCET • Vol 353 • February 20, 1999