Reply to Recommendation 1254 (1994) on the medical and welfare rights of the elderly: ethics and policies

19 September 1995

Doc. 7389

COMMUNICATION FROM THE COMMITTEE OF MINISTERS

Reply to Recommendation 1254 (1994)

on the medical and welfare rights

of the elderly: ethics and policies

(adopted by the Committee of Ministers on 11 September 1995

at the 543rd meeting of the Ministers' Deputies)

The Committee of Ministers shares the concerns expressed by the Assembly in its Recommendation 1254 (1994) on the medical and welfare rights of the elderly: ethics and policies.

1. Concerning the deterioration of the public health system in Central and Eastern Europe:

The European Health Committee has already under the Demosthenes programme been providing assistance to the countries of Central and Eastern Europe in the form of training seminars in subjects of major interest to them. These have covered such themes as blood transfusion, organ transplantation, quality assurance, equity and efficiency. Study trips for groups of experts have also been organised.

Two new initiatives are the following:

- A Task Force for the restructuring of blood transfusion services in Central and Eastern Europe. This Task Force which includes representatives of the European Commission, WHO and industry (both the profit and non-profit sectors), aims at providing advice to those countries that request it on the measures needed to restructure their blood transfusion services;

- The second initiative concerns the former States of the USSR (Russian Federation, Belarus, Moldova, Ukraine) and other non-member States of Central and Eastern Europe. It is proposed to advise on the legislative, organisational and training aspects of access to health services and medical care.

Within the intergovernmental work programme, the European Health Committee has started a study on the organisation of health services for the elderly in institutions.

2. Concerning social cohesion :

With regard to cost containment and equitable access, the European Health Committee has always based its work on the principle of equal access to health services.

The latest study on balancing equity and efficiency deals specifically with the problem raised in paragraph 8 (iii).

Moreover this theme is the subject of a Conference of Ministers of Health to be held in Poland in the second half of 1996. The Conference will discuss "Social challenge to health : equity and patients' rights in the context of health reforms".

3. Concerning the development of local services for the old and the introduction or development of training for welfare workers :

In Recommendation No. R (94) 9 of the Committee of Ministers to member States concerning elderly people, guiding principles are set out to be taken into account when taking measures concerning elderly people. In particular one of these principles states that "The State, voluntary welfare organisations, the local community and the family should aim to promote the social integration of elderly people, in order to prevent their social exclusion in all its forms, whatever their ethnic or national origin, family status, language, religion, or social condition."

The Steering Committee on Social Policy is conducting a co-ordinated research programme on the initial and further training of social workers, taking into account their changing role. Reports on the situation in a number of Central and Eastern European countries will be incorporated in the final report of the programme.

4. Concerning more effective public social services so as to provide real support for the community and families :

In Recommendation No. R (94) 14 of the Committee of Ministers to member States on coherent and integrated family policies, basic principles are set out for family policies which "must support families in present-day society, giving them the protection and assistance which they need to discharge their functions in society." Specific reference is made to the fact that "in order for older family members to enjoy a dignified and secure old age, it is particularly necessary to respect their capacity to stay independent, to continue to take their own decisions and to remain a part of the community."

5. Finally, concerning demographic evolution :

The European Population Committee (CDPO) has been following the demographic evolution since 1973 and has not failed to draw the attention of the governments of member States to the increase in the ageing population.

This phenomenon leads to new problems arising from factors such as:

- an increase in number and proportion of very old persons (over 80 years) many of whom need constant medical care and assistance;

- the deterioration of the dependency ratio (active/inactive);

- inadequate structures and trained staff;

- the increasing financial burden for the community.

A group of specialists, appointed by the CDPO have just completed a study on the "ageing and its consequences on the socio-medical system" (published in July 1995 in the series "Demographic Studies"). The study envisages a number of measures to meet these problems which are likely to give rise increasingly to social and financial problems.