Check against delivery.

 

Ladies and Gentlemen,

I am very pleased to be here today back to my homeland.

The numbers are also pleasing as we can see the average life expectancy increased everywhere across Europe. According to the most up-to-date data, the lifespan of Europeans has grown from the average of 74 years in 1990 to 80 years of age in 2015.

However, with the increasing life expectancy, median age of population is also growing dramatically.

Indeed, Europe is turning increasingly silver and it looks like this trend will continue in the decades to come. According to the Commission’s Ageing Report of 2015 life expectancy is expected to grow for men by 7 years to 84.8 years in 2060 and for women by 6 years to 89 years. It will definitely bring many challenges.

But let me start with a few contradictions I see.

 

First of all, for too long we have been linking ageing society to 'getting sick' society. But people live longer in better health as well – meaning our efficiency increases. And our further goal should be working towards longer lives in better health.

Plus, demographic growth is lower therefore I wouldn't see major conflict between younger and older generations in labour markets.

What we need to do in order to get ready for the challenges that ageing population will bring – apart from starting working on prevention and protection right away – is to develop sound knowledge base.

In fact, providing more and better data for evidence-based policy making is the very reason why the European Research Consortium "Health, Ageing and Retirement" was created.

In addition, the Commission has taken – under President Juncker – a number of further steps to support Member States to cope with demographic change.

These include:

  • developing more country-specific and cross-country knowledge about health systems;

  • working with Member States on the impact of healthy ageing on health systems; and

  • exploring the role that eHealth, mHealth and telemedicine can have as potential solutions to promote health and to address chronic disease challenges.

 

Let me take each of these points in turn.

First, President Juncker specifically asked me to "build up country-specific and cross-country knowledge which can inform policies at national and European level".

My services have been engaged with strengthening such knowledge, as well as with reinforcing the broader network of knowledge intermediary to support to Member States.

The Commission is now considering how best to strengthen country-specific and cross-country evidence, as a follow-up the 2014 Commission "Communication on effective, accessible and resilient health systems".

Country analysis could create a tool for mutual learning to facilitate dialogue and policy action, which needs to be:

  • transparent in the way that Member States could replicate the results presented;

  • consistent in the sense that all countries be examined on the basis of the same indicators.

  • And also consistent with the work of the Organisation for economic and social development (OECD) and the European Observatory on Health Systems and Policies; encompassing both quantitative and qualitative indicators.

Common methodologies and indicators are important to draw a precise picture of the situation and to develop healthy ageing policies that incorporate both prevention and care.

The Survey of Health, Ageing and Retirement in Europe will be instrumental towards promoting cooperation in this area and in helping to develop comparable data.

Country analysis could also incorporate other frameworks such as the European Innovation Partnership on Active and Healthy Ageing.   

This Partnership, which the Commission fosters, has brought together over 3,000 partners, 1,000 regions and municipalities, and 300 organisations to tackle together the challenges of an ageing society on a European scale.

One of the major lessons learnt from the Partnership is the benefit of mainstreaming innovative solutions for healthy ageing across all relevant policies at European and national level, as a way of promoting effective, long-lasting sustainable improvements.

 

This brings me to my second point – the impact that demographic change and population ageing will have on our public health and on health systems.

Usually discussion of this issue tends to focus on the challenges it brings and the negative consequences it will impose on health systems.

But before addressing these, let me stress again that this is the result of a major success of achieving longer life expectancy for people, which is certainly something to celebrate. And I don’t think that we should continue de facto associate ageing with illness.

Illnesses can start very early - because of risk factors, lack of prevention or promotion. If we implement and manage the latter activities properly, if we place sufficient focus and resources on preparing for the future, we can continue having life expectancy rising and people living longer in good health.

The challenge is to prepare for old age from early age, by promoting healthy lifestyles and by taking a long term approach to a healthy life.

If all our citizens would eat healthy, would exercise, would not smoke, nor abuse alcohol; they would avoid many health problems; and they would age in much better health.

This is why the time has come to focus much more on public health; to develop lifestyle medicine, the science of wellness; tackling all risk factors including smoking, alcohol, nutrition, exercise, stress. We also need to enshrine health concerns into housing, and working conditions.

Our aim must be to provide people with an environment that enables them to make healthy choices and live in good health into old age.

Of course, even the best promotion policies will not eliminate the pressure that ageing will put on our health systems. Part of our older citizens will have more complex needs for care, such as those arising from multi-morbidities. But again, multi-morbidity can arrive at early age as well.  

It is also true that often, older citizens require support from both the health and social care systems. Rising demand in care needs can lead to increased healthcare expenditure.

On top of this, we might be facing a shortage of healthcare workers. Even in the short-term, by 2020, there will be a shortage of up to 2 million health workers in the EU.  This presents serious challenges for the optimum organisation of health systems and for the delivery of quality healthcare.

Taking all these points together, it becomes clear that our current health systems are not prepared to deal with ageing. They cannot ensure the necessary quality of care to older citizens.  In addition, the sustainability of our health systems is at risk.

Naturally, we need to look for effective solutions to solve these fundamental problems.

Ageing provides an opportunity to strengthen promotion and prevention and to modernise health systems, to tailor them to the needs of the elderly; to help them preserve their autonomy.

We need to take an integrated lifecycle approach, based on the needs of older citizens and focused on keeping people in good health, functioning, independent and able to participate in society. This is what “Healthy Ageing” is all about.

Our health systems need to adopt a person-centric, proactive and integrated approach, linking and coordinating with social care.

Our health systems would need to consider:

  • New care models that place emphasis on empowering patients, on community care and on comprehensive prevention strategies.

  • Systematic use of improved risk screening tools in order to identify persons at the highest risk and with the highest need for care, focusing on early interventions for such persons.

  • Training the healthcare workforce in new skills, including the use of digital tools and putting in place multi-disciplinary care teams of GPs, nurses, specialists and social care workers to address people's complex needs.

  • Making use of ICT such as eHealth, mHealth and telemedicine to facilitate the delivery of care services.

Work in this direction is already well under way. For example, the European Innovation Partnership I mentioned earlier has been piloting and showcasing innovative care services.

Indeed, in several locations and regions in Europe, innovative solutions for chronic disease management, adherence to treatment, integrated care and fall prevention have been tried, have proved their worth and are now being deployed.

And significantly, we see examples of proven innovations being transferred and replicated into other settings. For instance:

  • the “National Telecare Development Programme” in Scotland has delivered benefits to citizens and efficiencies to care systems;

  • the “Holistic Health and Social Services at Home” programme in the region of Valencia has been transferred to another Spanish region; and

  • the “Community Assessment of Risk and Treatment Strategies Programme” in Ireland is being transferred to Northern Ireland, Portugal and Spain.

It may seem at the outset very difficult to embark on transformations of health systems.  But the message we can extract from these examples is that it can be done.

We can design and deploy new and more effective prevention and care services.

We can achieve Healthy Ageing and health systems that are fit for purpose, fulfilling their mission of delivering to citizens the quality of care they need and deserve.

 

My third and final point is that, in order to bring this vision to life, it will be necessary to fully integrate digital solutions in our social and healthcare systems.

e-Health, m-Health and telemedicine products can and must be a prominent part of the solution.

For instance, mobile apps – or mHealth apps – can assist the elderly to take their medication on time, increasing medication adherence and preventing escalation of their chronic illness. There are other examples.

Digital technology provides opportunities to empower patients to monitor their own health by giving them hands-on tools to make decisions on their health management and wellbeing.

And they can improve the sustainability and efficiency of health and social care systems, while creating new opportunities for businesses and economic growth in the broader silver economy.

 

Ladies and Gentlemen,

To conclude, I have touched on the importance of developing broad solutions to the complex challenges linked to the ageing of our population.

Let me finish by stressing the importance of the work, analysis and data resulting from the European Research Infrastructure Consortium in further strengthening the evidence-base of these activities.

The results of this initiative for the Survey of Health, Ageing and Retirement in Europe will no doubt contribute to our collective efforts to better design and manage the health systems of tomorrow – and towards our efforts not only to cope with but also to prosper within the context of an ageing society.

Thank you.