Opening by H.U.Deppe - Barcelona Conference 1999

H-U Deppe


Welcome/ Opening intervention, the Barcelona Conference 1999

Dear Friends,

all conferences of the IAHP I opened - I started with some words about our group. We should remind the contents and conditions when we began to work together in 1982. And during the next days we should take in mind , what we have formulated in our STATUTES:

The IAHP in Europe is a scientific and cultural organisation. It is an international association of health workers, researchers and politicians with the aim of promoting scientific analysis of public health and providing a forum for international comparisons and debate on health policy. The overall objective is to promote health for all and reduce inequities.
A major theme is the interrelationship between theory and practice in health policy. The IAHP in Europe is coming from a social and political movement, which criticised without dogmatism the health policy in our market societies. We thought about alternatives for a humane and democratic health care system. We made contacts with international organisations and regional movements, who are struggeling for the same or similar aims.

Since some years IAHP in Europe became an organisation with formal structures. We started this process 1993 in Bishops´s Stortford close to London. Our basic idea for this process was: to become an organisation without loosing the positive aspects of our experience as an political movement.

It is an attempt. We are on the way. And I think in an positive sense. A special element of our conferences is that we are not blind to general social and political developments when we are presenting and discussing our special academic analysis. We try to reflect our scientific work in the context of the actual historical process.

Today I have to mention at this point the Kosovo War - a war in Europe. I am sure we will have the impact of this event in many of our discussions
and we should articulate our common opinion to this catastrophe during the conference. In times of war the priority of health workers is changing fundamentally: It is changing from health to life!

The title of our international conference is: Neoliberalism, Management and Patient-Health Worker Relationship. I would like to formulate some questions to this theme that you can see why we decided for it. First:

Neoliberalism - a worldwide phemomenon which is touching our health care since many years. We should ask, how Neoliberalism - especially market and competition - determines the different dimensions of health care? It is not an abstract question - we all have real experience with it.

Is it possible to stop or to modify Neoliberalism in Europe? In all European countries we have more or less welfare states. They were introduced by struggle. They are a part of our civilisation.

Meanwhile the populations of the most European countries voted for new governments which are dominated by socialdemocrats. Do this change of governments mean a change of politics?What means it for health reforms?

Second:

Management. At our Berlin-Conference in 1991 shortly after the German unification a Spanish friend and member of our organisation said: "If we will not manage like privates we will be managed by privates". (Vicente Ortun) What do we think about this sentence today - 8 years later?

Can medical institutions be managed like commercial enterprises? And -

Can a profit-centre develop social responsibility?

Third:

Patient-Health Worker Relationship. If health or sickness becomes the commercial character of a commodity, which is sold under conditions of competition - what means this for patients and health workers?

What means the recommendation of a health worker - even for a well informed patient: This is medically not necessary - or: The risk of the intervention is for you to high - or: This application is in your case uneffective. Do this mean it is not necessary from the view of medical experience and science - or: Do this mean only: It is to expensive? From whom and from where the patient shall know, why the health worker gives him this recommendation? Is it indeed the best form of therapy? Will possible alternatives be suppressed? Do the recommendation depend from and influence the income, the carrier, the working place of the health worker or the shareholder -value of a hospital? Or: Did the health worker got just the information that his/her budget is overdrawn?

You see there are many relevant questions - and I hope that we can include them in our conference and try to find some answers.

To our international conference the participants are coming from different countries with different experiences in Europe.

They are coming from: Austria, Belgium, Croatia, Denmark, France, Germany, Greece, Italy, The UK, Sweden - and last but not least from Spain.

We have guest from: Algeria, Argentine and - also last but not least from Cuba.

I am glad that you all find the way to this beautiful place in Barcelona.

To organise this conference was only possible by the reliable help and support of the
Centre d´ Análisis i Programes Sanitaris (CAPS)
represented by Oriol Ramis Juan.

The preparation of the political event on friday evening about the "Health Reform in Spain" was possible by the Federacion des Associaciones para la defensa de la Sanidad Publica.

For all participants I thank you very much.

In German: Herzlichen Dank für Eure Solidarität und Geduld.

In English: Cordial thanks for your solidarity and patients.

I wellcome you all!