01.02.2010 Prevention is better than cure!
Forum Vlasta Mercier. Switzerland is one of the few industrial countries with no legal framework in place to strengthen and coordinate prevention measures at national level. Given the aging population, medical and technological developments and the increase in chronic diseases (cardiovascular diseases, diabetes, cancer, mental illnesses), the care sector is likely to see a very significant increase in costs in the near future. However, only part of this cost increase is unavoidable: with improvements to prevention policy and health promotion frameworks, the rise could be cut to a considerable degree. Moreover, a growing number of studies are showing that prevention measures are effective and represent a good investment.
The Prevention Law will establish the conditions needed to strengthen health promotion, prevention and early detection at every level: federal, cantonal and private, both within and outside the healthcare sector. The national targets defined on the basis of the main problems affecting the public health service and the strategy of the Federal Council will serve as control and coordination instruments. This will make the prevention and health promotion frameworks more effective and prevent duplication of effort to ensure that the wheel does not have to keep being reinvented. In this sense, the definition of national targets represents genuine added value. The cantons will remain responsible for the implementation of preventive measures; in return, however, the federal government will now offer them better technological and methodological support. This support, provided through a national framework, is essential for best practice recommendations, effective measures or cost-benefit analyses of interventions. This framework also needs to incorporate the national programmes by which these targets are to be achieved. Centralising these functions is more practical than distributing them across a number of different bodies, as is currently the case. The status quo would not serve to improve coordination at national level.
Regrettably, the function of cantonal prevention bodies is not prescribed by law, although all cantons already have such a body. Indeed, cantonal representatives would contribute useful and expert knowledge to the development of targets by the Federal Council and cantons, supporting policy decisions and establishing a link to the grass roots. Moreover, the appointment of one official representative per canton would strengthen the role of prevention in our healthcare system. Switzerland’s healthcare sector shows a clear lack of data and statistical monitoring. Even if the draft law recognises the significance of harmonising data collection and the disease register, it only contains minimal provisions in this area. It is a shame that this opportunity is not being used to create the foundations for a uniform system of data collection for the whole of Switzerland.
Despite a few flaws, leaving room for improvement, parliament will adopt a progressive law which incorporates all the values promoted by the Ottawa Charter.
Through this law, prevention and health promotion activities will be given equal status with care, treatment and rehabilitation – as a fourth pillar of our healthcare system.
President, Association of cantonal health promotion officers in Switzerland