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Minister

Flemish Ministry of Welfare, Public Health and Family (WVG). Minister. Strategic Advisory Council. Policy Council. Management committee. Child and Family. Flemish Agency of Disabled Persons. PC Geel. PC Rekem. Flemish Agency forCare and Health. Youth Welfare. Care

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Minister

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  1. Flemish Ministry of Welfare, Public Health and Family (WVG) Minister Strategic Advisory Council Policy Council Management committee Child and Family Flemish Agency of Disabled Persons PC Geel PC Rekem Flemish Agency forCare and Health Youth Welfare Care Inspectorate Departement WVG Fund for Youth Welfare Flemish Care Fund

  2. Health and health care policy in Flanders (Machteld Wauters - VAZG) • VIPA: funding health care infrastructure (Christophe Cousaert - VIPA) 3. Innovation initiatives: Primary Care Safe and Flanders’ Care (Machteld Wauters)

  3. Health and health care policy in Flanders Machteld Wauters Flemish Agency for Care and Health

  4. Health in Flanders • Belgium: regions and communities • Competences in health • Flemish policy in health • Public health • Health care

  5. Belgium

  6. Political situation • (De)federalisation process: since 1980 responsibilities for health care are increasingly delegated to regional level (‘devolution’) • Complex: 6 authorities responsible for health matters in Brussels! • Interministerial conferences to ensure consistency and complementarity of policies

  7. Competences healthcare Belgium/Flanders

  8. Health care budget

  9. Flanders • Competences in health and health care • Policy in public health • Policy in health care

  10. Objectives of the Flemishhealthpolicy Flemish competences in health • Promote the choiceforhealthylifestyles • Prevent diseases, their risk factors and complications • Stimulate and monitor the performance of health care services • Tune the supply of health care to the needs of the population • Provide accessible and affordable care • Strengthenactiveparticipation and correct treatment of users of care • Health promotion • Prevention of noncommunicable and communicablediseases • Implementation of hospitalstandards, qualityassurancepolicy in health services • Subsidizinghealth care infrastructure • Ambulatory mental health care • Coordination of home care Flemishagency

  11. Flemish Agency for Care and Health • The mission of the Agency is to create the conditions to promote, protect and restore the welfare and health of the current and future population of Flanders, aiming for an optimal level of welfare and health of all citizens.

  12. Decree on preventive health care 2003 working with health targets Flemish preventive policy METHODOLOGY

  13. Decree on preventive health care 2003 Epidemiological basis for policy Health conference  large societal basis Health targets (SMART) Prevention strategies Approved by Parliament Executed by government  political commitment

  14. Decree on preventive health care 2003 Epidemiological basis for policy Health targets Prevention strategies Implementation of policy Health in all policies • Partner organisations • Organisations in the field • Logo’s • Individual providers

  15. Main causes of death per age group

  16. Evolution of deaths preventable by primary prevention (1999 – 2008)

  17. Flemish health targets Diet and physical activity Tobacco, alcohol and drugs Breast cancer screening Suicide prevention Injury prevention Prevention of infectious diseases by vaccination

  18. Health care • Belgian Health care system • Flemish competences and policy

  19. Belgian health care system • Compulsory public health insurance system • Independent medical practice • Free choice of health care provider by the patient • Fee-for-service payment of providers, with reimbursement

  20. Flemish competences in health care • Implementation of hospital standards, quality assurance policy in hospitals and nursing homes • Subsidizing health care infrastructure

  21. EXPLOITATION Basic legislation Execute (recognitions) Inspection of recognitions - BFM (budget financial resources) - RIZIV € INFRASTRUCTURE Basic legislation Strict legislation VIPA Funding 40% (BFM) Subsidy/guarantee 60% € € Division of competences in Belgian health care policy : hospitals FEDERAL LEVEL FLEMISH LEVEL €

  22. Flemish competences in health care Implementation of hospital standards, quality assurance policy in hospitals and nursing homes Subsidizing health care infrastructure Coordination of primary care and home care Ambulatory mental health care

  23. Flemish policy in health care Priorities: • Stimulate and monitor the performance of health care services • Tune the supply of health care to the needs of the population • Provide accessible and affordable care • Strengthen active participation and correct treatment of users of care

  24. VIPA - Flemish Infrastructure FundChristophe Cousaert Flanders, Belgium

  25. VIPA: Flemish Infrastructure Fund • Funding hospital infrastructure • Facts and figures • Policy health infrastructure

  26. 1. VIPA: Flemish Infrastructure Fund

  27. Policy area Welfare, Healthcare and Family (WVG) Minister Strategic Advisory Council Policy Council Management committee Child and Family Flemish Agency of Disabled Persons PC Geel PC Rekem Care and Health Youth Welfare Care Inspectorate Departement WVG Fund for Youth Welfare Flemish Care Fund

  28. Mission “VIPA’s mission is to develop initiatives and provide funding for a high-quality, accessible and affordable infrastructure for the provision of care and services within the framework of matters relating to the individual.”

  29. 1. The funding, in any way, of infrastructure of welfare and care 2. The coördination, steering and direction of public-public and public-private partnership (PPS) 3. 4. The promotion of knowledge and expertise in terms of concept, finances and technical engineering The building up and management of financial reserves Key assignments

  30. Scope of application 1. Hospitals, psychiatric care homes, psychiatric hospitals Elderly homes, day care centers, short stay centers, local service centers 2. 3. Facilities for disabled persons 4. Facilities for youth welfare 5. Preventive and ambulatory healthcare 6. Creches General welfare centers 7.

  31. 2. Funding hospital infrastructure

  32. Funding hospital infrastructure 40% 60%

  33. Basic rules 60% accepted costs < max. cost price 1.100 €/m² (priority renovations = 10% Flanders) Max. m²/resident (f.e.: 110 m²/res. general + 25% university; 90 m²/res. psychiatric) New building, renovation, purchase + renovation Moveable investments = 60% accepted costs Budget Financial Resources – 40% write-off amounts

  34. Alternative funding hospital infrastructure Agreement in principle Flemish minster 20 years utilisation grants linked to utilisation norms (f.e.: occupancy rates, …)

  35. I. Approved strategic care plan (ticket to start) II. Approved technical-financial plan (businessplan + plans of architect) II.1. Agreement in principle (no commitment) (= spreading funding over economic life of infrastructure (20 years)) II.2. Funding (utilisation grants) during 20 years linked to functional application to be justified (by reviewing utlisation norms) Procedure alternative funding

  36. 3. Facts and figures

  37. Facts and figures 10,6 mio inhabitants 6 mio inhabitants 45.000 hospitalbeds 31.000 hospitalbeds 100 general hospitals 71 general hospitals

  38. Facts and figures - evolution - 20% Incl. 4 university hospitals – excl. 39 psychiatric hospitals

  39. Facts and figures - evolution One day hospital: 34% in 2000 to 47% in 2008 (+ 85% treatments) Incl. 4.600 university beds – excl. 10.000 psychiatric beds

  40. Facts and figures - evolution 800 mio € (80 mio €/year) 2010-2014: 1.800 mio € (360 mio €/year)!

  41. 4. Policy health infrastructure

  42. Quality of infrastructure Comfort Healing environment: accent on userscomfort Indoor climate: lower CO2-emissions Sustainable and energy-efficiënt construction: sustainability criteria Evolution to high-tech hospitals: best practices?

  43. Quality of infrastructure Art Design meets art – art meets design Flemish government subsidizes art works integrated in infrastructure projects

  44. Networking Future challenges = working together Evolution to centers of excellence in specific segments

  45. Innovation and Entrepreneurship in Care

  46. Care: large economic impact 16% activepopulation 2014 + 70.000 jobs 8% GDP Flanders (unchangedpolicy) source: Planbureau

  47. Investing in qualitative and accessible care Maximizing societal added value Investing in innovative care Maximizing new perspectives in (health) care Investing in strong entrepreneurship in view of Market innovation in Flanders Maximizing economic added value International valorization Flanders’ Care

  48. Care & Innovation & Economy Ingrid Lieten, Vice Minister-presidentinnovation Kris Peeters, Flemish Minister-presidenteconomy Jo Vandeurzen,Flemish Ministercare

  49. Flanders’ Care mission statement To measurably improve the quality of care through innovation and responsible entrepreneurship

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