Memorandum by British Geriatrics Society
Specialist Medical Society for Health in Old Age
THE BRITISH
GERIATRICS SOCIETY
The British Geriatrics Society (BGS) is the
only professional association, in the United Kingdom, for doctors
practising geriatric medicine. The 2,200 members worldwide are
consultants in geriatric medicine, the psychiatry of old age,
public health medicine, general practitioners, allied health professionals,
and scientists engaged in the research of age-related disease.
The Society offers specialist medical expertise in the whole range
of health care needs of older people, from acute hospital care
to high quality long-term care in the community.
GERIATRIC MEDICINE
Geriatric Medicine (Geriatrics) is that branch
of general medicine concerned with the clinical, preventive, remedial
and social aspects of illness of older people. Their high morbidity
rates, different patterns of disease presentation, slower response
to treatment and requirements for social support, call for special
medical skills. The purpose is to restore an ill and disabled
person to a level of maximum ability and, wherever possible, return
the person to an independent life at home.
The Society is delighted to be given the opportunity
to contribute to this debate and would comment as follows:
1. How relevant is the mental health of the
population for the EU's strategic policy objectives, as detailed
in section 1?
1.1 Mental health is clearly relevant to
a number of EU strategic policy objectives, but the Green paper
fails to outline how these objectives differ from those of the
individual nations that comprise the EU. In short how EU-level
policy objectives add in any way to those already in place at
national level.
2. Would the development of a comprehensive
EU-strategy on mental health add value to the existing and envisaged
actions and does section 5 propose adequate priorities?
2.1 Section 4 acknowledges widespread mental
health inequalities within and between member states, illustrating
this point with regard to national suicide rates. The Green paper
states that there are no uniform solutions and restricts its aim
to "exchange and cooperation between Member States and the
opportunity to learn from each other". Section 5 lays out
the reasons for an EU-wide strategy:
(a) Creating a framework for exchange and
cooperation between Member States.
(b) Helping to increase the coherence of
actions in different policy sectors.
(c) To open up a platform for involving stakeholders
including patient and civil society organisations into building
solutions.
2.2 Aim (a) appears sensible since the EU
possesses appropriate resources and experience in setting up frameworks
to enhance exchange and cooperation between member states.
2.3 Aim (b) is appropriate insofar as it
relates to EU institutions, in particular ensuring coherence of
policies proposed by the EU Commission in different spheres (eg
trade, environment, education etc).
2.4 Aim (c) is less clearly defined. Many
platforms already exist within individual nations to take forward
solutions locally. It is unclear how an EU-wide platform would
add to this, especially since it is unclear how representation
at such a platform could be equitably organised. Otherwise, those
organisations with the greatest resources within the EU may end
up over-represented compared with less well-resourced organisations,
perhaps from newer EU members. The EU needs to address this issue
before such a platform could be supported as adding value.
3. Are the initiatives proposed in sections
6 and 7 appropriate to support the coordination between Member
States, to promote the integration of mental health into the health
and non-health policies and stakeholder action, and to better
liaise research and policy on mental health aspects?
3.1 Numerous initiatives are proposed in
Sections 6 and 7. Many overlap with current EU member state priorities.
It is unclear how far practices in one state are relevant to very
different cultural traditions and economic circumstances in other
states. A guide here would be to use available resources to focus
on those initiatives where the EU can clearly add value rather
than merely replicate nationally established programmes. There
is a role for the EU to provide guidance based on the EC Treaty
and European Human Rights legislation as interpreted by the European
Court of Human Rights. There are initiatives, such as those relating
to the mental health of migrant workers, which may be addressed
better at an EU than at a national level. Similarly the EU has
a clear role in promoting collaborative research between member
states into mental health.
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