Dr Cabrnoch said health records should be more easily transferred between member states – provided patient data is properly protected – as this will make it easier for patients to receive healthcare while travelling.
It would also help doctors to know which vaccines their patient has had, allowing patients to slot into national immunisation programmes when they move from one European country to another.
Dr Cabrnoch believes doctors need more accessible information on national vaccination schedules if they are to improve immunisation rates across the EU.
He also lent his weight to proposals for a for children which European officials hope could ensure children are vaccinated even if they move between health systems.
“I fully support the introduction of a vaccination passport for children. For years we in the Czech Republic have been using a kind of vaccination passport which has shown extraordinary results,” he told Vaccines Today.
He said an interoperable electronic vaccination record should be rolled out in all EU member states as an aid to doctors, parents and children.
“The information should be saved in a format which is interoperable so that it would be understandable for all information systems in all medical centres in all member states. It should be part of the electronic health record of each citizen,” he said.
Dr Cabrnoch said governments need to work together on health issues to learn from one another, but he ruled out closer “harmonisation” of health systems or immunisation schedules. He added that the Czech Republic has a strong record of high vaccination rates thanks to cooperation between public health authorities, doctors and the insurance industry.
According to Dr Cabrnoch, more data sharing between European member states could help improve standards across the EU but he stressed that health policy remains an area where national governments will always retain control.
This is a transcript of an interview with Czech MEP, Dr Milan Cabrnoch
Vaccines Today: You’re a doctor and a politician: what do you see as the biggest public health threat facing Europeans?
Dr Milan Cabrnoch: Health and freedom are one of the most important values in everybody’s life. Public health is a value for the whole society as well.
It is not easy to decide what exactly the biggest public health threat is for Europeans. Personally, I can see big challenges arising from population ageing; in growing incidence of chronic diseases and a large need for nursing care. Our country and the whole society has to deal with the question of growing costs and with the problem of balancing what medicines can offer to patients and what can be paid from the public funds.
It is pleasure for me to say that nowadays infectious diseases are no longer in first place in terms of causing public health threats. This happened above all thanks to the effective tools in prevention and therapy.
Vaccines Today: Are you concerned by increase in measles rates in Europe?
Dr Milan Cabrnoch: We are not facing the problem with measles in our country because most of the population is vaccinated. I’m a paediatrician, I finished my studies in 1986 and I have never come across measles in my medical practice.
According to my information, the increase of measles occurred thanks to the false campaign which was led in some countries. The campaign promoted the idea that vaccination might cause other health problems so this led to a number of parents deciding not to vaccinate their children. Based on this example we can clearly see how the whole population can be threatened by insufficient vaccination.
Vaccines Today: What can be done to improve paediatric immunisation rates across Europe?
Dr Milan Cabrnoch: The rate of paediatric immunisation is a very important criterion not only for population protection against infectious diseases but also for quality of healthcare organisation.
In the Czech Republic, where I live, we are very proud of the paediatric immunisation rate because it is one of the highest in the world.
The key to our success lies in the organisation of child and youth care. General practitioners (GP) for children and youth, together with the GPs for adults, are a part of primary care. The paediatrician looks after children in primary care from birth to the age of nineteen. The parents are free to choose a particular doctor for their children. Afterwards the paediatrician can register the child – registration is not obligatory but the doctor’s remuneration fully depends on the registration.
Prevention has strong support in our legislation. Vaccination is obligatory and those parents who don’t bring their children to the doctor can be fined. Vaccination is also a requirement for accepting children at kindergarten. In the Czech Republic, the authorities established a list of diseases against which children must be vaccinated. The state recommends the combination of diseases against which to vaccinate and the intervals in which it should be done. The state also buys appropriate vaccines. But the final decision to vaccinate is left to the parents and on the doctor, although the majority of people respect the state’s recommendation.
Also health insurance strongly supports prevention and vaccination. All obligatory vaccinations are fully covered by the health insurance company or by the state. The insurance companies cover nine preventive medical examinations in the first year of life and then after each two years.
Vaccines Today: The theme of this year’s European Immunization Week was ‘Shared Solutions to Common Threats’. What can EU institutions do to coordinate the response to public health threats?
Dr Milan Cabrnoch: The exchange of information and experience is very important for protecting public health. From my point of view this functions very well and it doesn’t need any special changes. According to my information, the early warning system for some dangerous infectious disease works very effectively as well. Systematic monitoring of disease occurrence, which is a source of valuable information for organising healthcare in member states, is also considered to be very useful.
Vaccines Today: What can be done to reduce barriers between Member States in how health threats are tackled?
Dr Milan Cabrnoch: Detailed work with health information is enormously important for providing quality and safe healthcare in the modern European health service.
Patient care involves a large number of specialists. How the patient moves between member states also shows the changing role of the GP. That’s why it is very necessary to have all information accessible in the right place at the right time in an understandable way. In recent years the epSOS project has given us certain solutions and it has been continuing successfully until now.
A number of important principles have been negotiated in terms of outlining patients’ rights by providing healthcare abroad. One of the principles enshrined in this directive is the patient’s right for information about healthcare organisation – as well as about the immunisation calendar – in particular countries.
The next important patient right is to obtain information – including in electronic form – about the healthcare that has been provided to the patient abroad. Similarly it introduces basic rules for interoperability in the field of electronic prescribing of pharmaceuticals. The European Commission obtained the mandate to organise a working group which will specify data standards for interoperability of basic information about health.
Vaccines Today: Do you think neighbouring member states should cooperate to have harmonised immunisation schedules given the movement of citizens within Europe?
Dr Milan Cabrnoch: I can’t see any difference between neighbouring countries and those which are not neighbours. I don’t think that it is possible and necessary to harmonise immunisation schedules in all member states. Deciding about healthcare organisation is a sovereign decision for all member states. This decision is not only influenced by scientific knowledge but also by the economic situation in the country, the system of healthcare financing, the organisation of healthcare systems, and last but not least by the historical context and current practices.
In medical practice doctors lack information about immunisation schedules used in particular member states. It would be very useful to have some up-to-date overview about the vaccination calendar in individual member states. This overview should be accessible for all medical doctors in all member states. The doctor would then have relevant information about the patient and vaccination schedules in other members states, helping them decide how the patient should be vaccinated.
Vaccines Today: What is your opinion of introducing a showing which vaccines they have had?
Dr Milan Cabrnoch: I fully support the introduction of a vaccination “passport” for children. For years we in the Czech Republic have been using some kind of vaccination passport which has had extraordinary results. The vaccination passport is a source of information for doctors as well as for the patient or for parents.
The vaccination passport should be rolled out in all member states in electronic form. The information should be saved in a format which is interoperable so that it would be understandable for all information systems in all medical centres in all member states. It should be part of the electronic health record of each citizen.
The vaccination passport should be accessible also for the citizens, patients and in case of children also for their parents. The citizen (or parents of the child) could give doctors and others access to the information by their signature in the electronic vaccination passport.
The relevant authorities in the European Commission should elaborate a recommendation for work with information about vaccination in electronic format, similar to what has been done in the area of electronic prescription or for patient data.