Impact'of'the'6th'state'reform'on' urological'prac4ce'in'' Flanders,'Brussels'and'Wallonia' Filip'Ameye,'MD,'PhD' ' Chairman'Professional'organisa4on'of'Urology'
The'future'role'of'the'' Belgian'Associa4on'of'Urology' aBer'the'6th'State'reform' Filip'Ameye' BAU'General'Assembly'' 12/2014'K'Spa'
VBS/GBS'
BVU'
BBVU'
SBU'
BAU'
WG'1'
WG'2'
Na4onal'Stakeholders'
WG''…''
Historical'poli4cal'evolu4on' • 1970: De eerste staatshervorming – Nieuw evenwicht nationale instellingen – Cultuurraden
• 1980: De tweede staatshervorming – Federale staat – Gewesten en gemeenschappen – Bevoegdheidsverdeling (persoonsgebonden – territoriaal)
• 1988-1989: De derde staatshervorming – Meer bevoegdheden, waaronder onderwijs – Brussels Hfdst Gewest
Historical'poli4cal'evolu4on' • 1993: De vierde staatshervorming (Sint-Michielsakkoord) – Formeel federale staat
• 2001-2003: De vijfde staatshervorming (Lambermont- en Lombardakkoorden) – – – –
Herfinanciering Bijkomende fiscale bevoegdheden Bijkomende bevoegdheden Brussel
• 2011: de zesde staatshervorming (Vlinderakkoord) – – – –
Bsl-Halle-Vilvoorde Financieringswet + fiscale autonomie Bevoegdheden : cfr Dr Demeere Sociale zekerheid
Evolu4on'aBer'the'Sixth'State'Reform' Ouderenzorg
Geestelijke gezondheidszorg
Personen met een handicap
Preventie
Ziekenhuis beleid
Organisatie eerste lijn
Evolu4ons'in'Belgian''healthcare'aBer'2011' • Federal'' – RIZIV/INAMI'(nomenclature)' – Hospitals':'programma4on'
• Regional' – Hospitals':'norms'and'standardisa4ons' • Focus'on'Quality'/'accredita4on'/'audits'/'…'
– Medical'professions':'Recogni4ons,…' – Preven4ve'/'primary'/''chronic'care' – …'
Quality'management'in'Belgian'Health'care' • Federal' – Health'care'Ministry'('De'Block)' – Breaking'news'today' • Differen4al'levels'of'Care'and'Care'Ins4tu4ons' • P4Q/P4P'
• Regional' – Flemisch'region'' – Wallons/'Brussels'region''
Flanders'Region'–'Flanders'Health'Care'Plan'
Flanders'Health'Care'Plan' • • • •
Quality'control'in'hospitals' Accredita4on'of'hospitals' External'audits'of'hospitals' Indicator'project'('VIP2'project)' – development'and'implementa4on'of'several'QI' – Public'repor4ng'of'this'quality'data'
'
VIP2'project' • Quality'indicators' – General'area’s' – Specific'area’s':' • 'breast'cancer,'orthopedics,'…'
– Future'area’s' • Urological'profession':'Prostate'Cancer'Indicators' • Impact'on'future'P4P'/P4Q''?'
Quality'management'in'Belgian'Health'care' • Federal':'De'Block' – Health'Care'Financing'':'P4Q/P4P'?' – Programma4on'?'
• Regional'‘'Health'care'plans’' – Flemisch'region''K'Wallons/'Brussels'region':' • Different'scopes,'strategies'and'4melines'
• Example':'Pca''QI'
PCa'Quality'Indicators' • KCE' – Prac4ce'Guidelines'on'locally'confined'Pca' • 2013':'Ac4ve'Surveillance' • 2014':'local'treatments'
• BVU' – VIP2':'Development'of'QI'in'progress'
• SBU' • Solu4on':'BAU'integrated'approach'
Quality'management'in'Belgian'Health'care' • Federal':'De'Block' – Health'Care'Financing'':'P4Q/P4P'?' – Programma4on'?'
• Regional'‘'Health'care'plans’' – Flemisch'region''K'Wallons/'Brussels'region':' • Different'scopes,'strategies'and'4melines'
• Prominent'Role'for'scien4fic'and'professional' organisa4ons' • VBS/'GBS'–'Adap4on'of'the'statutes'
General'Assembly'11'october'2014' • Adap4on'of'the'Statutes' – VBS'remains'Federal'organisa4on' – For'regional'maeers':'AVS'/'AMS'Fr'
' • ARTSEN'VERENIGING'van'VLAAMSE' SPECIALISTEN:'AVS' • ASSOCIATION'des'MEDECINS'SPECIALISTES' FRANCOPHONES:'AMSFr'
• STATUTS% I.%Dénomina/on%–%Composi/on%–%Siège%–%Objet% Ar/cle%1.'Le'«'Groupement'des'Unions'Professionnelles' Belges'de'Médecins'Spécialistes'»'(GBS)'–'en'néerlandais'«' Verbond(der(Belgische(Beroepsverenigingen(van(Artsen5 Specialisten(»'(VBS)––'est'une'fédéra4on'd’organisa4ons' professionnelles'cons4tuée'dans'le'cadre'de'la'loi'du'31'mars' 1898'sur'les'unions'professionnelles.'Pour'tout'ce'qui' concerne'les'ma4ères'fédéralisées,'les'membres'du' Groupement'sont'représentés'respec4vement'par'l’'«' Associa4on'des'Médecins'Spécialistes'Francophones' »'(AMSFr)'et'par'l’'«'Artsenvereniging(van(Vlaamse( Specialisten(»'(AVS).'
Ar4cle'18'
• Pour'tout'ce'qui'concerne'les'ma4ères' fédérées,'les'membres'francophones'du' comité'directeur'agissent'en'tant'qu’'«' Associa/on%des%Médecins%Spécialistes% Francophones%»;' • Pour'tout'ce'qui'concerne'les'ma4ères' fédérées,'les'membres'néerlandophones'du' comité'directeur'agissent'en'tant'qu’'«' Artsenvereniging*van*Vlaamse/Specialisten*»'
The'future'role'of'the'' Belgian'Associa4on'of'Urology' aBer'the'6th'State'reform' A'proposal'for'adap4on'of'' the'BAU'structure'
VBS/GBS'
BVU'
BBVU'
SBU'
BAU'
WG'1'
WG'2'
Na4onal'Stakeholders'
WG''…''
AVS' BVU'
VBS/GBS' V'
AMSFr'
BBVU' AVS'?'
SBU' AMSFr?'
BAU'
WG'1'
WG'2'
Na4onal'Stakeholders'
WG''…''
Regional%Stakeholders%
Future'role'of'the'BAU'aBer'the'Sixth'State'Reform' • Reflec4on'on'the'role'of'the'BAU'' – Scien4fic'level' – Professional'level'
• Reflec4on'on'the'structure'role'of'the'BAU'WG' – Co'–'chairs''' – Autonomy/'Delegated'authority'for'the'several'levels'
• Adap4ons'?' – BAU''Structure' – BAU'Statutes''
