Professor Mariam Klouche from Germany explained that, normally during the JIB programme, one country is chosen as the ‘pays d’honneur’, generally speaking a francophone country, as JIB is the largest French-speaking congress of its kind.
Speakers from the chosen country are then invited to present, during the scientific programme, techniques and tests and so on unique to their country in use there, or have been put in place. Germany, the 2014 ‘pays d’honneur’, is not only linguistically different but also its presentation format will aim for something completely new to JIB.
Brainchild of the sessions’ moderators, Professor Mariam Klouche, from the Laborzentrum Bremen, Germany and Dr François Blanchecotte, President of the Syndicat des Biologistes, France, the forum is highly ambitious in the area it intends to cover.
‘Whenever the government starts to compare our health service, they point to Germany,’ Dr Blanchecotte pointed out. ‘Germany and France represent two of the largest healthcare sectors in Europe,’ Professor Klouche added. ‘Each can, without doubt, learn from the actions and procedures of the other. However, our idea is to present the facts neutrally and not represent one as being superior to the other.’
‘The programme is constructed around three major pillars that are relevant to both healthcare structures but, due to historical and administrative variations, they are quite different between the two countries,’ said Dr F Blanchecotte. ‘We will be considering the way laboratory medicine is structured, e.g. 4,000 laboratories in France in 2011 – now 1,200 in 2014 – compared with less than 400 hospital and 150 private laboratories in Germany, and the concentration still going on; then, the training that medical biologists undergo (medical doctors and with restricted practice, and natural scientists in Germany vs. Pharmacy/Biology backgrounds in France), an finally the tests provided and reimbursement schemes in each country.’ Invited speakers from both countries will present for 20 minutes on how these aspects are treated in their respective country and then live debate with the audience will be encouraged to assess the pros and cons of each system.
‘François and I have planned to outline the main areas of difference for each set of presentations’ the professor explained, ‘so that the debate is informed and well structured.’
Originally, the idea was that the forum should be in English but, on reflection, it was decided this would perhaps exclude some very know-ledgeable and well placed speakers and also lose nuances in translation because ‘although some organisations have similar or overlapping functions, these are not strictly comparable and therefore the Haute Authorité de Santé in France cannot be easily translated to the German Richtlinien der Bundesärztekammer, which is the guideline-producing self-organising Federal Chamber of Medicine in Germany’ explained Professor M Klouche. Therefore, each speaker will present in their native languages with simultaneous translation provided.
It is impossible to discuss laboratory medicine without considering the political implications and governmental influence. ‘The law relating to laboratory medicine has changed recently in both countries’ said Professor M Klouche.
Both governments are expecting significant changes in laboratory medicine provision over the next five to 15 years. ‘France expects 50% of the budget to be focused on preventive testing by 2030, as opposed to the 70% spent on diagnostic tests today,’ Blanchecotte explained, ‘with a reduction in the volume of tests prescribed and especially in the type of tests, fewer PSA and vitamin D measurements for example.’
The changing landscape in France is identified by many new and on-going processes, such as the open data initiative that was rolled-out to run from July 2014 onwards (data.gouv.fr).
This will also have an effect on laboratory medicine, in addition to more direct legislation, which includes the necessity for laboratory accreditation by 2020 and medicalisation of laboratory reports.
German laws have been passed to restrict the number of specialists for laboratory medicine established in registered laboratories, e.g. new registered laboratories can open primarily in rural areas to create a more homogeneous nationwide cover, and also changes in reimbursement levels and social security payments that have begun to be put in practice.
In respect of the political implications of laboratory medicine on healthcare policies, the afternoon session will include presentations from ministries of health from both countries, hopefully from the Ministers themselves.