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Council meeting - Eger, Hungary, April 2001 Report of the Meeting

Council Reports Contents

Wednesday 4 April 2001

Session 1: Joining the new and the old

The President of EURACT Professor Jan Heyrman welcomed the Council Members of the Spring 2001 meeting. This was the first meeting after the election of the new Council and seven new members came to the meeting. New members from Albania (dr. Llukan Rrumbullaku), Bosnia-Herzegovina (Prof. Muharem Zildzic), Ireland (dr. Fergus D. O' Kelly), Italy (dr. Francesco Carelli), Rumania (dr. Iuliana Popa) and Sweden (dr. Bengt Mattsson) introduced themselves to the Council, describing their background, current work and personal fields of interest. Dr. Ivana Bogrova who was elected the new representative from Czech Republic could not attend the meeting due to the illness of her mother.

Afterwards the existing members of the Council briefly introduced themselves to the new members. The country news on paper were distributed and read by the council members. Silent reading was followed by questions and a plenary discussion of selected issues.

Thursday 5 April 2001

Session 2: Business meeting

At the beginning the report from the previous meeting in Kusadasi was discussed. No major comments were made. The report was approved.

The list of new applicants to the Academy was presented to the Council (8 from Bosnia, 1 from Croatia, 1 from France, 5 from Italy, 2 from Lithuania, 3 from Norway, 1 from Finland, 1 from Portugal, 8 from Russia, 10 from Turkey). All of them were approved. The names of the members approved in particular countries is available in Annex 7.

The problem of raising the membership in several countries was presented. The contents of the benefit package for members was discussed. The issue was shifted to a “five minutes – one slide” presentation.

Due to the delayed payments from Russian and Norwegian members the election process in these countries is still in progress. It is expected that representatives from those countries will join the Council during the next meeting in Barcelona.

Due to the new term of the Council a new President and two officers had to be elected. The terms of the Honorary Secretary and Honorary Treasurer are still going on. There was only one candidate for the presidency – dr Justin Allen from UK. The candidate was approved by acclamation. The following candidates were proposed as Executive Board Members: Prof. Jan Heyrman, Prof. Paula Vainiomäki, Prof. Igor Švab, dr Egle Žebiene and dr Okay Basak. Dr Basak and dr Žebiene did not accepttheir nomination. The candidates who did accept, briefly introduced themselves. The issue of the continuity was raised. A group of female members raised the issue of women's representation in EB. There was also a proposal to assure automatic EB membership for retiring president. All these issues need to be first introduced to the bylaw of the Academy. Voting was done in two rounds separately for both posts. Prof. Jan Heyrman and Prof. Igor Švab were elected new EB members. Prof. Vainiomäki was invited to advise EB and attend its meetings. The new Executive Board will have to address the issues of the composition of the Executive.

Dr Justin Allen and Prof. Igor Švab were proposed as candidates for the board of European Society. Both candidates were approved by acclamation.

The provisional budget for 2001 was submitted by the Honorary Treasurer (see Annex 2). The Treasurer explained some specific issues. First of all he stressed the need for projects to be done on behalf of EURACT. It was explained that some funds are secured to support the local organizers of the Council meeting if they need it. There was also a proposal to change the rules for reimbursement of travel expenses as follows: countries with a 5 EURO membership fee would get 90% reimbursement, and countries with a 20 EURO fee would get 45%. Council members from countries with a 40 EURO fee would not be entitled to get any reimbursement for travel expenses. The organisation still has surplus of 966 795 BEF which can increase by 600 000 BEF of WONCA subsidy which was not paid in time this year. It was stressed that membership fee should be paid to the Treasurer by bank transfer or in cash during the Spring meeting. The financial report and the new proposals were approved. The Honorary Treasurer's report is available in Annex 6.

The concept of working with a business plan was introduced by dr Allen. In fact he refreshed the idea developed in 1996. Standing and Supporting Committees should review their activities and develop plans. If EURACT funding is going to be requested, the EURACT application form for project funding should be filled in.

On behalf of Executive Board, professor Heyrman introduced the proposals for new co-option. He explained the difference between the observer who attends the meetings on his/her own costs and has no right to vote and the co-opted member who enjoys full Council member rights and duties. Co-option should be done to the specific reasons, experience, task or expertise gained due to this. It was stressed that co-option should be reviewed annually. The new rules are available in Annex 3.

New rules for representation in the Council were presented. The essential change proposed was that a country would be entitled to have a representative in the Council only when it has at least 10 paying members. The proposal was criticized from different perspectives. It was stressed that different conditions exist in different countries (stage of development, status of general practice etc.) which prevent national representatives from increasing the membership. There were more voices “against” than “pro” these changes to the rules. The proposal was rejected. The issue needs further consideration, in the light of other discussions on meetings and a final decision was postponed.

Meeting with the Hungarian family doctors Dr János Szabó introduced his Hungarian colleagues who work as teachers, researchers or course organizers at different universities in Hungary. Council members briefly introduced themselves. The Hungarian speakers shortly described the history and current development of general practice in their country. Professor Csaba Arnold, former Hungarian representative to EURACT, described the evolution of teaching of GP in the years 1970–2001 showing great progress in quantity and quality. Professor Arnold stressed his experience gained as a New Leeuvenhorst Group member helped him to contribute to the development of modern teaching of family medicine in Hungary. There followed speakers presenting from the other departments of family medicine in Hungary. These presentations were followed by questions and a general discussion.

Session 3: Active learning in Tampere

Dr. Allen introduced the concept which should be used for the workshop in Tampere. He summarised the existing models for adults learning. He presented the learning model consisting of four steps: experience, reflection, conceptualisation, experiment. These four phases come in circular process. Reflection is going to be the crucial part of the process. It is proposed to engage participants as much as possible and let them reflect on their involvement. From the methodological point of view there should be the rule ”Learning by doing”.

The rest of the session took place in small groups, according to the topics of the workshops for Tampere. Reports were to be presented during the last session on Saturday.

Session 4: One slide – five minutes presentations

• Professor Jan Heyrman introduced the issue of the current state of the art of Vocational Training in Europe. We do not have current overview. A short questionnaire was distributed to collect this information.
• Dr. Justin Allen introduced the EU directive 93/16 which requires to take the advice of Advisory Committee on Medical Training. This advisory committee -has been abolished. Right now there is a body of Senior Public Health Officers who can take any position in this field, but are often government officials, not doctors.. The fact remains that the Directive is mainly interested in free movement of physicians, not in quality.
• Dr. Dolores Forés reported problems with implementation of EURACT work in Spain and perhaps also other big European countries. As one of important barriers she mentioned language which is not widely spoken in her country. Then she asked about benefit package to potential members. She believes that EURACT documents are too theoretical and do not take into consideration specific situation in different countries. This issue is going to be discussed in a small group.
  

Friday 6 April 2001

Session 5: Preparations for the Barcelona conference

The aim of this conference is the review of the definition and core competencies of General/Family Practice in Europe. Two documents should be developed which could serve in future as a common basis for setting up the educational, research and quality assurance agenda. The documents should be adopted by the European Society (WONCA Europe) and UEMO and then by the network organizations. The conference will be hosted by SemFYC and WHO Europe. EURACT as an initiator of the conference is responsible for preparative documents which need to be discussed during the conference. These documents will be distributed to all the participants before the conference. The proposals developed by Dr. Justin Allen (definition) and Professor Harry Crebolder (core competencies) were further discussed in small groups.

Session 6: Standing Committees

Three standing committees worked separately. These were as follows:

• Basic Medical Education lead by dr. Yonah Yaphe
• Vocational Training lead by dr. Margus Lember
• Continuous Medical Education lead by Prof. Paula Vainiomäki
  

Session 7: Supporting Committees

Three Supporting Committees worked separately. These were as follows:

• Member Service Committee led by dr. Egle Žebiene
• Communication Committee led by dr. Justin Allen
• Academisation Task Force led by dr. Adam Windak
  

Short reports were presented during Session 9. For full reports see Annex 5.

Saturday 7 April 2001

Session 8: Barcelona conference-continued

Dr. Justin Allen summarized the discussion on the definition which was done in small groups. He stressed that still certain disagreements exist in terms to be used. The group discussed the draft paper developed by dr. Allen. The group did not answer several questions which still are to be answered by the group. Dr Allen asked the members of the Council to read the document and to comment on it. It is going to be send around to the network organizations in Europe and will be discussed further in Tampere.

Professor Crebolder summarized the discussion on the Core Competencies. He briefly described the changes or corrections proposed by the participants of the small group discussions. It was agreed that all members would read the text carefully and give it back to him. After correction it will be given to Prof. Heyrman and dr. Švab for further elaboration. Consequently it will be discussed with the network organizations and during the WONCA Europe Conference in Tampere.

The teaching agenda is the third topic which will be developed by EURACT for the Barcelona Conference. Dr. Ivar Østergaard is responsible for this part of the work. It was proposed to discuss it further in three small groups which will report to the Council and will produce a written report which will help Dr. Østergaard to prepare the discussion document. The groups will concentrate on the following issues:

• 10 recommendations for education
• New VT scheme
• Consequences of Core competencies
  

Dr. Švab reported on the BME committee (instead of Dr. Yaphe who had already left Hungary). The committee reviewed a paper to be sent to EJGP and discussed ideas for the EURACT workshops around Europe to review expertise and experience available. The full report is available in Annex 4.

Dr. Margus Lember reported on the Vocational Training committee. They discussed the paper on selection of training practices. The retraining of specialists was the second issue discussed by the group. It is going to be the next topic for the group. The full report is available in Annex 4.

Prof. Paula Vainiomäki reported on the CME committee. The committee discussed the paper on CPD developed together with EQuiP. The issue of accreditation was discussed in more detail. The document will be discussed further with EQuiP just before the Tampere conference and then during the conference. The final version will be prepared for Barcelona conference. The full report is available in Annex 4.

Dr. Justin Allen reported on the Communication committee. The first issue was web-site. Dr. Yaphe will produce a form in which basic background information about every Council member (max. 50 words) and his/her photo will be added. It was also suggested that a link should be put to the Socrates programme, which is aimed at the exchange of experiences in Europe. The financial issues of the web-site was also discussed, And the costs were judged as reasonable. For the section in the European Journal Dr. Allen is going to frequently put some information from different countries. At present it was felt that it would be nice to include some information about the new countries in the Council (Albania, Bosnia & Herzegovina). Later Prof. Bengt Mattsson will write on Sweden and Dr. Okay Basak on Turkey. The group discussed also the collaboration with the EJGP. Prof. Vainiomäki is going to discover whether it will be possible to promote EURACT in a booth during the Tampere conference. The full report is available in Annex 5.

Dr. Egle Žebiene reported on the Member Service committee. The group has developed a programme for financial support for organizations in collaboration and for individuals, mainly support for research and exchange activities. It is also proposed to award grants for participation in the Riom and Blad courses. The idea was welcomed and the details are going to be decided by EB. The full report is available in Annex 5.

Dr. Adam Windak reported on the Academisation Task Force. The state of the artin the review of academic structures in Europe was presented and discussed. It was decided to continue to the overview, which should be finished hopefully by autumn 2001. The idea to collect successful stories from different countries, illustrating development of academic general practice was also presented. All Council members are invited to pass such stories to Dr. Maldenka Vrcic – Keglovic. The full report is available in Annex 5.

Five Council members will attend the World WONCA Conference in Durban. There is no special programme for EURACT.

The Tampere WONCA Europe Conference is going to be a successful one. There are already over 1500 participants registered. Prof. Vainiomäki is going to inform the secretariat about the place and time for General Meeting. There will be also Executive Board meeting and several workshops held by EURACT Council members.

The Barcelona conference will be in combination with the Council meeting. For the meeting we will have only Wednesday and Thursday. Friday and Saturday are reserved for the Core Content conference. The Council will start on Wednesday at 3.00 p.m. There is no formal session planed for Saturday afternoon.

The Spring 2002 meeting will take place in Maastricht on April 10-14, 2002, On Friday April 13 there will be a workshop on Higher Professional Education with three topics (what is it, why is it needed, how is it done). The Dutch College will be involved in this workshop.

The WONCA Europe conference in 2002 will take place in London on June 9-13. It will be connected with 50^th anniversary of Royal College of General Practitioners in UK. Following European WONCA conferences will take place in Ljubljana (June 18-21, 2003) and in Amsterdam (June 1-4, 2004).

The Council meeting in spring 2003 probably will take place in Lithuania – Vilnius.

There is a problem with the host for the autumn 2002 meeting. It was decided that the meeting should take place even if we would need to finance it in part out of EURACT sources. This is going to be discussed further by EB.

At the end of the meeting dr. Justin Allen, as a new elected President, thanked Prof. Jan Heyrman – retiring President – for all his efforts during 12 years of his leadership of the Academy. He summarized shortly the achievements of Prof. Heyrman as President. He also reflected on personal attributes of Prof. Heyrman as a friend and as a colleague.

The meeting was concluded by the new President who asked two departing Council members to take the floor. First dr. Mårten Kvist summarized his experiences as a Council member. As one of the members who contributed to the creation of the Academy he expressed his pride in the achievements and recognition received by EURACT. He declared his willingness to contribute further to the work of the organisation if the need arose. He also stressed the exceptional friendship which exists in the Council and which he experienced during all these years.

Dr. Dag Søvik who was a EURACT and New Leeuwenhorst Group member since 1982 thanked all the members for the years he worked with them in the Council. He reflected especially on the warm and friendly atmosphere.

Dr. Allen thanked dr. Janos Szabó for marvellous arrangements for the meeting and hospitality which we experienced during it.

Post-Conference EB meeting

The meeting was enlarged by Prof. Paula Vainiomäki, Dolores Forés and chairpersons of the Standing Committees.

Member Service Committee

The grants will be as follows:
- Bled: 300 EURO accommodation + 150 EURO fee x 5 persons
- Riom: 150 EURO x 5 persons

Deadlines for applications are May 30, 2001 for Bled and August 31, 2001 for Riom. The answers will be in 14 days. Information will be placed on the web-site, applications will need the counter-signature of the national representative.

Barcelona conference

The final paper is going to be developed by EB. There was a proposal that Graham Bucklay and his team should contribute to the conference.. It was decided that only one would be invited. On Wednesday evening there will be a dinner and sightseeing tour only for EURACT people. On Friday there will be a late dinner with all the conference participants. On Saturday dinner in Barcelona will be for EURACT only. The costs of one night and dinner in Barcelona for the Council members will be covered by EURACT. Prof. Heyrman is the contact person for this meeting.

General Meeting in Tampere

The Council Member Handbook is going to be proposed by Justin Allen and Adam Windak before the Barcelona conference.

Pre-conference EB meeting in Barcelona will take place on Wednesday morning. EB members are expected to arrive on Tuesday evening.

The EB meeting in Tampere should take place on Wednesday afternoon before the Conference dinner.

Travel reimbursement

Summary of EURACT Council decisions – Eger 2001

• The report from Kusadasi Council meeting was approved.
  
• 40 new EURACT members from 10 different countries have been approved.
  
• Dr. Justin Allen has been elected the new President of EURACT.
  
• Prof. Jan Heyrman and Prof. Igor Švab were elected new EB members. Prof. Vainiomäki was invited to advise EB and attend its meetings.
  
• Dr Justin Allen and Prof. Igor Švab were approved as candidates for the Executive of the European Society.
  
• The new rules for reimbursement of travel expenses are as follows: council members from the countries with 5 EURO membership fee can get 90% of reimbursement, members from countries with 20 EURO fee can get 45% of the travel reimbursement. No travel reimbursement for members with 40 EURO membership fee will be made.
  
• EURACT funding for projects can be awarded by the EB. An application on the EURACT application form for project funding must be submitted.
  
• There are new rules for co-option to the Council.
  
• Draft documents for the Barcelona Conference (definition and core competencies) should be critically reviewed by all the Council members and comments should be passed to Dr. Allen and Prof. Crebolder.
  
• Dr. Østergaard is responsible for the development of the discussion document on the teaching agenda for the Barcelona Conference.
  
• The next EB meeting is going to take place during the Tampere WONCA Europe Conference.
  
• The Spring 2002 meeting will take place in Maastricht on April 10-14, 2002.
  
• There are 10 grants for attendance at the Riom and Bled courses available.
  
• EURACT will contribute financially to the organisation of the Bacelona meeting.