APPROVEDminutes of the Section meeting, 16 October 2009, Ljubljana, Slovenia
APPROVED MINUTES
1.Present
1.Prof Jose Ayuso-Mateos – Spain – Spanish Society of Psychiatry
2.Prof Jacek Bomba – Poland – Polish Psychiatric Association
3.Dr Andrew Brittlebank – United Kingdom – RoyalCollege of Psychiatrists
4.Dr Brendan Cassidy – Ireland – Irish Medical Organisation; Treasurer
5.Ms Joanna Carroll – UK – RoyalCollege Psychiatrists; Administrative Secretary
6.Prof Can Cimilli – Turkey – Psychiatric Association of Turkey
7.Dr Elisabete Fradique – Portugal - Portuguese Medical Association
8.Prof George Garyfallos – Greece – Hellenic Psychiatric Association
9.Dr Dan Georgescu – Switzerland – Swiss Society of Psychiatry and Psychotherapy
10.Prof Manuel Gómez-Beneyto – Spain – Spanish Association of Neuropsychiatry
11.Prof Edvard Hauff – Norway - Norwegian Medical Association
12.Dr Marc Hermans – Belgium - Belgian Association of Neurologists and Psychiatrists
13.Dr Slaðana Iveziæ – Croatia - Croatian Medical Association, Society for Clinical Psychiatry
14.Dr Torsten Jacobsen – Denmark – Danish Psychiatric Association
15.Prof Blanka Kores-Plesničar – Slovenia – Medical Chamber of Slovenia
16.Prof Jyrki Korkeila – Finland – Finnish Psychiatric Association
17.Dr Astrid Kubli Bauer – Switzerland – Swiss Society of Psychiatry and Psychotherapy
18.Dr Andreas Landsnes – Norway - Norwegian Psychiatric Association
19.Prof Nils Lindefors – Sweden – Swedish Psychiatric Association
20.Dr Amit Malik – UK – EFPT[1], Past President
21.Dr Françoise Matthys – Belgium – Belgian Association of Neurologists and Psychiatrists
22.Dr Brigitte Mauthner – Austria – Austrian Medical Chamber, Section Vice-President
23.Dr Lucie Motlova – Czech Republic – Czech Psychiatric Association
24.Prof Michael Musalek – Austria – Austrian Society for Psychiatry and Psychotherapy
25.Dr Kajsa Norström – Sweden – Swedish Medical Association
26.Dr Jørgen Nystrup – Denmark – Danish Psychiatric Association
27.Dr Izu Nwachukwu – Ireland – EFPT (invited guest)
28.Dr Eva Pálová – Slovakia – Slovak Psychiatric Association; Section Vice-President
29.Dr Martina Rojnic Kuzman – Croatia – EFPT, President
30.Dr Joseph Saliba – Malta - Medical Association of Malta / Maltese Association of Specialists in Psychiatry; Honorary Secretary
31.Prof Henning Sass – Germany – EPA[2]
32.Dr James Strachan – UK – RoyalCollege of Psychiatrists; Board President
33.Prof László Tringer – Hungary - Hungarian Psychiatric Association
34.Dr Halis Ulas – Turkey - Psychiatric Association of Turkey
35.Dr Roland Urban – Germany – Professional Association of German Psychiatrists
36.Dr Andreas Zachariadis – Greece - Hellenic Psychiatric Association
37.Prof Slavko Ziherl – Slovenia - Psychiatric Association of Slovenia, Medical Chamber of Slovenia; Board Vice-President
2.Apologies
1.Dr Roelof ten Doesschate – Netherlands – Dutch Psychiatric Association
2.Dr Tsvi Fischel – Israel – Israeli Psychiatric Association
3.Dr Christa Schaff – Germany – UEMS Section of Child and Adolescent Psychiatry
4.Prof Paul Hodiamont – Netherlands – Dutch Psychiatric Association; Board Vice-President
5.Prof Fritz Hohagen – Germany - German Society of Psychiatry, Psychotherapy & Neurology
6.Dr Luboš Janu – Czech Republic - Czech Psychiatric Association
7.Dr Lucien Manuceau – France – French Association of Psychiatrists
8.Dr Kari Pylkkänen – Finland – Finnish Psychiatric Association; Section President
The meeting was chaired by Dr Brigitte Mauthner, Vice-President of the Section in the President’s absence due to continued ill health.
Dr Mauthner welcomed the delegates to Ljubljana and thanked the Slovenian Psychiatric Association for hosting the meeting. Special welcome was extended to Dr Kajsa Norström who succeeded Prof Jacobsson as the new delegate of the Swedish Medical Association,Dr Marc Hermans, a new delegate from Belgium, Prof Michael Musalek replacing Prof Lenz as a delegate of the Austrian Society for Psychiatry and Psychotherapy, and to Dr Jose Ayuso Mateos of the Spanish Society of Psychiatry and Dr Rojnic Kuzman, President of the EFPT, attending their first meeting.
3.To approve the minutes of the previous meeting
The minutes of the meeting held on 24 April 2009 in Budapest, Hungary, were approved as a correct record of the proceedings, subject totwo minor amendments.
4.Matters arising from the minutes not covered by this agenda
a.EU dementia strategy – progress report
Dr Georgescu reminded the delegates that in 2008 he attended the conference on old age medicine in Wrocław, Poland, on behalf of the Section. The conference focused primarily on the promotion of geriatric medicine in EU countries. The first draft of the ‘silver paper’ that emerged from the conference referred to tele-psychiatry onlyand did not mention mental health disorders in old age at all. In view of Dr Georgescu’s strong objections to this the ‘silver paper’was circulated electronically for consultation albeit after it had already been published online. The final published version included references to psychiatry and mental health.
The importance of the Section’s involvement in various European fora and their associated agendas was pointed out. It was suggested the Section should discuss how to respond to political pressures of this kind.
ACTION: put this item on the agenda
b.Progress report on informal communication with GAMIAN
Dr Saliba reported that his informal meeting withDolores Gauci, President of GAMIAN-Europe was followed by a formal letter listing several recommendations on possible collaboration. Most suggestions made in the letter had already been incorporated in the Framework.
The Section welcomed the comments and supported the suggestions for collaboration.
ACTION: inform GAMIAN
5.Report on reciprocal representation with the EPA
Dr Mauthner referred delegates toDr Pylkkänen’s letter to Dr Sass clarifying several issues regarding reciprocity including voting rights which, by mutual agreement, should not be reciprocated.
Dr Sass confirmed that the EPA Board and ECwould very much value close collaboration with the Section and were keen to continue the dialogue with the view to overcoming organisational obstacles. The EPA structure differed significantly from that of the UEMS – its membership consisted primarily of individual specialists organised into several scientific sections and committees. Section officers and committee chairs would normally hold their meetings during the EPA annual congress. Additional meetings outside the congress might be held. The meetings offered a real opportunity for discussions and the UEMS input at this level would be particularly relevant.
The EPA Board had suggested that their Committee onEducation would be the most appropriate forum for the Section to join in an observer capacity. An alternative would be for the Section to join the EPA section officers meeting.
It was pointed out that the real reciprocity would require an observer status within the respective decision making body of each organisation. The Section’s decisions were made by its entire membership whereas the EPA’s decision making bodies were the Board and EC. As the EPA had been granted an observer status in the Section the full reciprocity would require the Section’s observer status within the EPA Board and EC.
Following discussions, it was agreed that the Section’s officer would be invited to the general part of the Board as well as the section officers meeting. Conversely, the EPA delegate would be invited to join the Section and Board of Psychiatry working groups. The effectiveness of this arrangement should be evaluated regularly. Dr Sass agreed that the EPA would write formally to the Section to maintain the record of correspondence.
ACTION: Dr Sass to write to the Section regarding reciprocity
6.Progress on psychiatry across borders
Prof Hauff reminded the delegates that the proposal to establish a working group on this issue was rejected in October 2008 in favour of drafting a policy on collaboration with non-EU countries.
Following discussion, it was agreed that the WHO would be a much better forum for this initiative. The Section would be able to offer professional expertise in mental health which could be usefully disseminated through the WHO network. DrMatt Muijen would be invited specifically to our next meeting to discuss this in detail. Prof Hauff agreed to contact him informally in the first instance.
ACTION: Prof Hauff to contact Dr Muijen
7.Financial matters
a.Subscriptions update
Dr Cassidy reported that Croatia, Greece and Sweden had paid their subscription recently. Payments from Cyprus and Italy were still outstanding.
The associations whose subscriptions were still outstanding had been contacted.
b.Budget 2010
The Treasurer informed the delegates that Iceland had withdrawn from the UEMS Council which led to amendments in the sharing out key. The subscriptions to the Section would remain at the same level thanks to the Section’s large budget reserve from previous years. The budget was approved.
c.Income from the EACCME
Income from the EACCME was not included in the budget as it was unpredictable and irregular. No payment for evaluations carried out this year had been received. The Treasurer had written to the UEMS council several times regarding the Section’s new account. No reply had been received to date.
8.Membership matters
a.Election of Section Vice-President
No nominations had been received by the agreed deadline. The Chair confirmed that Dr Pálová expressed willingness to continue in her current role and pronounced her duly elected. Her new term of office would run for 4 years until April 2013 when she would be eligible for one last term.
ACTION: inform Council of election result
b.New EU member states – Bulgaria and Romania
Dr Saliba confirmed that the Presidents of the Bulgarian and Romanian Psychiatric Associations had been contacted. Dr Dan Prelipceanu, President of the Romanian Psychiatric Association, confirmed that Prof Tringer had initiated contact and that his association would be keen to cooperate with the UEMS. A formal letter inviting the Romanian Association to join the Section had then been sent. The Section agreed to continue efforts to enrol these two countries.
ACTION: JC to send reminders to Romanian & Bulgarian associations
c.Report on non-attendees
Presidents of those psychiatricassociations whose delegates failed to attend the last two meetings had been contacted but did not respond. The Section agreed to contact medical associations in those countries through the UEMS Council delegates. It was important that countries with large numbers of psychiatrists participated regularly in meetings to contribute to the Section’s work. A copy of the correspondence would also be sent to the psychiatric associations.
It was also agreed that the president of the PWG would be contacted regarding representation at the Section. Dr Chaudhry did not attend the last Board meeting despite being present in Budapest and made no further contact to date.
ACTION: JC to write to medical associations of non-attending countries and to PWG
9.Working groupmatters – new proposals
a.Commercial relations
Prof Gómez-Beneyto presented the proposal prepared jointly with Dr ten Doesschate. The objective would be to develop a framework providing guidance on the boundaries of good practice for EU psychiatric organisations in their relationships with pharmaceutical companies and other commercial organisations. The working group membership should include at least one EFPT delegate. Dr Malik confirmed the EFPT would be happy to join and compare feedback with their own work on this subject which focused specifically on the industry impact on training.
It had been suggested that the impact on individual practice should be added to the main objectives of the working group. This was supported.
The working group was approved subject to the total number of working groups at any one time not exceeding 4.
b.Coercive intervention
Dr Torsten Jacobsen gave a brief presentation outlining the background to this new working group. When the Section report on mental health legislation was archived in 2006 it was decided that carrying out extensive surveys was ineffective and unreliable. The decision was made then to focus on specific legislative aspects of mental health. The Section had already produced the report on compulsory treatment in the community. Dr Jacobsen was now proposing to look at the use of coercive measures in the EU. The objective wouldbe to describe the coercive methods, their monitoring and statistical analysis with the view to highlighting the discrepancies between the law and its practical application.
The Section agreed that it was an important matter but it would be impossible to collect reliable data from all EU countries as most did not monitor this aspect of mental healthcare.
A more effective way might be to focus on practice rather than legislation. Other suggestions included providing comments on the range and value of different restraints used in treatment and drafting recommendations and rationale for the use of specific methods. It was also suggested that changing the term coercion to e.g. emergency treatment measures would widen the field to cover patients in general wards which might help to destigmatise this issue. Cultural and political issues would have to be carefully considered.
Dr Jacobsen pointed out that a survey demonstrating the lack of data on the use or restraining methods would in itself be of benefit and might prompt legislative changes at national level.
It was noted thatthe institute in Manheim published an annual report on coercion as part of the Eunomia project.
Following a vote in which 8 countries voted in favour of Dr Jacobsen’s proposal and 18 against, it was agreed to form the group with its first task to revise the proposal in view of discussions.
c.Private Practice
Dr Matthys presented a new written proposal for the working group as agreed in Budapest.
The main objective was to determinetheposition, quality controls and funding methods of private practice and the correlation with the public sector in each country. The dynamics between the private and public sectors were rapidly changing in many European countries and it was important for the Section to establish a view on this. The show of hands indicated that Germany, Denmark, Slovenia and Portugal would be able to provide data if the group decided to carry out a survey on private practice. It was suggested that the survey should be descriptive rather than asking for specific data.
The group agreed to meet and reformulate the proposal in view of discussion. The membership of the working group should include both private and public sectors practitioners. Dr Motlova stepped down from the group.
d.Old age medicine
Dr Fradique explained that due to recent elections at her association there was no time to prepare the proposal for this working group in time for this meeting. It was suggested she should discuss this with Dr Georgescu’s group on old age psychiatry in the first instance to avoid any duplication of work.
10.UEMS Council Matters
There was no report on the UEMS Council matters in Dr Pylkkänen’s absence.
Dr Strachan raised a concern regarding EU doctors who under the freedom of movement legislation were able to practise in any member state without registration for 12 months. Previous regulations preventing migrant EU doctors from working without registration were removed under the Swedish EU presidency. Medical associations had been lobbying for tighter controls for doctors, particularly those with ongoing investigations in their country.
Dr Strachan suggested the Section should inform patient and carer organisations such asGAMIAN and EUFAMI of this potential risk to patients and urge them to lobby the EU.
ACTION: Write to EUFAMI and GAMIAN
11.Improving the corporate identity of the Section of Psychiatry
It was agreed that discussion on this issue should be held over until Dr Pylkkänen was able to attend the meeting.
12.Standing Committee on CME
On behalf of Prof.Hodiamont who was unable to attend the meeting, Dr Saliba informedthe delegates that the CME approval process online seemed to run smoothly. It was a quick and easy process with all the relevant information provided online. However, the involvement of pharmaceutical or other industry sponsors was acknowledged by a single confirmation of the venue organiser of disclosure of interest.
The EACCME were expanding its operations to cover e-learning events and Prof Hodiamont, Prof Sass and Dr Küey had enlisted as evaluators.
Prof Sass confirmed that the communications with the EACCME were not always satisfactory.
Dr Strachan informed the delegates that EACIC had recently written to Dr Pylkkänen regarding cooperation. It was noted that EACIC was dependant on the industry and it would be inappropriate for the EACCME to be associated with them. However, the CME accreditation market in Europe and beyond was increasingly competitive and the EACCME as the only group representative of specialists and with no conflict of interest should ensure its leader’s position.
It was agreed that Prof Hodiamont be asked to give a brief presentation/overview of the background and UEMS role in European accreditation to facilitate further discussion on the subject at the next meeting. The response to EACIC letter should be delayed until then.
ACTION: JC to ask Prof Hodiamont to prepare a presentation
13.UEMS CAP Section
In Dr Schaff’s absence there was no report. Dr Pálová gave a brief report of the CAP Section’s meeting she attended in Budapest inAugust. They had similar structure but met once a year only and their working groups met the day before the plenary meeting. The CAP Section confirmed thatDr Schaff was appointed a permanent delegate to the Section of Psychiatry.
14.Brief feedback from delegates on professional, training or service matters
Delegates briefly summarised items of news on professional, training and service matters. The proposal from Germany for delegates to send items of interest to the Secretariat prior to the meeting for publication on the secure page of the website was welcome and approved.
ACTION: JC to remind delegates to submit their items of news in advance
15.Administrative issues
Joanna Carroll reported that the trial to distribute agenda papers via a secure page on the Section’s website went very well and delegated did not report any difficulties with accessing the documents online. It was therefore agreed that agenda papers for the meetings would from now on be posted on the secure page of the website at least one month before the meeting. Delegates would be reminded 2 months prior to the meeting to submit items for the agenda and items of news for the website.
Delegates were reminded that the next officers elections will be held in October 2011 for the offices of the President (currently Dr Kari Pylkkänen), Vice-President of the Section (Dr Brigitte Mauthner), Treasurer (Dr Brendan Cassidy), Vice-President of the Board (Prof Slavko Ziherl) and Honorary Secretary Dr Joseph Saliba).