1. Amsterdam 2016
Health the Global
Context
“Ah well! I am their leader, I really ought to follow them”
Alexandre Auguste Ledru-Rollin (1870-1874)
Ambrose McLoughlin, Ireland

2. Key Policy Imperatives
Health and wellbeing are an economic imperative, delivering
competitiveness, economic productivity and they are an
essential ingredient of prosperity for all citizens in the
“Participation Society” we live in and serve in.
Political decision makers and policy makers as well as
society generally need to reflect on this.

3. A healthy society will be a better place
for all its citizens economically vibrant
and socially equitable

4. A perspective on health
 “The politics of health can be likened to driving on a dark
night over unfamiliar icy roads, hills and mountains in a
dense fog” (David Trimble modified)
 “Health service management requires we go the furthest
limit of what is possible” (Chan WHO, modified)
 “People deserve an honest implementable approach to
improving heath and well being –not fairy stories and
promises that will not be delivered”

5. My perspective on health
 Leadership requires like one of Beckett’s characters “We
will go on, because we must go on”
 We are engaged in an adaptive collective leadership
challenge
 A “coalition of the willing” to improve health and health
services with active, full participation across societies will
bring benefits to this generation and those that follow

6. Leadership in health
“Leaders ignore the convenience of the day and
look to how we make things better tomorrow”.
Health sector leaders must focus on a better
tomorrow”
“Effectiveness and adding value matter”

7. Health in the 21st Century - The Age of
Wisdom
 If we fail to meet the targets for health we will face
insurmountable challenges in the health services and the
additional resources will not bring real health benefits for
citizens and patients
 The case for direct health levies on the sale of and
advertising of alcohol is overwhelming
 Equally compelling is the case for direct health levies on
the sales of fast-food, sugar and tobacco
 The resources generated can be invested in social
marketing campaigns including social media initiatives, in
smart living and lifestyle changing programmes

8. Government and Societal Response
 From a” Care and Welfare Society to a Participation Society”
 “Smart Living and Smart Ageing” now a reality
 40% of current expenditure on illnesses relates to alcohol, obesity and
tobacco
 14 million person days per annum lost through illness in my country.
 75% of those presenting in very stretched Emergency Departments in
Ireland present with cardiac, endocrine or respiratory disease
 Most adults over 65 years have at least one chronic illness - 50% have 2
chronic illnesses
 Modify health service delivery system to manage chronic disease

9. The Chronic Disease Challenge in The Wisdom
Age
The 21st Century Challenge:
 Patients and carers at the centre with eHealth and health targets
 eHealth where are we now – We have had telephones for 135 years ?
 eHealth revolution and creating support networks ?
 eHealth and health professionals ?
 eHealth – Health providers and funders ?
 eHealth challenges and opportunities – medical entrepreneurship ?
 eHealth engaging patients – risks and opportunities?
 Connected or convenient health care ?
 Creating new era care treatment and prevention centres
 Patients accessing new era ambulatory care and virtual care systems

10. Cultural Challenges across the Globe
 Alchogenic culture and society
 Substance abuse
 Obesogenic culture and society
 Physical activity deficits
 Tobacco
 Mental health and well being
 Smart ageing and smart living challenge

11. OBESITY
 In all age groups especially younger cohorts
 Substantial and real risk of early onset of chronic cardiac and
endocrine disease
 Very easy access to fast food across suburbia and in every city
suburb town and village in the western world
 Smart living choice – balanced diet and moderate exercise - 1
hour a day

12. Tobacco
 Continuing major threat
 Governments must deliver a major sustained effort at a
legal and political level
 Strong global entities need to be challenged and ovecome
 5,500 Irish people die every year due to tobacco, 700,000
EU citizens die every year from tobacco related illness
 1in 2 smokers will die prematurely and the remainder will
have serious cardiac and respiratory disease
 The cost to our health service per annum is €1.2 billion
per annum or 12% of current expenditure

13. Mental Health
 Incidence and prevalence of mental illness is of serious concern
across the globe
 Associated with self-harm and suicide
 In 2012 in Ireland – 541 people lost their lives through suicide
 2013-2014 figures show a reduction in lives lost through suicide
 In 2013, 11,061 presentations to Emergency Departments
related to deliberate self harm
 Depression and anxiety major factors
 Alcohol and illicit drugs increase risky behaviour

14. Major Leadership Challenge
 Plain packaging anti-tobacco legislation has been enacted in some
countries despite the best efforts of big tobacco interests
 An action plan on alcohol is mission critical. Minimum unit pricing
legislation is hugely important
 A world-wide strategy and action plan needed to tackle alcohol
misuse
 A new nutrition and obesity policy and action plan are required to
address the challenge of overweight and obesity. New healthy eating
guidelines are required. Legislative proposals to require restraunts,
take-aways and all food service outlets to post calorie details of all
meals for menus have been approved by Government must be
implemented.
 Increased investment in Primary Care and children's health a top
priority

15. Governance and Health
 A new dynamic approach to developing healthy communities and
workplace policies is required. Public sector companies and agencies
must be incentivised to make their communities and workplaces
healthier and to get more active in improving their physical and
mental health. Public agencies to develop a” healthy community and
workplace” policy to promote the physical, mental and social
wellbeing of citizens and employees
 Are organisations fit for purpose – auditing the accounts and financial
affairs of organisations is not sufficient. The benefits of health and
wellbeing need to be addressed with leadership and management of
organisations and brought to the attention of Boards and senior
decision makers

16. Leadership Challenge in the Wisdom Age
 Smart ageing and smart living promote
opportunities for the commercial
development of new innovations, new
technologies, service offerings and
generating significant job opportunities
 Predicting protecting and preventing
chronic disease is the major challenge of
our time

17. The to-do list for Leaders in the Health
Sector across the globe
 Strengthen, the delivery and leadership roles in securing the further
development, sustainability and viability of economies and society,
and the health and well being of all citizens
 Strategic coherent frameworks in the health sector to harness and
connect disparate initiatives for health and well-being already
underway in the sector in most countries
 A credible sector presence for health in society, secure national level
endorsement in the sector for health, ensure a consistent
standardised approach in the sector, and enable the achievement of
the goals of, and the progression to a healthy society and a healthier
globe
 Health and well being is likely to be attractive to parents,
communities, senior academics and most societal and political leaders
 Just how healthy is the population? Vital data on the state of the
nation’s health needs to be regularly updated and reported to
parliaments across the world.

18. 8 Technologies that will help
 The smartphone – apps, hubs, large scale research, virtual consults
 At home portable diagnostics- hospital level in the home- smart
assistive technology, biomarkers
 Smart or implantable drug deliver mechanisms- smart pills,
implantable drug delivery
 Digital therapeutics - computerised cognitive behaviour therapy - new
digital preventive therapies
 Genome sequencing- falling sequencing costs ($1k), population level
studies, predicting patters and trends
 Machine learning – enhanced artificial intelligence, new insights into
big datasets
 Blockchains – decentralised data bases and health records
 The connected community- peer to peer networks, connected
communities, reshaping patient contacts

19. The Age of Wisdom from now to 2025
 How to ensure equality of access to cost effective
evidence-based protocol driven health. Care and
treatment when necessary
 How to encourage uptake of new care methods and
models
 How to manage the great volume of health information
the new technologies are generating
 Health and wellbeing really matter
 Meeting the normative needs of people is mission critical

20. Health in the 21st Century
 “Management is doing things right, leadership is doing the
right thing”
Peter Drucker
 “Leadership and learning are indispensable to each other”
Peter Drucker
 “A leader is one who knows the way, goes the way, and
shows the way”
John C Maxwell