Proposition 52K0504

Proposition de résolution relative à la recherche sur les affections cérébrales et à une meilleure prévention de l'accident vasculaire cérébral (AVC).

General information ¶

Authors

Open Vld Yolande Avontroodt, Hilde Vautmans, Katia della Faille de Leverghem

Submission date

Dec. 5, 2007

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

medicine health policy medical research resolution of parliament scientific research illness

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo LE PS | SP Open Vld N-VA LDD MR FN VB

Party dissidents ¶

• Thérèse Snoy et d'Oppuers (Ecolo) abstained from voting.

Contact form ¶

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Discussion ¶

March 6, 2008 | Plenary session (Chamber of representatives)

Full source

There are two rapporteurs, namely Mrs Lambert and Mrs Muylle.

Mr. Speaker, Mr. Minister, colleagues, I am co-rapporteur with Mrs. Lambert on this subject.

During the meetings of 22 January and 29 February last year, the Public Health Committee discussed three resolutions on brain diseases. It is document 504, proposal of resolution on research on brain diseases, submitted by colleagues from Open Vld, document 613, proposal of resolution for better prevention of cerebrovascular accident, in other words CVA, a resolution that mainly deals with hypertension as the biggest risk factor and which was submitted by the colleagues of sp.a, Green! and PS, and document 614, proposal for a resolution on the implementation and standardization of multi-professional brain tumor treatments, submitted by the colleagues of sp.a and PS.

Collega Avontroodt highlights in her explanation some epidemiological and economic aspects of brain diseases. For example, we are talking about brain tumors, neurological diseases such as dementia, epilepsy, Parkinson’s and CVA, and mental disorders such as addictions and anxiety disorders. In Europe, patients suffering from some form of brain disorder account for an estimated 35% of the total burden of all patients. In Belgium, 28% or about 3 million people suffer from this disease. Its total cost is estimated at 10 billion euros. The costs are higher than those of cancer or diabetes, but are still underestimated. Due to ageing, they will continue to increase in numbers in the coming years. Therefore, sufficient resources should be permanently allocated for scientific research on medicinal products and treatments.

In addition, the resolution on brain disease research also calls for greater attention to the framework. A master plan on mental health care should be developed, including focusing on multi-professional teams and family and child-friendly accommodation structures.

In her resolution on better prevention of CVA, Ms. Detiège points out that it is the second leading cause of death in our country. Approximately 19,000 people are affected annually, of whom 5,000 die within a month and even 6,000 remain permanently disabled.

She emphasizes that 52% of CVA cases are due to inadequately or insufficiently treated hypertension. Knowing that 2 million people suffer from high blood pressure and that half do not even know it, votes to think. Healthy eating, limited use of salt and alcohol, and more exercise are the highlights in this resolution.

After explaining the various resolutions, it was decided to integrate both texts. For this purpose, amendments were submitted which were approved by the majority parties. Snoy also submitted amendments to include elements of her resolution on electromagnetic pollution in the text.

According to certain scientific sources, exposure to electromagnetic effects and brain diseases are linked to each other, so Ms. Snoy requires more attention to environmental causes of the disease.

These amendments, as well as those to address stress at work, were rejected. The resolution will be treated separately at a later date.

The amended draft resolution was adopted with ten votes in favour and one abstinence. For the second proposal of Mrs. Detiège on implementation and standardization for multi-professional brain tumor treatments, which was simultaneously scheduled in the committee, the further discussion was postponed to the presentation of the National Cancer Plan.

This was the report on the work of the committee.

Mr. Speaker, if you allow me, I will also briefly present the position of my party.

It is true that these draft resolutions address the problem of people suffering from congenital or non-congenital brain disorders. This group of patients is indeed a large group that should not be neglected and that deserves additional specific attention, among other things because it is much more than just the treatment of a physical brain injury.

In addition to medication and/or surgical treatment, these patients often also need psychological guidance to learn to live with their sudden intellectual and cognitive impairments. There are the logopedist, the ergotherapist and so many others who, both in the hospital and in the rehabilitation center and in the home environment, will ambulantly support the affected patient.

In addition to the physical, cognitive and affective aspects of the patient, the family – the children and parents of the patient with brain disorders – also has a lot to deal with. They also need to learn to deal with the limitations on the cognitive level or on the affective level that can greatly influence the relationship, the interpersonal aspect. Psychological guidance for neighbors is necessary as well as teaching practical everyday affairs that were previously obvious.

Surgery, neurology, oncology, pediatrics, psychology, the rehabilitation sector, social assistants, work counselling, many domains have interfaces and must work together to ⁇ an optimal result. During the entire treatment and rehabilitation process, the general doctor should not be forgotten. He has often been the trust person of the various family members for years and thus plays an important role, not only in the medical field.

From our party and from the cartel, we want to have additional attention in the policy for chronically ill people and for people with a serious and long-term illness. In consultation with the Communities, the overall package of care for long-term illnesses should be developed within the scope of each’s competence and taking into account the budgetary boundaries.

Certainly children with a severe brain injury should receive timely adapted care so that the chances of a possible partial recovery can be fully exploited. CVA patients, patients with a traumatic brain injury, can be severely dependent on care. In addition to acute treatment, we must ensure that they, usually for the rest of their lives, receive appropriate care in an institution or in the home environment. In this regard, we have approved the proposals of resolutions.

Possible policy measures in the field of scientific research on treatment, awareness of risk factors for CVA, cooperation with the Communities, cooperation between the different specialties in the health care professions, family and child-friendly environments and adapted working conditions when re-entered on the market should be considered, including the budgetary aspect.

Unfortunately, there is no Minister present at the explanation of this resolution. That is always...

M is Michel, you didn’t have a pas vu. My apologies .

I regret, of course, that the Minister of Health is not here because it is an initiative from all banks to come up with a kind of health goal.

While studying the needs of brain diseases and patients with brain diseases, I was surprised that so little is known about it. We discussed themes that often come on the agenda through the media. But precisely these problems are not addressed through the media and therefore I think that it is also a task of parliamentarians to put precisely these hidden needs on the agenda of the Parliament and on the table of the minister.

I would like to thank the rapporteur, not only for her report, but also for the positive contribution. I would like to thank the other members of our committee for this.

Brain disorders is a word but it includes a large number of different disorders. Most are given individual attention. I am talking about dementia. During the previous legislature, our colleagues Bacquelaine and Vautmans, among others, voted on a resolution calling for attention to Alzheimer’s. This is just one of the elements of dementia.

MS is also such an element. There are more than 10,000 patients in our country who lead to MS. They are also part of this resolution.

Parkinson’s disease belongs to the so-called neurological syndromes. In addition, there are the neuro-surgical diseases. I must say that the first proposal for a resolution submitted by our group also had a very large chapter dedicated to brain tumors.

This, together with the proposal of Mrs. Detiège, was not integrated into this draft resolution at the request of the Minister. However, we will be careful that brain tumors will be a substantial part of the announced Cancer Plan. Under this condition, we have less emphasized that chapter in this resolution.

Colleagues, as regards the unborn brain injury, there have been several parliamentary initiatives and questions. Today, more than 2,000 people who are victims of an unborn brain injury – very often victims of road accidents – cannot receive adequate care. That is to say, 50% live in a rest and care home. Of course, they are not in their place. 30% live in an institution for disabled people. In addition, there is still a small percentage that falls into psychiatry. In itself, this shows that more can be done and that tailor-made care is still far away.

The largest group are psychiatric disorders. They also belong to the category of brain diseases. This includes addictions. Last week, the press spoke about the costs incurred in fighting drugs and addictions. That is only a fraction of what these diseases involve in costs.

The reporter made a very explicit reference to the size. These are frightening figures. In Europe, it is about 127 million people and costs 386 billion euros. In Belgium, we do not have exact figures, as to the totality of brain diseases, but in reverse it is 829 euros per inhabitant. That would mean a small 10 billion euros for our country. Direct and indirect costs are calculated together. It is very difficult – that is exactly one of the points of attention – to obtain in our country an accurate numeration, accurate data and an accurate registration.

That is one of the points we now advocate, besides, Mr. Mayeur, the data needed for the cancer registration. Given the size, it is ⁇ equally important to have a good registration and to be able to formulate a good health goal based on data.

The lack of epidemiological and economic knowledge is one of the highlights of this resolution. Last week, the importance of research was once again clearly highlighted following the research of Professor Bart De Strooper, who won the MedLife Foundation’s International Alzheimer’s Prize. He said: “In the beginning, when one began to study the brain, it was as if we were landing on a huge continent, without a good map. We had a limited legend. Today we have a much more detailed map of that area and we have a much clearer molecular picture of the problem. Several interesting therapeutic targets have been derived.”

What I want to demonstrate with this is that the brain is the organ that has been studied the least today. There is still a very large scattered area.

The 5th Framework Programme of the European Union currently spends 85 million euros. Our request to the Minister is to seek, together with her European colleagues, to raise that budget to 500 million euros, and to dedicate it to the cost and utilities of brain research in Europe.

For information, our country spent 7.3 million euros in this regard last year. Of course, this is not enough to ⁇ this goal.

Colleagues, I would have liked to have asked something to the minister himself, but I am convinced that the two ministers present will ask their colleague, namely to take very active part next year in the multidisciplinary forums that are launched around the European Brain Council and which next year will be about Parkinson’s disease.

Parkinson’s, dear colleagues, is also a condition that does not belong exclusively to the elderly. There are also many, and more and more, young people who become the victims of it.

I will leave the leak over the CVAs to my colleagues Detiège and Mayeur. That was also a substantial part of our resolution, but because they address it specifically, I will leave it to them.

Finally, I would like to conclude with two major strength lines.

First, my repeated plea for child psychiatry. We just heard the screaming report from the Foreign Affairs Committee. Also in our country there are still a lot of scary conditions in the field of child psychiatry. There are waiting lists of years before parents can end up with their child suffering from a childhood psychiatric disorder. This is not all pink smell and manishness. This is a very sensitive point.

There is an absolute shortage of child psychiatrists. There is an absolute shortage of reception in child psychiatry and youth psychiatry. There were efforts made for young criminals. I would also like to repeat that those who have the resources can still put their children in the child or youth psychiatry. Children of people who do not have the resources often fall into youth crime because of their psychiatric condition. It cannot, in my opinion. This is not worthy of our country. Those children or those young people should also have the chance not to fall into the crime because of a psychiatric disorder. This is a plea that I have been making for years, but which to this day has received too little attention.

Secondly, I would like to repeat to the Minister that we will be absolutely vigilant so that the multi-professional treatment of brain tumors is explicitly included in the cancer plan, because this is an essential part of our resolution. The shortcomings in epidemiological and economic knowledge will form the basis for making future brain diseases a real goal.

I thank you for your attention.

Mr. Speaker, Mr. Minister, dear colleagues, since our previous colleague has been extremely extensive on the subject, I will only address the second aspect of the resolution that was adopted: stroke.

Every year, they make a lot of casualties in our country: 19,000 people suffer a stroke in our country, which leads to either death or permanent disability. The causes of these strokes result, in more than half of the cases, from hypertension, hence stress, smoking and finally diabetes.

While there is a real political mobilization in the fight against tobacco, while our former Minister of Health, Mr. Demotte, has set up a national plan Health Nutrition, the fight against hypertension and especially for its prevention seems to nevertheless less mobilize the energies. The current figures are therefore all the more revolting that they could be significantly reduced if we acted early against this hypertension. Regular blood pressure monitoring would reduce the risk of stroke by 30 to 40% and the risk of heart attack by 25%, hence the importance of optimizing this systemic screening and prevention of hypertension.

It is in response to these multiple concerns that we have worked together, as has been emphasized, to this broad text that requires the government to take full measure of the challenge of brain diseases and strokes and, on the other hand, to respond to them in an appropriate and relevant manner. Of course, this is still a matter that belongs both to the federal power but also to federal entities since we are in the field of prevention that, on the one hand, is a medicalized prevention and that, on the other hand, is prevention that has been institutionally transferred to these other levels of power. Again, it is noted that here it is worth working together, unless we can concentrate in one place the overall policy of prevention in medical matters.

We will therefore vote on all these texts, as, I hope, all the groups of this assembly.

I would like to speak on behalf of the Ecolo-Groen Group! Let us tell you what we think of this resolution.

I will tell you first that the Ecolo-Groen group! will vote in favour of this resolution, as it is not for us to oppose a better consideration of serious health problems such as brain disorders. This seems obvious to us.

These diseases affect the autonomy and communication capabilities and, as such, require special attention and a comprehensive and multidisciplinary approach, including in the research dimension. These diseases affect not only those who are directly victims but also their relatives and require treatment often very heavy and above all human accompaniment, which we insist very much on. The costs cited in the resolution give the extent of the burden these diseases put on society.

However, this resolution remains unsatisfactory for us. We first ask ourselves about the relevance of primarily dealing with health matters disease by disease. There will be a cancer plan; today we are dealing with brain conditions. Tomorrow we will submit a resolution on obesity problems and next week on neuromuscular diseases? We can ask ourselves how far we will go.

Without denying that the evolution of certain diseases deserves special attention, we would be more favourable to a comprehensive analysis of the evolution of diseases and to a comprehensive approach to our health system based on consultation with all relevant levels of power.

Furthermore, we are especially disappointed that in the text of this resolution there is no questioning about the causes of the evolution of these brain disorders. We take this as an accomplished fact, saying that it is increasingly serious, that it costs more and more, that the treatments are very heavy, that therefore more and more resources must be devoted to it and that we must ask the European Union to help us.

It seems to us that our first duty, as political representatives, is to see how these diseases can be avoided and therefore to see how to establish effective prevention by acting on the factors of good and bad health such as the environment, diet, lifestyle. I am talking about primary prevention.

Today we know that a significant number of diseases are linked to our exposure to toxic chemicals. Heavy metals are responsible for brain diseases such as saturnism, which is linked to lead exposure. More recently, numerous scientific studies have concluded that there is a risk associated with exposure to non-ionizing radiation from radio frequencies and low frequencies. Intensive use of GSM increases the risk of brain tumor. According to the Bio Initiatives report, which is a scientific journal published in 2007, exposure to electromagnetic waves leads to risks of impairment of brain functions.

In the face of these warnings launched by scientists, shouldn’t we worry, seek to know more? Is it not important to protect the citizen, the consumer, the user, the patient and to allow him to avoid the risks before the disease? That is why we introduced amendments. Madame Muylle, you have somewhat reduced the scope of these amendments in your report because they were not intended to mix this text with the resolution I had filed on electromagnetic radiation. Our aim was to introduce general amendments. They were perfectly relevant and should not be rejected, at least not under this pretext.

Our amendments focused on three points: medical data collection, research and prevention. We wanted data collection to include indicators of people’s environmental exposure, their occupational exposure, and their lifestyle. We demand the same for most major diseases such as cancer and generally, we want a more integrated system of health data collection. We ask that research also address the causes of the disease. It sounds so obvious that I am upset by the fact that most other groups in the Health Commission refused to hear it. Working on the search for causes is obvious, among other things, on environmental causes but not only.

We also called for measures to be taken ahead of the disease. It is very good to detect hypertension but can not be worked in advance on its causes, cited by Mr. Major, such as smoking, stress or obesity, for example? We encountered a systematic opposition: environmental causes could not be mentioned under the pretext of a lack of scientific evidence. If one must wait for scientific evidence in everything, if one cannot adopt a minimum of the precautionary principle, one must wait 50 years as for exposure to asbestos. That’s what we’ve been waiting for so long before fighting smoking.

I regret and am surprised by this bad faith. I therefore consider that this resolution proposal is incomplete and unsatisfactory because it constitutes only the aggravation of problems without attempting to resolve them. Therefore, personally and with the consent of my group, I will abstain.

Mr. Speaker, I will be brief. After all, most have already been said by my colleagues, Mr. Mayeur, Mrs. Avontroodt, Mrs. Snoy.

I am pleased that a number of points, for example, related to brain tumors and the CVA are included in a global package.

I would like to remind my colleagues that cerebrovascular accident – cerebral bleeding – is the second largest cause of death in Belgium and that something can be done about it. Two million Belgians suffer from hypertension and one million of them do not know it. That is why we need to take action and do a number of things in Parliament. There were already hearings on the subject during the previous legislature.

I am pleased that both the opposition and the majority are behind this.