01.07.2012 At first hand

Editorial Pascal Strupler. The Prevention Act still has a rough ride ahead of it before it becomes law. Parliament has been mulling over the Swiss government's accompanying report on the bill since 30 September 2009 – first the National Council (lower chamber), then the Council of States (upper chamber). On 1 June, the deciding vote of the Council of States president at long last enabled the bill to be introduced – and after article-by-article consideration the upper chamber approved it by a majority of 20 to 16. The matter is not over yet, however. But more of that later.

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The bill gets people hot under the collar. While nobody has anything against prevention as such, lots of objections are voiced to the forms it might take. There is talk of the nanny state, of overzealous powers-that-be. The alliance of opponents from the SME sector wants a moderate measure of prevention, but their measure seems to fill up pretty fast. No punches are pulled when arguments are exchanged, and half-truths are not uncommon.
The Swiss Conference of the Cantonal Ministers of Public Health (GDK) has been resolute in its support of the bill. This particular voice is, and will remain, of great importance. Why? It became obvious, especially during the debates in the Council of States, that the representatives of the cantons feared one thing above all: loss of cantonal autonomy in the shaping of prevention programmes. This fear is unfounded. Because the Swiss government has deliberately refrained from prescribing specific individual measures, the cantons will retain full freedom of action in drawing up their prevention programmes, and they can decide for themselves how much they want to spend on prevention, health promotion and early identification.
Unlike now, the goals of prevention will in future be defined at the federal level – though not, for instance, by the Federal Office of Public Health (FOPH). Instead, the goals will be set by the Swiss government for periods of eight years, but with input from the cantons. In addition, the Swiss government will be obliged to involve the cantons when defining the strategies to be applied. The same applies to the FOPH's national prevention programmes.
However, let's prevent any premature rejoicing: the bill is to be submitted in autumn for resolution of differences between the two chambers, and the Council of States still has to ease the brakes on spending. This requires the agreement of a majority of deputies. The matter won't be over until the final vote is over. And the SGV (Swiss union of crafts and small to medium-sized enterprises) is threatening to try to force a referendum … so the fight goes on!

Pascal Strupler
Director of the Federal Office of Public Health

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