Avoiding Unnecessary Variations and Diversities of Child Health Care Systems in Europe Paediatrics in Europe is characterised by the diversity, variety and heterogeneity of health care offered in the 53 European countries with more than 200 million children aged less than 18 years and with more than 200.000 paediatricians. Paediatrics respects the rules on child development which state that an adolescent is not a young adult, a school child is not a small adolescent, an infant is not a small child, a neonate is not a small infant and a premature newborn is not a small neonate. Paediatricians care for both healthy and sick children. Health care management differs according to where it is offered such as inpatient care in hospitals, outpatient care in hospitals or in private practices, homecare and rehabilitative care in special rehabilitation units. Paediatric health care focuses on the patient and not on diseases; however children with acute diseases need a completely different case management than children with chronic diseases. Special care is given to underprivileged and marginalised children such as children with chronic diseases and disabilities, children with a migrant background and poor children. Children have no voice in society and their caregivers do not speak with one voice, which has led to considerable inequity of health care in many European countries.
There is currently no European wide “bank” of data to enable comparative studies of service outcomes to encourage health service research relating to infants, children and young people. The aim of our presentation is to improve international cooperation in child health care in all European countries in order to improve future services. Understanding how and why services work, relating structure and process to experience and outcomes is essential at a time of economic recession. Paediatricians should not aim at creating a monopoly; instead they must favour the team approach of all caregivers.