Tuesday 27th February 2018  
Quality and patient-focused
According to the recommendations of the "Report of the Panel of Experts on Effective Ways of Investing in Health“, investments should be guided by the quality and safety of care. May we ask if this principle is shared only by Providers or known by Regulatory States too? Tariff reduction in the private sector remains a frequent temptation. The example of Portugal is so bad that it is shocking. How to provide quality service when unilaterally prices are cut by 10%? What sector, be it public or private, can absorb this shock, which calls into question training, investment and organization strategies, without inevitably deteriorating the service provided? In "Regulatory States", the independence between the regulator and the provider is a must recalling the simple principle of equity regardless of the legal nature of the establishment.
The European Union of Private Hospitals (UEHP) is engaged in all the battles at the service of the patient - respect for their free choice - but there is still a need for "fair competition" to be recognized among sectors. Investment strategies and managerial intelligence are the main strengths of our industry for organizational innovation. Low-cost health is a losing strategy because it is the patient who ultimately is not taken into consideration. We expect shared responsibilities and equity in any public decision that affects the organization of healthcare. These are strong reasons to have private hospitals: the quality of service and the focus on the patient. We cannot therefore accept a short-term approach and value only the price. The only true solution to European commitments is to base decisions on the quality of the services provided.
Dr Paul Garassus
President of UEHP
Partner of HIMSS Europe on 27-29 May 2018 in Sitges (Barcelona)
The UEHP has signed a conference cooperation agreement with HIMSS Europe, a non for profit society that promotes new technologies in health.
The conference will be taking place on 27-29 May 2018 in Sitges (Barcelona, Spain), supported by the Dutch Ministry of Health.
The conference will include sessions which will address the whole spectrum of the digital health ecosystem with the aim to reach key audiences in the sector: from hospital CEOs to innovative SMEs and start-ups, as well as CMOs, clinicians and nurses. Conference themes will include: digital transformation, cybersecurity, interoperability and data into knowledge.
HIMSS Europe is renowned for gathering the most influential hospital CEOs and CIOs with the most important technology providers and industry leaders. Health 2.0 Europe, the leading showcase of cutting-edge innovations transforming health systems, brings together a grassroot community of innovators. Connecting these two worlds, the goal is to step from vision into action: initiating meaningful business conversations; connecting supply and demand and creating marketplaces; accelerating investments and large scale implementations.
UEHP members can benefit from a discount on the registration fees! For more information please contact me and I will provide you with the discount code.
More information here
Speaker at BIT, Milan
UEHP and AIOP speak at the congress “Medical Tourism: a strategic resource for health and tourism systems”
On 11th February, our UEHP Secretary General, Ms Ilaria Giannico, participated as speaker to the congress “Medical Tourism: a strategic resource for health and tourism systems”, organised by Intercare in Milan (Italy).
The congress took place during BIT, longstanding event organized from Fiera Milano which, since 1980, attracts to Milan tourism operators and travelers from all over the world.
Intercare, the first International Medical Tourism Congress and Exhibition, has marked a turning point in the communication and marketing of Medical Tourism destinations.
Crossborder medical tourism is a social and economic phenomenon in rapid expansion which involves over 10 million patients generating 100 billion dollars in revenues each year.
Ms Giannico was invited to participate to the round table “Medical Tourism: objectives and models in Italy and Europe”, with a presentation on patients mobility and the state of the art of the implementation of the EU Directive 2011/24 on on the application of patients’ rights in cross-border healthcare. Ms Giannico also presented the UEHP position on the Directive and what are the actions needed at all levels in order to concretely implement the Directive in all EU Member Countries.
Mr Gabriele Pelissero, President of AIOP, the Italian Association of Private Hospitals, was invited to take part to the same round table, with a speech on “Medical Tourism and Healthcare Internationalization: how Italian private healthcare system must take this chance.”
The congress marked the union of two worlds, Health and Tourism, only apparently detached which, instead, have more and more common touchpoints. It was also a unique chance to gather Institutions and operators to ponder on opportunities and potential which can be unleashed for both sectors.
Read the full congress report: here
Listen to the speakers’ presentations: here
UEHP latest AG - Interview
Dr. Tapani Piha, head of Unit, Cross border Healthcare & eHealth, DG SANTE
The video
Dr. Tapani Piha, medical doctor by training and head of Unit, Cross Border Healthcare & eHealth, DG Sante, reviews the Directive on Patients’ Rights in Cross border healthcare which was a major step for Patients‘ rights and for establishing a legal framework for the cooperation between Member States.
Dr. Piha explains that there are ongoing compliance checks focusing mainly on breaches of patients‘ rights. In October 2018 an official account on how the Directive is going will be published.
The aim of the Directive is not to create patient flow but to give rights to patients.
The Commission supports further improvement of National Contact Points (NCP).
Regarding the 24 current European Reference Networks (ERN), presently, they involve 900 clinics cooperating using high secure IT tools.
A new call to enter the existing ERNs might be launched by the end 2018 and it will look at 3 criteria:
  • Quality
  • Filling the gap in skills and knowledge
  • Benefitting certain member states who are not in yet.
UEHP latest AG
UEHP plans to organize a series of fee-paying workshops. The first, on risk management, is already planned for April and SHAM has agreed to support the session.
  • WS 1: Risk Management
  • WS 2: Information System and Cybersecurity
  • WS 3: Sustainable Development
  • WS 4: Medical Technology, Innovation and Financing.
UEHP latest AG
Dr. De Smedt from Eurostat held a presentation during the latest UEHP AG in Brussels on 02 02 2018.
The mission of Eurostat is data collection but also data dissemination regarding, as far as the healthcare sector is concerned, healthcare expenditure (compulsory data) and non-expenditure healthcare statistics (a voluntary annual data collection).
Eurostat is a Directorate General of the EC, a European Statistical System regrouping all national statistical institutes. It is legislation based with compulsory data collection, which means that it is obligatory for MS to send Eurostat all the data. It is not the case with OECD and WHO, two institutions which work closely with Eurostat.
All statistics can be consulted by theme on the Eurostat website.
UEHP latest AG
Healthcare Business international 2018
Mr. Max Hotopf, journalist and CEO of Healthcare Business International, announced the next Healthcare Business international conference on 10-11 April 2018 in London.
The context: no industry has more exciting prospects than private healthcare services in Emerging Markets. Governments are extending mandatory insurance and turning to the private sector to deliver efficient healthcare to citizens. Demand will also grow as populations age. The sector is also rapidly becoming international. Acute care, home care, nursing homes, labs, and dialysis: there are now intercontinental, often global players. To maximise returns as an operator, or as an investor, there is a need for clarity on markets and operators.
EU expert Panel on Health
Publication of three Opinions to help guide policy makers
On Friday 9 February, the independent Expert Panel on effective ways of investing in health has adopted three Opinions related to access to healthcare, innovative payment models for high-cost innovative medicines and performance of primary care.
The Opinion on benchmarking access to healthcare in the EU responds to the request for quantitative and qualitative benchmarks to assess progress in reducing unmet need for healthcare. It can support Member States in bridging the gaps in access to healthcare, giving effect to the principle of access to healthcare enshrined in the European Pillar of Social Rights (November 2017). The Opinion is based on the data collected through the EU annual Survey of Income and Living Conditions (EU-SILC), drawing attention to evidence of relatively high rates of unmet healthcare needs in some EU countries. The Panel proposes a mechanism for setting an ambitious but achievable target for unmet needs based on the median achievements of the best performing Member States. The Panel also advises on how to identify the distribution of unmet needs and how to address challenges by mobilising resources available at national and European level.
The Opinion on innovative payment models for high-cost innovative medicines analyses how national pricing and reimbursement authorities could improve patients' access to innovative medicines and foster innovation that matters whilst ensuring that health systems are financially sustainable. It explores feasible new ways of setting prices for specialty medicines in terms of improving access. While stressing the unlikelihood that a single payment model would be optimal for all situations, the Opinion sets out some broad principles to guide the definition of specific payment models. These include greater price and cost transparency, looking at patent law and market exclusivity rules to promote and reward high-value innovations, and developing and using methods to measure the social value of pharmaceutical products, e.g. in the context of Health Technology Assessment (HTA).
The Opinion on tools and methodologies for assessing the performance of primary care explores how to measure the performance of primary care. It takes account of the complex structure, modes of operating and services provision of primary care, and also of its outcomes, particularly in terms of relevance, equity, quality and financial sustainability. The Opinion translates multiple dimensions into comparative key indicators, and descriptive additional indicators, related to the 10 identified domains of primary care. It also sets out some procedural steps necessary for a performance assessment system, including multi-dimensionality, shared design, evidence-based benchmarking of results, timeliness and transparent disclosure. Finally, it recommends some criteria to ensure relevant performance indicators are selected, for example: alignment of indicators with objectives of the health system, ability to routinely collect the indicator, the validity and reliability of information. The Opinion will feed into the work of the Member States' group on Health Systems Performance Assessment (HSPA) on primary care, which will publish in the first quarter of 2018 a report on measuring primary care.
To read the opinions in full: click here
10% price cut imposed on private hospitals
Critical situation in Portugal related to a 10% price cut imposed by the government regarding contracts established between private providers and ADSE (Portuguese Health Subsystem for civil servants) which represents 20% of the activity of private hospitals in Portugal.
ADSE surprised private healthcare providers with a price cut of around 10%, incompatible with maintaining the high standards of quality and scope of coverage with which both private providers and collaborating doctors and other health professionals seek to work daily at the service of the population in general and of ADSE beneficiaries in particular.
ADSE did not present any economic or clinical justification for the cuts that it intends to make. This administrative position of ADSE is not acceptable. Firstly, it was not preceded by any negotiation with private hospitals. Secondly, because in the best interest of ADSE beneficiaries, the provision of healthcare services cannot be an instrument for blind and administrative price cuts especially without any underlying clinical criteria.
In order to maintain the quality and safety of ADSE beneficiaries, the Portuguese Federation Private Hospitals (APHP) cannot accept these prices and this new chart in the form and magnitude in which it was presented. ‟If we did so, maintaining the standards of quality, access and safety that we are not willing to do without, we would have very significant negative economic results for almost all the activity to be carried out for ADSE. It is simply not possible to reconcile the proposed prices with the quality standards and the way in which we daily take responsibility for the well-being of all those who trust us with their health, namely ADSE beneficiaries. APHP can assure all ADSE beneficiaries that private hospitals are firmly committed to continuing to provide them with high quality care”, declares Oscar Gaspar, president of APHP.
The reality of private hospitals in Portugal and the activity of the Portuguese Association (APHP)
Tariffs cuts for the private hospital sector, a European trend !
Portugal faces a 10% price cut imposed by the government regarding contracts established between private providers and ADSE (Portuguese Health Subsystem for civil servants).
Prof. Pelissero explains that the situation in Italy is somewhat similar. The government wants to give more activity to the public hospital sector but since they are short on funds, they decided that the solution was to impose price cuts on private providers.
Michel Ballereau, Secretary General of the French Federation Private Hospitals (FHP), adds that price cuts in France, although implemented more gradually, is also a reality that the FHP must face. It is a common trend that needs to be addressed.
Private hospitals from Lombardy create their own "health tourism" portal
The portal "Healthlombardy.eu" brings together all private hospitals and centers of excellence implanted in the Lombardy region, offering almost all clinical specialties, including cardiovascular medicine and surgery, neurology, orthopedics and oncology. A "map" - available in English, Chinese or Russian – has been designed to allow foreign patient to structure their care path.
Each year, more than hundred thousands Italians living outside Lombardy, a region in the northern part of Italy, choose this region for their health care needs. According to a recent ranking published by Bloomberg, 1.5 million patients are treated each year in the 208 hospitals that counts the region, of which 125.000 are coming from abroad. Among all foreign patients in 2015, considering also those who live in the area, almost one third had African origins. Following: other Europeans, Asians and Americans. Among the most requested services are angioplasty, cardiac surgery, hip replacement and cancer treatment. According to Gabriele Pelissero, president of the regional entrepreneurial association Assolombarda and of the Association of Italian Private Hospitals (AIOP), "Our healthcare facilities are already recognized worldwide for their excellent quality of service". "We need to communicate our local excellence outside the borders of Lombardy", says a representative of the working group on health tourism in Confindustria Lombardia, Health and Services. "We have the opportunity to transform healthcare and make it an opportunity for growth for the entire territory".
Health, research and related technologies are key resources for Lombardy’s development. Lombardy hosts almost a third of all Italian biotech and medical devices firms and counts the main Italian research centers, among which 13 universities, 12 CNR (National Research Council) institutes and 19 IRCCS (Scientific Institutes for Research, Hospitalization and Healthcare).
Source : click here
A platform for quality and transparency
As regard to transparency in quality management, private hospital groups in Germany have taken the lead with the creation of two institutes: IQM and Qualitätskliniken.de-4QD, joined under an umbrella organization: the SIQ foundation for quality management (Stiftung Initiative Qualitätskliniken).
Today, patients can consult a web platform (qualitätskliniken.de), which includes data of more than 450 private, private-non profit and public hospitals. Data related to quality of medical treatment, patient safety, patient satisfaction, physicians satisfaction, ethics are collected through declarative statements and verify by audits, and a ranking list facilitates the choice of a hospital.
The rehabilitation hospitals search engine has been redesigned and has been re-launched.
Leader in the European Union in foreign investments
A total of 86,743 jobs will be created in Poland as a result of the 335 direct foreign investment projects announced in 2017. According to a report by fDI Markets, that’s the best result in the entire EU.
Data also shows that Poland is no. 2 in the EU in terms of total value of investment projects, according to the Polish Investment and Trade Agency. The level of activity by foreign investors in Poland in 2017 was quite impressive. In the course of the year, the number of projects announced by investors rose from 272 to 335. Particularly notable is the increase in direct foreign investments, both in annual terms (by 52% y-o-y) and in the number of jobs created (by 48%), announced by foreign investors. Most projects are in the construction sector (95), ICT (73), automotive (49) - an industry that will attract the greatest amount of capital inflows into Poland (a total of EUR 2.1bn). The next highest sectors include transportation (47 projects) and innovative services (37). Projects which create more than 100 jobs predominate, with 217 such investments in 2017.
Brexit: the great escape of European physicians
Brexit or the great escape of European physicians. The upcoming Brexit (the date in which Great Britain will leave the European Union), and the total uncertainty on what will be the rules to be followed afterwards, are bringing to a real exodus of qualified personnel from the National Healthcare System (NHS).
According to a survey of the British Medical Association, 45% of European physicians working for the British NHS are thinking about leaving the country, while 18% have already found another job elsewhere. 62.000 EU citizens work in England for the NHS and over 6.000 of these are Italian.
The “Brexit effect” is already there: according to the data of the General Medical Council, last year the number of EU physicians coming to England dropped down to 3.458, a 9% decrease to the minimum from eight years. This situation is already creating problems for the NHS, which is experiencing a financial crisis and a overload of work because of the extension of life expectancy and the increase of chronic medical conditions. The main reason for the exodus of European physicians is basically linked to the impossibility to plan their life on the long term and be sure they could have a stable working future in Great Britain. Despite the preliminary agreement between London and Brussels signed last December, there are still different question marks on the rights of the EU citizens resident in the United Kingdom and their rights after Brexit.
"The referendum on Brexit has been well over 18 months ago, yet too questions keep on not having an answer", said Andrew Dearden, treasurer of the British Medical Association. Despite the attempts of the Government to reassure the residents, uncertainty prevails, especially in light of the continuous tensions between London and Brussels that could result in a missed accord, a scenery known as "hard Brexit."
"The Government must keep on giving guarantees that EU physicians will always be welcome and that their contribution to the NHS will be appreciated”, said Jane Dacre, President of the Royal College of Physicians. “It is crucial that the British NHS can continue hiring professionals in a system that is currently suffering from shortage of stuff”.
The shortage of stuff does not concern only the physicians, but also the nurses: the NHS is missing 40.000 nurses and the number of applications of employment of EU citizens willing to work in the UK has collapsed of 96% in 2017. Paradoxically, Brexit would have had to be the beginning of the raising of the NHS. The Minister of Foreign Affairs, Boris Johnson, one of the greatest supporters of Brexit, declared during his electoral campaign that 350 millions of pounds that Great Britain gives to the European Union would have been spent for the NHS after Brexit.
This statement had been criticized by the UK Statistics Authority because it was "intentionally misleading", since it referred only to the gross amount that London gives to Brussels without taking into account the amount that the EU gives back to Great Britain. Boris Johnson has recently repeated his promise to put more money into the NHS after Brexit, but the Government did not ever commit to that.
Clinical Research, a vector of excellence
Since the creation of the cardiology department, now a center of excellence for the Ambroise Paré Clinic located near Paris, cardiologists have chosen to adopt a private university approach. "During years, we had a voluntary approach, attending congresses and working with limited resources. This tenacity paid off from 2010 onwards, when we were allowed to train interns. We see a direct link between our previous scientific output and this teaching recognition, as well as the interest of interns in integrating teams that do some research," says Dr. Pierre Squara, cardiologist-resuscitator.
Interns choose this establishment in their 8th or 9th semester. Currently, two interns in reanimation, one in cardiology and one in anaesthesia officiate at Ambroise Paré. The research team then took a second significant step: obtaining a state grant for research and innovation in 2016. "We have entered another dimension! Today, we have four clinical research associates and, above all, a legal and administrative framework that protects clinical investigators. Our clinic cooperates with three others which belong to the same group. We have drafted a charter that specifies our actions, following the collective purpose of improving the quality of care delivered and the image of our institution. The funds are used to reward doctors according to the time spent in doing clinical research, but most of it will be spent to encourage, structure and develop clinical research. The ultimate goal is to encourage medical and scientific cohesion."
The cardiologists at Ambroise Paré are very comfortable with the idea that the funds raised thanks to them finance for instance the work of two young very promising orthopedists. This favors the sense of community. We want to create a community of physicians who strive towards the same goal, a group dynamic. We want to institutionalize our research so that it does not remain a hobby for physicians. There are extremely intelligent doctors who are not interested in doing research at all, and others, juniors and seniors, who are ready to spend an hour a week or their weekends, depending on which phase in life they are, when their children are grown, etc. Doing some research adds a new dimension to our job an allow physicians to go beyond their daily routine. Today, we have initiated studies that we have had in mind for a long time but could not get them started due to a lack of means. We have become clinical research promoters even for public organizations, and rather than validating new materials, we can imagine and fully design them."
A dozen clinical studies and three promotion studies are in progress.
Interview conducted in the context of Dialogue Santé n°24 of the FHP-MCO (French Federation Private Accute Care Hospitals), 2017, updated in February 2018.
5 - 6 March
Gaining the Benefits of Improved Health Data Quality
10 - 11 April
Healthcare Business International 2018
27 - 29 May
Sitges, Spain
HIMSS Europe 2018 & Health 2.0 Conference
8 June
UEHP Council meeting