UEHP  
  Monday, 20th July 2020  
 
EU does not crack under pressure
After facing such a difficult spring with the COVID-19 crisis and the lockdown of European citizens, the EU is still at work during summertime. Major projects are currently under discussion: a €750bn recovery package is scheduled, and more precisely, regarding the healthcare sector, the new health program EU4HEALTH which engages €10bn for the next 5 years. Furthermore, the Green Deal will channel new programs including economic incentives relating to the safeguard of the planet and specific actions against cancer are also under way.
UEHP is also at work calling attention to the relevant role and experience of European private hospitals in the fight against the virus but also to the need of organized coordination between actors. But we are more and more concerned by the future of the EU under the same objectives. Sustainable health systems require new solutions including e-health and smart hospitals, able to offer the best access to patients and limit unnecessary cost. Private hospitals have also taken positive action in the area of Green Hospitals reflecting the social goals of Ecology. The services we provide are also perfectly synchronized with the EU perspective against cancer.
The private hospital sector and EU policy makers share the same motivation: find relevant solutions to improve patient care and to ensure the sustainability of healthcare systems. Let´s work together!
Dr Paul Garassus
President of UEHP
 
       
 
LATEST NEWS
INSTITUTE OF GLOBAL HEALTH
Are we currently able to predict the end-dates of the COVID-19 pandemic?
Professor Antoine Flahault, Director of the Institute of Global Health, Geneva
The Institute of Global Health publishes a daily dashboard, the COVID-19 Daily Epidemic Forecasting, which provides forecasts for 209 countries over 8 days. The only reliable data we have is an 8-day forecast. To create this dashboard, we ran a competition between fifty existing mathematical models and selected the top 5, which make accurate 8-day forecast. Predicting, scientifically, beyond this period, would not be reasonable, given the high margin of error for all the models analysed.
Looking at the next 8- day forecast, there is no sign of a second wave in Europe, but there are upsurges elsewhere in the world. Only the arrival of an effective and well-tolerated vaccine could lead to a relatively fast exit from the pandemic crisis. In the absence of a vaccine, the protective mask seems to be a very precious tool for reducing the probability of transmission of the virus, which is even more effective than mere social distancing, which is sometimes difficult to maintain.
Performing mass tests seems difficult to me, especially since those where a swab is introduced into the nostrils for a nasopharyngeal sample are not well accepted, especially by asymptomatic people. From an organizational point of view, it is best to test patients who have developed symptoms first, and then trace the people who they have been in contact with.
Following the first wave in Europe, what observations can we make?
We had a painful first wave, especially in certain countries which experienced high mortality rates, such as Italy, Spain, France, the United Kingdom, and finally Sweden. Health systems in Europe were put to the test, but they have generally held up. Europe currently offers one of the best responses in the world to COVID-19, even in the United Kingdom, which is very affected and whose health system has withstood the first wave well.
Today, we are in total decline with a very strong decrease in the pressure on the hospital system, but we are not immune to a second wave, judging from the extremely violent outbreaks in India, Pakistan, Bangladesh, South Africa, Latin America, and the United States in particular.
We will closely monitor the progress in Australia, which for us is a benchmark country due to its health system which is quite comparable to ours in Europe. Australia, located in the southern hemisphere and for a large part of its urban areas, in a temperate zone, is undergoing the onslaught of winter and is trying by all means to stem the current COVID-19 wave. We can learn the lessons in crisis management from this continent. For the moment, the situation there is under control.
What should be done "differently" in case of a second wave?
Generalized confinement was put in place in emergency, but none of the countries want to return to total confinement. It is a kind of weapon of last resort because it has an impact in terms of social and economic life. it will be necessary to extinguish outbreaks where they occur and act regionally, as it is being done in Germany, which has shown that we can test, trace and isolate virus carriers, and in other countries such as Taiwan, South Korea and Singapore.
The role of hospitals, of all legal status, in Europe should also be rethought. Private hospitals in Switzerland, France and other European countries were fully involved in the fight, but for the most part did little work, when they could have managed scheduled operations and patients without COVID-19. We realize today that there is room for improvement and that is a good thing.
Europe as a whole has responded extremely well. Good cooperation between European countries can help avoid general confinement. In terms of data, better reporting by European countries to the European Centre for Disease Prevention and Control would be useful to refine our forecasts. European collaboration at the research level is also considered necessary.
 
EU
First meeting of the new eHealth Stakeholder Group
Last 13 July, the new eHealth Stakeholder Group held its first virtual meeting kicking off the new mandate 2020-2022.
UEHP retains its seat in the eHEALTH STAKEHOLDER GROUP of the EUROPEAN COMMISSION for its third consecutive mandate!
As part of the EU's commitment to engage stakeholders in public policy making, the eHealth Stakeholder Group provides advice and expertise, that support the Commission to develop policy and implement the Communication on enabling the digital transformation of health and care in the Digital Single Market, that was adopted in April 2018.  In particular in relation to the following areas:
  • Health Data, including taking forward the Commission Recommendation on a European Electronic Health record exchange format and the further elaboration of the baseline set of technical specifications and better interoperability
  • Digital health services
  • Health data protection and privacy issues
  • Cybersecurity for health and care data
  • Digital tools for citizen empowerment and person centred care
  • Artificial intelligence and health
  • Other cross cutting aspects linked to the digital transformation of health and care, such as financing and investment proposals and enabling technologies
The first meeting of the renewed group was the occasion to virtually meet all members of the group and the officials of the European Commission for the first time and to set the scene for the work of the group during the new mandate. The Commission presented the Work Programme for 2020-2022, as well as the Rules of Procedure of the group.
Presentations from DG SANTE and DG CNECT included the Digital Health response of the Commission to the COVID-19 pandemic, the current status of the creation of the European Health Data Space and a reflection on the Digital Transformation of Health and Care. 
Background
The call for applications closed in September 2019 and the Commission received over 100 applications for a maximum of 40 membership places. In selecting organisations, the Commission took into account not only the eligibility and selection criteria, but also the need for a balanced representation of the different interests needed to support the breadth of digital health over the next three years. Members are all umbrella organisations/associations with a European outreach, representing the following sectors/groups: the Health Tech industry, patients, healthcare professionals and the research community. The names of selected organisations are published in the Register of Commission Expert Groups.  
UEHP has been member of this group since 2015 and will continue working closely with the European Commission, as well as with the other stakeholders working in the healthcare sector, to bring the voice of private hospitals in Europe in the transition towards digitalisation of care across Europe.
 
EU
The German Presidency of the Council of the European Union - 1/7/2020 - 31/12/2020
On 1 July 2020, Germany assumes the Presidency of the Council of the European Union until 31 December 2020.
Under the motto “Together for Europe’s recovery”, the German Government is putting the focus of its Presidency on overcoming the COVID-19 pandemic and seeking answers to the challenges of the future that we need to address now, thus also expressing its goal of making Europe stronger, more equitable and more sustainable.
During its Presidency, Germany will again have a greater responsibility for helping to shape Europe, stressed Federal Minister for Foreign Affairs Heiko Maas last week. “Germany wants to be a driving force and facilitator during its Presidency of the Council of the EU. Our task will be to build bridges and find solutions that ultimately benefit everyone in Europe.”
Major priorities will include important issues for the future, such as climate action, digital sovereignty and Europe’s role in the world, alongside post-COVID-19 recovery.
The full programme of the German Presidency is available : here
For more information please visit the official website of the German Presidency: here
 
EU
The European Parliament wants a European Health Union
In a resolution adopted on 10 July 2020 by 526 votes to 105 and 50 abstentions, the European Parliament highlighted the need to give the EU a far stronger role in the area of health.
During the plenary session held exceptionally in Brussels last week, MEPs underlined the need to draw the right lessons from the COVID-19 crisis and engage in far stronger cooperation in the area of health to create a European Health Union. This should include common minimum standards for quality healthcare, based on urgently needed stress tests of member states’ healthcare systems to identify weaknesses and verify that they are prepared for a possible resurgence of COVID-19.
The resolution calls for a European Health Response Mechanism to be created rapidly to respond to all types of health crises through better coordination and management of the strategic reserve of medicines and medical equipment.  The upcoming EU pharmaceutical strategy must contain measures to make essential medicines more immediately available in Europe. Diversified supply chains need to be put in place to guarantee affordable access at all times.
The new dedicated 9.4 billion EUR EU4Health Programme is strongly welcomed and MEPs believe that long-term investments and commitments are needed. They request the establishment of a dedicated EU fund to improve hospital infrastructure and health services.
With the COVID-19 crisis ongoing, MEPs also reiterate their call for affordable access for all people worldwide to future COVID-19 vaccines and treatments as soon as they are available.  Joint EU procurement must be used more systematically to avoid competition between member states when public health is at stake.
Also, please find attached an update of ongoing COVID-19 related expertise work for the ECON, EMPL, ENVI, ITRE and IMCO committees of the European Parliament. The attached COVID-19 Newsletter focuses on the de-confinement strategies and EU measures to support the economic recovery.
 
EU
EC Report : two years of application of the General Data Protection Regulation
Last 24 June, the European Commission published the report "Data protection as a pillar of citizens’ empowerment and the EU’s approach to the digital transition - two years of application of the General Data Protection Regulation".
This very first report on GDPR refers in particular to the application of the rules on the transfer of personal data to third countries and international organizations and of the rules on cooperation. However, the report also addresses other issues that have been raised by various stakeholders over the past two years.
The general opinion is that in these two years the GDPR has successfully achieved the objectives of strengthening the protection of personal data and guarantee the free movement of such data within the EU. However, seven areas have been identified where improvements are needed:
  • application of the GDPR and functioning of the cooperation mechanisms. In general, the data protection authorities have made balanced and enhanced use of corrective powers. However, further efforts are needed to make cross-border case management more efficient and harmonized. Many stakeholders stressed the need for more practical guidelines, which contain more concrete examples. The Commission also stressed the obligation for Member States to allocate sufficient human, financial and technical resources to the Authorities;
  • harmonized rules but still with some degree of fragmentation. The fragmentation is due in particular to the use of the clauses. The Commission recalls that national legislation must never go beyond the margins established by the GDPR or introduce additional requirements;
  • control of people over their data. The right to data portability is not yet fully used, in fact the user is not always allowed to switch to another service provider. This indirectly hinders fair competition and innovation. Unlocking the potential that would result from data portability is therefore one of the Commission's priorities;
  • opportunities and challenges for organizations, especially SMEs. Data protection authorities have developed a series of activities to help SMEs comply with the GDPR, for example by providing models for the processing of contracts and registers, seminars etc. Some of these initiatives benefited from EU funding. The Commission invites to consider further activities to facilitate the application of the GDPR for SMEs. In this sense, the Commission is also currently working on standard contractual clauses in the relationship between controller and processor;
  • the application of the GDPR to new technologies. The Commission believes there is need to clarify how to apply the GDPR principles to specific technologies such as the A.I., blockchain, Internet of Things or facial recognition;
  • development of a modern international toolbox for data transfer. As part of this first assessment, the Commission is also required to review adequacy decisions; for this reason, it has initiated an intense dialogue with each of the 11 third countries affected by these decisions to evaluate the evolution of their data protection systems;
  • promoting convergence and international cooperation in the field of data protection. Synergies between trade and data protection tools to ensure free and secure international data flows will need to be further explored. In this sense, the Commission is setting up a "Data Protection Academy", a platform where European and foreign data protection authorities will be able to share knowledge, experiences and good practices.
The Commission then summarizes the actions to be carried out by Member States, DPA and EDPB, and the Commission itself according to whether it is:
  • implement and integrate the legal framework
  • ensure that the new governance system offers its full potential
  • support stakeholders
  • encourage innovation
  • further develop the toolkit for data transfers
  • promoting convergence and developing international cooperation
The full report is available : here
 
EU
Report - COCIR Webinar on Cybersecurity in Healthcare – in Partnership with UEHP on Tuesday 30 June 2020
Last 30 June 2020, COCIR, the European Trade Association representing the medical imaging, radiotherapy, health ICT and electromedical industries, held a webinar on Cybersecurity in Healthcare in close partnership with UEHP. 
As the digitisation of health and care progresses, the number of connected digital health technologies is increasing. This is inevitably accompanied by a growing number of cybersecurity risks. Cybersecurity is a shared responsibility. It must be clear to all parties involved that it takes organisational measures to ensure security, which can then be supported by product technology.
This webinar was an opportunity to understand the latest status on legislative developments and explore the concrete meaning and practical implementation of 'shared responsibilities', including the need for collaboration, communication and information between manufacturers and healthcare delivery organisations.
Presentations from the EU Institutions included an overview of the applicable cybersecurity legislation in Europe from DG CNECT, European Commission and un update on the implementation of the NIS Directive from EU Agency for Cybersecurity (ENISA). 
Those presentations were followed by the perspective of the manufactures and the hospitals on what it means to share the responsibility on cybersecurity. Our President, Dr Garassus, brought the voice of the private hospitals in Europe to the discussion, highlighting that hospitals need technical support and specific investment strategy in order to complete the transformation to the "smart hospital" and to ensure the safety of their networks. The European Commission is a real partner to limit risk in hospitals and we should all play our role in the fight against cyberattacks. 
Cyberattacks are no more ransomware or malware, but “killerware” : patients are in danger !
The presentations of the webinar are accessible via this link
 
EU
Call for proposals: IMI2 JU and CEF Telecom on Cybersecurity
Two interesting call for proposals from two different EU programmes which might be of interest for you and your members:
1) Innovative Medicine Initiative 2 Joint Undertaking (IMI2 JU)
As part of the Horizon 2020 program, the Innovative Medicine Initiative 2 Joint Undertaking (IMI 2 JU) has published the call for proposals number 23. IMI2 is a public-private partnership (PPP) between the European Union, represented by the European Commission, and EFPIA (European Federation of Pharmaceutical industries and Associations) which represents the interests of European pharmaceutical industries and associations. The call is intended to finance 6 Research and Innovation (RIA) actions. In particular, the topics of the call are:
The budget made available by IMI2 for this call is equal to 47.790.000 euros, while the contribution of the EFPIA consortium and the partners associated with IMI2 will be 47.360.000 euros. The deadline for submitting project proposals is set for September 29, 2020.
2) CEF Telecom: new call on cybersecurity
As part of the Connecting Europe Facility (CEF) - Telecommunications program, the European Commission has published a new call aimed at developing cooperation and cybersecurity capabilities and implementing related European legislation.
The project proposals must focus on one of the following objectives:
a) Support to operators of essential services, national Competent Authorities and Centers for sharing and analyzing information. In this context, the proposals should be aimed at creating a coherent ecosystem for risk management, information sharing and communication. As part of this objective, the proposals must include the participation of at least one of the following entities:
  • Essential service operators (as identified by the Member States in implementation of the NIS Directive);
  • Centers for sharing and analyzing information (ISACs) at European or national level that have at least one operator of essential services among their members;
  • National Competent Authorities or Single Points of Contact, designated by the Member States in implementation of the NIS Directive.
b) Support for cooperation for the joint preparation and development of a common awareness of cyber threats as well as for the implementation of a coordinated response to cyber security crises and accidents. The project proposals must include at least one of the following entities:
  • National authorities and public bodies;
  • legal entities in charge of IT security at national level.
c) Support for the implementation of cooperation activities foreseen by the Second biennial Work Program of the NIS Cooperation Group (2020-2022). In this context, the actions financed must be aimed at strengthening the know-how and skills of the national public authorities and of the subjects participating in the NIS Cooperation Group. For the purposes of this priority area, proposals that include the participation of national authorities and / or public bodies from at least two different Member States are considered eligible.
d) Support for cooperation and the development of skills for IT security certifications in line with the Cybersecurity Act, Regulation (EU) 2019/881. As part of this objective, the proposals must include at least one of the following entities:
  • National cybersecurity certification authorities, officially designated (or in the process of being designated) by a Member State, in accordance with the Cybersecurity Act;
  • National accreditation bodies, located in a Member State and appointed pursuant to Regulation (EC) 765/2008.
The overall budget made available for this call is 10.5 million euro. It is expected that € 1 million will be reserved for projects related to objectives 3 and 4 respectively. The indicative duration of the actions financed must be 36 months.
The deadline for submitting proposals is 5 November 2020. For more information, see the official publication page of the call: here
 
EU
Save the date - EU Health Summit - 26 October 2020
Lessons learnt from the COVID-19 pandemic
The next EU Health Summit will take place on 26 October 2020 in Brussels
COVID-19 has exacerbated many of the existing, underlying problems of healthcare systems. At the same time, it has highlighted the devastating impact that serious public health threats can have on both the health and well-being of our citizens as well as on our economies. The current crisis has clearly demonstrated how healthy populations and economic growth are interdependent and mutually reinforcing.
This public health crisis has also shown us the importance of cooperation among sectors and actors in ensuring our healthcare systems work to their optimum ability in preventing premature deaths and protecting citizens. Building on the concrete recommendations that 34 organisations across the health community put together in late 2018, this second edition of the EU Health Summit seeks to translate the lessons learnt from the COVID-19 pandemic into a political vision capable of maximising collaboration and ensuring a healthy and equitable future for everyone in Europe.
Health now tops the European political agenda, as demonstrated by the proposed stand-alone EU4Health programme with an ambitious budget of 9.4 billion Euros. We must not lose this momentum. Join us and contribute to the design of the future vision of health in Europe! 
If you are interested in joining these discussions, please register here.
Attendance will be possible both in person and remotely. The Health Summit may be converted into a virtual event depending on the evolution of current circumstances. 
The EU Health Coalition was created following the first-ever EU Health Summit, in November 2018. The Coalition promotes a shared vision of health in Europe, based on jointly developed recommendations. The purpose is to ensure that health remains high on the political agenda and to champion the changes required to address the unprecedented challenges that an ageing population and an increasing prevalence of chronic diseases pose to healthcare systems and citizens.
The EU Health Coalition is composed of patient organisations, EU research-oriented medical societies, industry organisations, healthcare providers, regional and local health authorities and other relevant stakeholders, who all share a common vision. To find out more about the work of the EU Health Coalition, please visit our website here.
 
       
 
MEMBER'S CORNER
GERMANY
Private Hospitals during the Corona Pandemic - a German Perspective
The first corona wave reached Germany in mid-March. The German government reacted quickly and extremely cautiously. Germany, like most other European countries, went into lockdown. Social life came to a standstill.
Thomas Bublitz, Executive Director of the German Federation of Private Clinics (BDPK)
From almost one day to the next, the 2,000 hospitals and 700 prevention and rehabilitation facilities in Germany were called upon to massively cease their operations in order to free up as much capacity as possible for COVID-19 patients. The aim of the German government was to prevent hospital overcrowding and supply shortages that could cost countless patients lives. The measures were taken in response to images seen in Lombardy, where patients were housed in tents and chaos reigned with stressed health professionals. The virus didn't reach Germany until long after, which probably gave us a very helpful advantage in terms of experience.
In addition to shutting down regular operations, the hospitals were preparing for the pandemic: Staff were retrained, the stockpiling of protective equipment and medication was optimised and patient flows of infected and non-infected patients were separated. Above all, however, intensive care beds were significantly increased and centrally recorded for capacity control. The hospitals of private operators made a considerable contribution to this. The private hospitals alone provided more than 5,000 intensive care beds and are able to provide an additional 2,000 within 24 to 48 hours.
In addition to the cessation of regular activities, hospitals prepared for the pandemic: Staff were retrained, storage of protective equipment and drugs was optimized and the flow of infected and non-infected patients was separated. Most importantly, intensive care beds were significantly increased and centrally listed for capacity control. Private hospitals made a considerable contribution in this respect in providing more than 5,000 intensive care beds. They are able to provide another 2,000 care beds within 24 to 48 hours.
The closure of hospitals and rehabilitation facilities and the cessation of regular operations in the face of the impending wave was understandable at the time, but it had an immediate consequence: the expected COVID 19 patients did not arrive, hospitals and rehabilitation centers quickly got into economic difficulties and insolvencies were imminent. In order to prevent this, the German government adopted rescue plans which, among other things, included flat rates for empty beds. We faced the crisis together, i.e. with all funding organisations, and were able to prevent the dreaded shortage of care. We have been able to admit and care for patients suffering from COVID-19 in France or Italy, for example.
We are currently facing the challenge of resuming regular operations. In the meantime, hospitals and rehabilitation centers are operating at 60-80% of their capacity, but normal operation is still unthinkable this year - hygiene measures and distance regulations do not allow for this. The question therefore arises: What is the next step? Will the emergency plan in Germany be extended beyond 30 September in order to prevent hospitals and rehabilitation centers from running into economic difficulties? To what extent will a second wave affect us?
Our conclusion from the last few months is that politicians have done a good job in the crisis and have carried out and eased an unprecedented stop of activity. Perhaps the shutdown was too drastic and the measures overcautious. However, in March it was not possible to predict the course of the pandemic in Germany and what hospitals and rehabilitation centers would actually face. Now it is necessary to act with a sense of proportion and reason and rely on the discipline of the population to avoid a new wave of infection. Then hopefully, not only in Germany, but in the whole of Europe, supply crises will be prevented. Because one thing is certain, the pandemic is not over yet!
ITALY
COVID-19: looking ahead
A contribution of Prof. Gabriele Pelissero, MD, Chair Professor of Hygiene and Health Organization at the University of Pavia and Former President and Managing Director of AIOP (Italian Association of Private Hospitals)
President of the Lombardy Life Sciences Cluster and President of the Future Health Foundation
Over the last 100 years, the epidemiliogical transition in Europe brought progressive decrease in the burden of infectious diseases and concomitant increase in non-communicable degenerative conditions. A century has passed since the last serious epidemic in our Continent, the "Spanish" flu; after the second World War, even more, the feeling of safety and success for having defeated one of the most dramatic threat for humanity – an epidemic – became integral part of societal thinking, and object of numerous scientific outputs.
We report below a graph, often used for teaching in Medical Scholis in the 90s, representing in a very illustrative and didactic way how health and well-being improved after Europe recovered from the Spanish Flu, thanks to multiple factors, including improved hygiene, living and working conditions, antibiotic use and mass immunization programmes.
Since the 1950s, the way of living in Europe has been evliving around this new epidemiliogical scenario. Housing, transportation, food, the built environment (hospitals, scholis, hotels, restaurants, prisons, nursing homes etc.) have been built and organized to cope with an ageing population and high chronic diseases prevalence in a world where physical proximity and social contact were not considered risk factor, rather an opportunity to socialize and make an efficient use of spaces.
The current outbreak brings us back to the past with a disease whose risk of airborne transmission increases with proximity and obliges us to rethink the whlie system where we live and work and to re-design the space around us.
In this context, society faces new needs that can be roughly divided in two different phases, in the short, medium and long-run.
In the short run, contrli efforts focus on the enforcement of behavioral preventive measures (individual protection, distancing, sanitation, quarantine), whose implementation at the population-level has large socio-economic impacts. In addition to preventive measures, the initial phase of the COVID-19 epidemic came with massive preassure on health systems, with particular reference to hospital services having to handle massive and unexpected healthcare needs of COVID-19 patients. This first phase – especially if adopted preventive measures are effective - is relatively short in time and is flilowed by endemic-epidemic trends with possible isliated clustered infection outbreaks, this until a vaccine will become available. However, other epidemics will eventually come in the future, this raising challenges in a second phase, and in the long-run.
The epidemiliogical, psychliogical, social and economic impact of the COVID-19 epidemic is likely to generate sliid and long-lasting awareness of the epidemic risk at the societal level, this supporting the implementation of structural interventions to modify the urban, architectural and functional characteristics of the world in which we live, so as design safe houses, scholis, public transports and other public pleases, nursing homes and, of course, safe hospitals and healthcare facilities. As done in past centuries when we designed and built aqueducts and sewers, monitored food production and distribution so as to ensure safety, likewise now we need to design and build a world that protect us from epidemics.
All this, both first and second phase actions requires money and resources. It will be therefore important that all stakehliders, starting from healthcare workers, develop a strong design thinking, proposing sliid ideas to gather economic resources that need to be efficiently used, also taking into consideration their management at the European level.
The healthcare sector, where we, and our associations authoritatively belong, has to raise its voice and contribute to the debate. We have a unique opportunity to help to create a resilient word, protected against future epidemics, and we can do that starting with:
  1. Strengthening scientific research
  2. Building safe spaces and facilities with limited biliogical hazards
  3. Identifying and secting technliogies supporting environmental safety in high-risk settings, including hospitals
  4. Promote the digitalization of processes and procedures
  5. Develop and implement of telemedicine services
  6. Improvement monitoring and evaluations systems
  7. Improve diagnostic capacities, with particular reference to rapid testing
  8. Develop new treatments’ protoclis
  9. Promote staff training and education
This, and much more, will contribute to the general aim of having a safer word, prepared to tackle new challenges related to infectious diseases spread. To lead the change we all need, without further due, to enter a new dimension, and be ready with strong ideas when, in the months to come, the European Commission will start to invest in this important new programme.
GREECE
Current state of COVID-19 outbreak
A contribution of HPHA (Hellenic Private Hospitals Association)
Overview
Today Report (01-07-2020): Coronavirus cases: 3.409, Deaths: 192. Recovered: 1.374.
The first COVID-19 case was diagnosed in Greece on February 26th. Contact tracing was initiated on the first and all subsequent confirmed cases, with all contacts being tested and isliated.
  • On February 27th, the annual carnival in Patras (an event which draws big crowds from all over the country), was cancelled. On March 10th, with officially 89 cases and 0 deaths, all scholis and universities across the country were closed.
  • On March 12th, movie theaters, gyms and courtrooms were closed. On March 13th, with 190 confirmed cases and 1 death, malls, cafés, restaurants, bars, beauty parlors, museums and archaeliogical sites were closed. On March 14th, organized beaches and ski resorts were also closed.
  • On March 18th, with 418 confirmed cases and 5 deaths, all stores were closed.
  • On March 23rd, with 695 confirmed cases and 17 deaths, a nation-wide restriction of movement (general lockdown).was enforced, whereby citizens could leave their house only for specific reasons and with a special notification-permit either written or send via mobile sms.
    Greece’s mobile application service that grants permission to citizens for necessary movement during the general lockdown was highlighted by OECD as a best practice for the containment of the coronavirus pandemic.
Currently with the easing of measures, Greece is gearing up for a tourism season that no one can predict its outcomes.
Countries like Greece, which successfully prevented the extension of the epidemic, can serve as an example for the development of effective epidemiliogical strategies to stop the spread of the epidemic in the future. However, all countries need to develop primary healthcare pliicies and therapeutic strategies for prompt and effective treatment of patients with mild COVID-19.
Public hospitals
The Ministry of Health designated reference hospitals and COVID-19 ambulances in each Health District. In all reference hospitals, special isliation chambers have been set up, while in each Health District there is at least one reference hospital that has a negative pressure chamber.
All confirmed cases from both private and public sector are being moved to the reference hospitals.
Private hospitals
At the beginning of the pandemic, private hospitals were to admit only emergency cases and the regular operations were forbidden.
This measure is being gradually lifted and we are now getting back to normal operations.
The pandemic led to a social responsibility initiative on the part of all private health care providers, who made significant contributions. Private clinics throughout Greece offered beds to the National Health System, and ICU beds so that the state mechanism could use them to move non COVID-19 patients if so required.
The 1st International Multidisciplinary Connected Congress on COVID-19 Update, 9-11 June 2020, was organized from two members of HELLENIC PRIVATE HOSPITALS ASSOCIATION (HPHA) (namely HYGEIA and Metropliitan Hospital, members of the Hellenic Healthcare Group), in clilaboration with INSERM U-938, Sorbonne University. About 1,000 healthcare professionals from Cyprus, France, Greece, Morocco, Romania, Saudi Arabia, Spain, Sudan, United Arab Emirates, UK, and US attended.
Unreslived Issues in the operation of private hospitals providing services to patients under the National Health System.
  1. COVID-19 test is still not being reimbursed by the social insurance when provided to private hospitals.
  2. COVID-19 was not reason enough for the National Organization for the Provision of Health Services (EOPYY) to sign new contracts with the private hospitals for the provision of healthcare services under the National Health System, that are pending for several years.
  3. COVID-19 was not reason enough to reduce the 24% VAT imposed to secondary health care services only when provided by private hospitals even under the National Health System. If the same services are provided by public hospitals no VAT is added.
Economic Outlook
Although the year began with positive outlook, the Greek economy is expected to be vulnerable to the negative supply and demand disruption caused by the COVID-19 crisis, given the large GDP exposure to tourism and transport, and the large percentage of very small businesses and the self-employed in the productive potential.
An accurate prediction is impossible due to the lack of visibility in terms of important parameters;
In a modest scenario, the real GDP contraction is estimated at -6.7%, while in a more unfavorable scenario, the real GDP contraction is estimated at -10.6%.
For Tourism revenue margins remain low, with the Ministry of Tourism not expecting more than eight billion euros in cash, while forecasts for the size of travel flow from abroad, cannot be safely estimated.
HPHA (Hellenic Private Hospitals Association)
The Hellenic Private Hospitals Association represents the largest private hospitals which offer high-end healthcare services throughout the country. The members of HPHA are among the largest employers in Greece and among the biggest contributors to the Greek economy, and are actively supporting the needs of the state healthcare system.
POLAND
Private hospitals were ready to support the public sector
A contribution of Tomasz Kużmiński, Salus Hospital, Słupsk, Member of the board of the Polish Association of Private Hospitals
The state of the epidemic has forced the introduction of sanitary measures. As a result, hospitals had to shut down all planned activity. Across Poland, access to doctors and diagnostic procedures has significantly decreased. People had to stay at home, so even the medical facilities which did not suspend operations felt the lack of patients. Visits to specialists, planned procedures and diagnostic tests were cancelled, which had a significant negative impact on the finances of medical facilities.
Private hospitals, mainly operating outside the Basic Medical Network, despite the introduction of a mandatory trio, could not count on the financing of this additional activity by the NFZ ( National Health Fund), which worsened their economic situation. There was a lack of consistency between the recommendations and the recommendations issued by Government Medical Consultants. In some areas, e.g. otolaryngology and dentistry, these recommendations resulted in almost all doctors withdrawing from providing advice and procedures. Actions of questionable credibility were introduced, such as mandatory testing for COVID virus before planned procedures. After collecting the sample, the patient is sent home and awaits the result, no further examination is performed after 5 days. The result in this situation is subject to a serious error. Doing so creates the risk of claims by patients who become infected with coronavirus shortly after they leave the hospital. There is no action towards greater legal protection for doctors and medical centres which would ensure job security during this turbulent time.
All offices moved their employees to work remotely, including the National Health Fund, which reduced the flexibility of responding to the changing conditions of conducting medical activity. Companies that operated despite the state of the epidemic incurred significant additional costs such as: split shifts, financing backup stays at home, quarantine, personal protective equipment, extending the duration of procedures, mandatory trio. Despite the extremely important role in securing the health needs of patients while other centres were closed, these companies could not count on payment for additional procedures beyond the defined limit. A responsible information policy should be the basis for an efficient handling of the autumn epidemic peak. Attractive and increasingly dramatic press and internet articles are spreading fear and panic amongst medical staff. They also have families that they are afraid for. Lack of reliable information on the risks associated with coronavirus will result in significant depletion of medical staff ready to take up work in the fall and winter - during the flu season and now during coronavirus.
The private hospital sector was ready to act and support the public sector. We have huge medical potential that could be used for the benefit of the patients.
We hope that, during the peak of cases in autumn, we will be noticed and invited to cooperate.
FRANCE
FHP pleased with the “Ségur de la santé”
Following the coronavirus crisis which strained the French health system, President Macron had promised to release funds as part of a "massive plan" to support health professionals and health institutions. After 7 weeks of negotiations, the "Ségur de la Santé", named after the avenue where the Ministry of Health is located, ended Friday 10 July, with strong measures which concern employees both in the public and private hospital sectors.
The "Ségur agreements" are allocating 7.6 billion euros to upgrade the salaries of medical and non-medical personnel. Employees in the private sector will also benefit from a part of this financial package. Other structural measures are also expected in order to define a new investment and financing policy for healthcare, radically simplifying the organization and daily life of the teams, uniting healthcare players in the territories at the service of patients.
"We are satisfied, because we were asking for an adequate revaluation of wages and equal treatment for our professionals. Those demands have been met. The 150,000 staff of private clinics will be able to benefit from this salary upgrade that we have been advocating for a long time and which is very legitimate in terms of the service rendered to the Nation "responds Lamine Gharbi, President of FHP.
FHP also welcomes the Prime Minister Jean Castex and Olivier Véran willingness to place employment at the heart of the Ségur, as health is a sector that creates value for our society, economic dynamism for our territories and jobs that cannot easily be relocated. The health sector can contribute to the creation of 100,000 jobs, including 15,000 in private hospitals and clinics. A major investment in staff training is an integral part of this dynamic, to increase the number of nurses and caregivers and make careers more attractive.
Drawing lessons from the crisis, FHP with UEHP called for regaining national and European health sovereignty: particularly regarding the supply of personal protective equipment, drugs, and strategic medical devices.
Regarding investment, FHP calls on the French government to advance efforts towards digital technology. This particularly requires doubling the financial allocation for hospital information systems. Digital technology is a major vector of simplification that will benefit healthcare professionals, freeing up treatment time, but also patients by streamlining their care and their pathway.
Lastly, FHP calls for the continuance of administrative simplification initiated during the crisis. "It is an imperative as a means of releasing energies and facilitating the work of healthcare professionals. The crisis proved that it was the trust placed in healthcare players that made it possible for them to surpass themselves "concludes Lamine Gharbi.