EY is partner of the 2025 Edition of the UEHP Factbook.
Private hospitals have become a structural pillar of European health systems, not a side player. Across the EU, hospitals already absorb roughly a third of all health spending and almost two-fifths of national health budgets, so the way hospital care is organised is central to the sustainability of welfare states. At the same time, ageing populations, the growing burden of NCDs (notably cardiovascular disease and cancer), persistent regional inequalities and post-COVID backlogs are putting huge pressure on capacity and finances. The UEHP Factbook 2025 on its own it a good example of the contribution of private hospitals, to get and share information to allow reflection and progress. This edition shows that nearly one quarter of Europe’s hospital capacity is now in the private for-profit sector, and that non-public providers collectively account for around 40–42% of beds in many countries, meaning that no realistic strategy for access, quality or cost-control can ignore private hospitals. Because private hospitals receive no subsidies and must balance medical responsibility with economic performance, they are natural laboratories for Value-Based Healthcare (VBHC), digital innovation and new partnership models with public payers and insurers. In this context, the contribution of private hospitals – through investment, flexibility and participation in EU initiatives such as the European Health Data Space (EHDS) – is essential to keep national health systems both solvent and responsive.
What do the figures and trends in the UEHP Factbook tell us about the transformation of healthcare systems in Europe?
The first thing that figures show is that all countries have a different reality and all need to adapt to its own idiosyncrasies.
They also show that European health systems have shifted from almost exclusively public hospital provision to a mixed landscape where public, private non-profit and private for-profit hospitals all play structural roles. Over the last two decades, the share of for-profit hospital beds has grown steadily and in several large countries private providers now hold a substantial part of acute capacity, while hospitals as a whole still absorb the largest share of health spending. This indicates that hospital care remains central to health budgets, but is increasingly delivered by a plurality of actors under public regulation and mandatory insurance schemes.
At the same time, the data on bed numbers, length of stay and activity point to a deep transformation in how hospital care is delivered. Most countries have reduced bed density while increasing the use of day surgery and shorter, more technical stays, with fewer unnecessary days in hospital and more activity flowing through ambulatory and intermediate care. This goes hand in hand with a growing hospital workforce and rising hospital expenditure per capita, but also with strong pressure to control spending growth and to redesign care pathways rather than simply expanding bed stock.
The Factbook also highlights workforce strain, territorial inequalities and the rising burden of chronic, non-communicable diseases, alongside the relative underfunding of prevention. Together, these trends suggest that Europe is moving from bed-centric, state-run hospital systems to more networked, pathway-centric systems where multiple providers are coordinated, data and outcomes become central, and both financing and governance have to adapt. In that new configuration, private hospitals are not marginal add-ons but embedded components of national strategies for access, quality and sustainability.
How can private hospitalization in Europe best address the key challenges (financial pressure, HR shortages, digital innovation…)?
First, private hospitals can support financial sustainability by acting as engines of efficiency and value. Operating without direct subsidies, they are used to strict budget constraints and can pioneer value-based contracts that reward outcomes rather than volume, such as bundled payments and risk-sharing around quality and readmissions. They also mobilize private capital for modern infrastructure, equipment and digital systems through direct investment and PPPs, allowing public authorities to upgrade capacity without bearing all the upfront costs. By standardizing processes, expanding day surgery and optimizing bed use, private providers can help reduce waste in the most expensive part of the system while offering additional capacity to cut waiting times.
Second, they can be part of the answer to chronic HR shortages and changing workforce expectations. Private hospitals have some room to innovate in human resources, for example by designing more flexible schedules, clearer career paths, performance-linked incentives and team-based organisation that make hospital work more attractive. They can invest heavily in continuous training, new professional roles and leadership development, helping to retain staff and reduce reliance on temporary agency workers that drive costs up and fragment care. In doing so, they not only stabilize their own workforce but also generate models that can be adopted or adapted by the wider health system.
Third, private hospitals are well placed to drive digital innovation and help tackle NCDs and prevention in a more integrated way. As early adopters of electronic records, telemedicine, AI-assisted diagnostics and remote monitoring, they can demonstrate how digital tools improve safety, efficiency and patient experience, and feed rich data into national infrastructures and the European Health Data Space. This, in turn, enables better benchmarking and value-based purchasing across all providers. With strong technical platforms, private hospitals can also anchor multidisciplinary programs for chronic diseases and screening, linking hospital episodes with follow-up, rehabilitation and prevention in cooperation with primary care and insurers. Under clear regulation, long-term contracts and data-driven, VBHC-oriented incentives, private hospitalization becomes a key lever to respond to financial pressure, workforce shortages and the digital transition while supporting universal access and better long-term outcomes.
Brussels, 19 November 2025: MEP Bugalho hosts the presentation of the new edition of our Factbook, at the European Parliament.
