UEHP Newsletter - December 15th, 2016  
  December 15th, 2016  
A full partner of change
On Monday, 28th November UEHP had the honour to be received by the EU Commissioner for Health & Food Safety, Vytenis Andriukaitis. In a very confident way we presented actions of UEHP, and discussed on major EU trends in Healthcare sector presented by the Commissioner.
This meeting confirms the UEHP position as major stakeholder in European Healthcare systems. Our voice is important. It is a first step for a long term Relationship with the European High Level administration and Policy makers, to express our specific position and be heard as full Partner of changes. UEHP is confident for the future, to offer the best service to all European Citizens, safe and cost-effective.
UEHP is active to support actions of private sector in EU and can diffuse important information presented by DG SANTE. Strategic views explained by Commissioner concern best practices to improve Member States Healthcare systems and reach cost effectiveness. Cooperation between sectors is required to increase efficiency and to assess sustainability of Health systems. The challenges are patient mobility, ageing, day care unit development, but new fields emerged as prevention of disease and promotion of healthy lifestyles.
Talking about the Implementation of the Directive 2011/24/UE on cross-border healthcare, the Commissioner encouraged UEHP in cooperation with national contact points and the European Reference Networks.
We presented the project of our next Conference in Lisbon, March 2017, supported by Portuguese Health Minister on European Patient mobility. As recently published by UEHP in the “Parliament Magazine” introducing the “Smart Hospital” concept, we confirmed our engagement to a modernization of hospitals improving quality and safety.
The great attention obtained during our discussion expresses the interest and consideration by the Commissioner to European Private Hospitals. We thank Vytenis Andriukaitis for this direct contact.
Dr Paul Garassus
President of the UEHP
"Greater flexibility, innovation, investment make private hospitals the key partners in times of budgetary restraint" says the title of the October issue of "Medico", the most important medical magazine in Portugal.

Ilaria Giannico, UEHP Secretary General, was invited by the Serbian Association of Private Hospitals to be a speaker on “European Healthcare systems and UEHP activities” during their General Assembly, held in Belgrade on 22nd October 2016. She had the opportunity to being introduced to all the assembly, building closer contacts and strengthening cooperation. She also encouraged other Balkan countries to follow the example of the Serbian association and to become members of UEHP, making their voice heard at EU level.

Ilaria Giannico, UEHP Secretary General, was invited by the Austrian Association of Private Hospitals to visit the Association’s headquarters in Wien and to be a speaker on “European Healthcare systems and UEHP activities” during their General Assembly, held in Salzburg on 11th November 2016.
The Austrian Association of Private Hospitals also organised a visit of the Klinikum Bad Hall, one of the most innovative and modern Centre for Rehabilitation in Austria. LINK
She also had the opportunity to visit Privatklinik Wehrle-Diakonissen, Standort Aigen, which hosted the General Assembly. LINK
This month, we return to the presentation made in Monaco by Angela Blanco, Policy Analysis at EU DG Health
Angela Blanco, Policy Analyst-Health Systems EU DG Santé, reported about the results of the Study on Cost of Unsafe Care and Cost-effectiveness of Patient Safety Programmes. The aim of the project is to provide evidence with a comprehensive picture of the financial impact of poor patient safety and cost-effectiveness of patient safety programmes in the EU, in response to adverse and to give some recommendations.
The burden resulting from adverse events is not negligible. The simulation model estimates EU-wide savings up to EUR 300 million for a programme to reduce several healthcare-associated infections; about EUR 2 billion for a programme to reduce pressure ulcers; about EUR 6 billion for implementing an electronic medication ordering system.
Economic assessments of patient safety initiatives face a few challenges : the definition of costs and the low number and high variability in published figures on prevalence and costs of adverse events.
For performing reliable economic burden studies and cost-effectiveness analyses in patient safety, it is essential to systematically collect data on patient safety related incidents and obtain reliable cost figures for these adverse events in European countries. For countries where such studies have not yet been performed, a standardized system for periodic reporting of adverse events would be helpful, as well as a standardized system for all countries. Many European countries still have difficulties with finding an adequate and reliable data collection model.
The Spanish largest private hospital group Quironsalud has been acquired by the German group Fresenius Helios, the largest private hospital group in Germany, for an amount of 5,760 million Euro in September 2016. Quironsalud represents 43 hospitals, 39 outpacient centers, more than 300 Occupational Risk Prevention Centers, 35,000 employees and a revenue over 2,500 million Euro. Quironsalud is the product of the merger of IDC Salud and Grupo Hospitalario Quirón in 2014. Quironsalud is also a pioneer in public-private-partnership models with five hospitals in Madrid and Barcelona integrated within the public healthcare network, receiving remuneration based on performed activity. Fresenius and Quironsalud will impulse best-practice transfer to enhance quality of patient care in both markets and become a European leader in hospital management. With the purchase of Quironsalud by Fresenius Helios, the first private European Group was born.
The European file on 'reasonable profit' imposed on services of general economic interest (SGEI), which include health facilities is a cause of particularly concern to the Federation of Private Hospitals in Paris. Indeed, the French State has decided to take advantage of the implementation of its legislation to modernise the health system in order to 'get itself' immediately in line with European legislation. The legislation governing 'reasonable profit' for health facilities is expected to be published before the end of the year. “This file is one of our main concerns. It is typical of the type of file on which we wish to work with other European private hospitalisation federations and the UEHP because it concerns us all and we have the same negotiating partner, the European Commission”, says Elisabeth Tomé-Gertheinrichs, Executive Director of the FHP.

Earthquake: Italian private clinics show solidarity

As a result of the devastating earthquake that struck central Italy at the end of October, Aiop Lazio, representing 106 clinics, was activated in order to provide quick assistance to populations affected by the earthquake.
Thanks to the mobilisation of all members in the Lazio region, first aid articles were distributed: Anti-inflammatory medicines, sterile compresses, bandages, plasters, disinfectants, disposable latex gloves, physiological solutions and sanitary items, sleeping bags, blankets, etc.
"Aiop Lazio wants to support local institutions and citizens in this time of extreme emergency, as well as during the reconstruction phase to come", explained President, Jessica Veronica Faroni.

Telemedicine in Europe
Many health systems in Europe want to use electronic patient records to provide telemedicine for the benefit of patients with chronic diseases.
The patient electronic health card ELGA introduced in Austria in December 2015 includes patient electronic health record. Hospitals are now connected to the network, followed by city doctors in 2017. The goal is then to integrate remote monitoring applications into the IT infrastructure. Thus, Austrian physicians will be able to keep track of their patients through a single, secured platform (e.g. blood sugar monitoring etc.) and patients will be able to use their patient records to transfer their data. For this a unique telemonitoring platform is necessary. Emphasis is initially placed on three indications: diabetes, heart failure and implant monitoring. Chronic lung disease should follow.
Measuring instruments, applications and devices used must also be compatible with the IT infrastructure. Austria is counting on the standards of the international organisation Continua. Many manufacturers use other standards, which poses a problem of compatibility of the devices and medical equipment with the platform.
Since 2010, Sweden has used a system very similar to that of the Austrians, and these two countries, as well as other Scandinavian countries are cooperating closely. In Sweden, electronic patient records are maintained at a national level, able to manage all the telemedicine operations and remote monitoring data. At a European level, Sweden is a pioneer in terms of the latter. With 10 million people, about 400 million digital transactions, mainly administrative patient data are exchanged each year on the platform. The next step is to use this platform for telemonitoring and video-conferencing in teletherapy. The Swedes face the same difficulties as the Austrians with respect to compatibility of standards and equipment and are putting pressure on the supervisory authorities to make Continua the standard reference.

Clinic St-Pierre, Perpignan
28 July 2016, the medical team at the Clinic St. Pierre in Perpignan has implanted the first leadless intracardiac pacemaker
With a size of less than one-tenth of that of conventional pacemakers, the Micra GST device is the smallest pacemaker in the world, designed to provide patients with bradycardia stimulation using the most advanced technology. It is small enough to be introduced into the venous network using invasive catheterisation techniques and to be implanted directly into the heart. It offers the aesthetic advantage of invisibility. Designed primarily to stimulate only the ventricles, this device brings the added advantage of being leadless, which obviates the need for a subcutaneous pocket for the medical device. It is also compatible with other systems, as well as with 1.5 and 3 Tesla MRI. The complications inherent to the lead are also avoided: problems with infection, failure and erosion of the system, moving, haematomas requiring surgery, etc. It is estimated that of the whole population eligible for implantation of a pacemaker, 15 to 20% of patients require single-chamber stimulation.
In the age of the collapse of healthcare
The situation in healthcare services today is sadly utterly dramatic in the literary sense of the world.
All of us have paid a visit to a state hospital lately and we have born witness to the delays for several hours for a medical examination in the departments; to the inability to perform diagnostic examinations as a result of malfunctions in the medical equipment due to the financial incompetence to perform the required maintenance services; to the outrageous waiting lists for a surgical operation the delay of which may prove to be a fatal one and, of course, to the shortages in healthcare expendables, surgical equipment, medication as well as clothing and personal care items; to instances of hospitalization in truckle beds without sheets, pillows and cleaning items.
Unfortunately, the inclusion of the healthcare system expenses in the obligations for the limitation of the expenses prescribed in the Memoranda, instead of leading us to radical reforms in the field of healthcare services, with reductions in the operational costs that can emerge out of merges of clinics and neighbouring hospitals with scarce occupancies, out of mobility of medical staff and medics and merges of diagnostic laboratories, out of common supply orders and a rationalization of the operational costs, we have been letting healthcare to collapse day-by-day, with patients who, due to their financial impotence, are not able to turn to the private sector and with an EOPYY [National Organization for the Provision of Healthcare Services] that provides funds only when it wants to, only as much as it wants to and only if it wants to!!!!!
It is at this point that the private sector is called to display its social sensitivity.
It has lately become both our duty and our obligation to provide increased health services, by substituting for and complementing basic operational structures of the NHS [National Health System], by securing the equality of access to quality treatment, by increasing the system’s efficiency through the provision of high quality services on the basis of the international standards, without waiting lists, with the use of the new technologies and of the e-health services, with the huge potentials that they provide us with and which constantly develop, and by adjusting ourselves to the constant progress of the medical science, medical technology, the new treatments and the revolutions of informatics.
At the dawn of the new age in all developed countries, which will be delayed however in Greece as long as it is regulated by the Memoranda, we will soon start talking about ‘smart hospitals’. As for our part in this state, we welcome and we will strive to be the driving force in this huge change in services. This is a grave challenge; the challenge of the future.
Health is a public good and the free choice of physician and infirmary is a right for each patient, irrespectively of the property status of the hospital to which he/she turns in order to recover his/her health.
The life expectancy is on the increase; the ageing of a population is a matter of fact; The occurrence of new diseases calls for innovative and at the same time precise diagnostic examinations, medication and treatment methods, whereas at the same time again the workforce that contributes to the income of the insurance funds is constantly on the decrease. The financial balance of the social insurance is negative and will remain so in the future as well. In the mid-term, however, state investments to healthcare will yield beneficial financial results with an active population that is healthy and integrated to the production and developmental process.
It is needless to say that securing decent health services for all citizens in collaboration with the private sector in the areas in which the Public Sector is handicapped, is an obligation of the state, via the persons that happen to govern each time, which should nonetheless cover the health expenses that we offer selflessly without imposing mandatory and anti-democratic cuts and curtails at the level in which the state itself has agreed but does not stick to its promise, and by readjusting healthcare expenses, by dividing them between the public and the private sector not on the basis of ideological bias but based instead on the patients’ choices and real needs.
Ideologically biased policies will mean the end of the private sector, which fights to make for a living on a day-to-day basis.
A healthcare system with no private sector, with no private clinics or diagnostic laboratories and with the complete malfunctioning at the same time of the public sector in 1st grade and 2nd grade healthcare will mean healthcare services of Third-World levels in terms of health provisions and survival in life for the few who can cover the required expenses for their hospitalization through private funds.
Greece at large and the Greeks in particular deserve qualitative, safe, efficient health services, without discriminations, with free access to new technologies and therapies as suit to a proud civilised people of a modern European country, the birthplace of culture as well as of Hippocrates.
Panhellenic Union of Private Hospitals
Grigoris Sarafianos, President
19 december 2016
UEHP Board Meeting