Private hospitals are present in all European territories, even far from Brussels. European history explains why social progress and modern healthcare systems are widely diffused. We illustrate our full involvement in the islands, parts of our common interest to offer the best service to all patients. “The Azores, Madeira, the Canaries, the Balearics, Cyclades, and the French West Indies or La Réunion” are often seen as tourist “clichés”. But European citizens live here and the delivery of the best services remains the first goal for UEHP. Private Hospitals are the natural partner of sustainable healthcare systems, from North to South, East to West: quality is our first compass. We attach sunny postcard illustrating all our colleagues’ hard work to brighten up the cold Brussels winter!

The four storey hospital will also offer medical specialties that were not available on the archipelago so far. It will comprise more than 40 medical specialties and several surgical units.

Madeira is a very popular tourist destination, which weighted positively on the decision of HPA to expand to Madeira. Health standards expectations in Madeira are high because of the amount of foreign tourists. In the Algarve region, about 40 % of patients are foreigners. “At a time where public hospitals are lowering their investments in training, new technologies and medical innovations, the HPA group wants to counterbalance this with huge investments in order to match international standards.” With an investment amounting 35 million euros, the hospital covering 13 000 m2 will be completed by the end of 2017.

This project has been warmly welcomed by the Madeiran authorities, and the creation of 450 new jobs is expected.

http://www.grupohpa.com/pt/

Today, the incorporation of private hospitals into hospital groups has consolidated the private health sector in the Balearic Islands and groups like Quirónsalud or Vithas are now present on the islands. Moreover, the private health sector is now united under an umbrella organisation The Balearic Union of Health Entities (UBES), which has become a basic part of the Balearic health system, complementary to the public system. The private health infrastructure has experienced significant growth in the last few years due to the scarcity of public infrastructure and the increase in tourism: the main industry of the region.

Today, the incorporation of private hospitals into hospital groups has consolidated the private health sector in the Balearic Islands and groups like Quirónsalud or Vithas are now present on the islands. Moreover, the private health sector is now united under an umbrella organisation The Balearic Union of Health Entities (UBES), which has become a basic part of the Balearic health system, complementary to the public system. The private health infrastructure has experienced significant growth in the last few years due to the scarcity of public infrastructure and the increase in tourism: the main industry of the region.

In order to properly serve both residents and tourists, private hospitals are strategically distributed to cover the entire geography of the Islands and are complementary to public institutions. Local residents show great confidence in private hospitals and almost 300.000 people have private health insurance; 28% of the population. The private sector provides 46% of the medical treatment performed in the Balearics and 42% of emergency care.

It is the aim of the private sector in the Balearics to make its service sustainable by building on its strengths : high quality service, intensifying medical tourism by using the infrastructure, the cutting-edge technology and the professionalism of the 300 or so doctors and medical teams.

Initially offering surgery and obstetrics, the clinic has refocused its activity since 1995 on the basis of the evolution of the population, and maintains 15 beds for general medicine, 25 beds for immediate care, 30 beds for the dependent elderly people and a home care service in cooperation with the public hospital. "In 1994, the clinic was in receivership, we had to reorganise the business. For me, closing the facility was unthinkable, both for reasons of health and employment. Today we have 47 employees and general practitioners, who ensure continuous care. In the absence of specialists on the island, Guadeloupe's specialised practitioners ensure the provision of medical treatment here. Since 2012, we have been completing our offer with prevention and therapeutic patient education programmes on chronic diseases. In this frame, my sister Dr Maryse Etzol and our pluridisciplinary team including nurses, caregivers, a psychologist, a sophrologist, a dietician and a nutritionist, offer an holistic patient care approach. We even offer reading and writing workshops about disease, therapeutic cookery workshops and, why not tomorrow a Creole garden in order to use better the native pharmacopoeia of the island. 65% of our patients have very low incomes and benefit from universal health coverage that allows them to access quality health care. In addition, I work on a logistics platform project to increase our autonomy. To keep people on the island on the one hand and on the other to remain close to the people, we need to think more globally."

Regional health care regulations have pushed Sicilian private hospitals to adapt and to take a proactive role in the delivery of health care, as part of its public service mission. In 2002 the Sicilian region started a system efficiency program, which led to new accreditation requirements based also on quality for public and private structures. “Before, private hospitals were affiliated to integrate the productive capacity of public facilities in high-demand areas. Now the goal of the National Health Service is to respond to the welfare of the population, ensuring the supply of healthcare services including advanced and high-technology care, delivered by both public and private institutions.” Further regional health care regulations have led to structural and financial reforms and the private sector has had to react positively to reach the objectives.

The regional law on health care reform in 2009, which reaffirmed the principle of patient choice and the equal treatment between public and private structures through regulated and transparent integrated competition, has been a turning point in the history of the Sicilian private sector. “Today, private accredited hospitals are certainly more modern and adapted to the health needs of the citizens.”

Private hospitals account for 3% of the budget and provide around 15% of health care delivery, including all types of medical expertise with a flagship activity: orthopaedics. These figures are far below those in other Italian regions where private hospitals play a greater role.

Until a few months ago, Sardinia counted eleven local health authorities. Since the beginning of 2017, seven of them have merged under the umbrella organisation ATS, which effectively handles the greater part of the budget of the Sardinian health system -over three billion euros per year.

A positive aspect to highlight is that in 2011, AIOP signed a three-year framework agreement with the region. The content of this agreement has evolved over the years so that the present agreement defines in precise terms all issues regarding the organisation of the private health care sector on the Island.

In Sardinia, as in many other regions in Italian, politicians tend to favour the public sector by slowing down reforms and turn a blind eye to some of the dysfunctions of the local health care system, as they are more concerned with retaining popularity with their voters.

Fortunately, private hospitals in Sardinia do not suffer from the problems that plague the sector in other regions. After five years of existence, the ASL of Sardinia pays on time, according to contract terms.

Corfu and Chios benefit from a general clinic with several specialties, Rhodes has a well-organised general clinic and a dialysis unit. On Santorini, there is a small dialysis unit and in Crete, Heraklion and Chania, 12 regulated private clinics offer general care, obstetrical and psychiatric care. Private dialysis units offer high quality health services to Greek and foreign patients.

The small islands do not have a broad offer due to the low number of permanent residents during 8 months of the year.

Generally, patients have to be transported to bigger islands or to Athens in case of emergency or for specific care. Those patients have to deal with many obstacles: defective army and air force air transportation and ambulances, lack of equipment and physicians and delays, which cause the loss of human lives.

Both islanders and visitors face the same difficulties in dealing with health problems and emergency care due to the lack of infrastructure, which to some extent is reasonable given the large number of islands. The lack of doctors in most specialties is significant, as many refuse to leave for the small and remote islands.

In order to address the problem, a system combining well- equipped ambulances and a centrally controlled air transportation system with medically-equipped helicopters manned by doctors and nurses qualified in first aid, where patients would be transported to the nearest islands with organised units or hospitals in the nearest urban area should be put in place.

This would be the only effective way to save patients’ lives. The residents of the islands and especially those of the smaller ones deserve it.

The private healthcare group Clinifutur was born on the island of Reunion on the initiative of a doctor, Michel Deleflie, who arrived to practise there 50 years ago. A success story, which today represents 12 institutions. “The group acquired other private clinics of the island in the course of history and today we are indispensable to Réunion. At the Sainte Clotilde Clinic, the group and region biggest clinic, we welcome a third of so-called “serious” patients, the other two-thirds are borne by the CHU on two sites in the north and south of the island, says Luc Triboulet, Director of at the Sainte Clotilde Clinic. “In terms of oncology, we are the equivalent of a cancer treatment centre - the major French public cancer treatment centres - because we control the entire course of patient cancer treatment and care. We treat about 1,200 cancer patients per year."

Investments in heavy equipment are made regularly and the clinic has just acquired the first True Beam on La Réunion, this radiotherapy device of which there are only 50 pieces in France. "The state has subsidised us to the tune of € 1.5 million for the imaging equipment. In La Réunion, public hospitals and private clinics are collaborating according to specialties and geographic positions. We provide the good public service that is the mission of a hospital available to everyone, but with private status. The State equally recognises both sectors. About 40% of our patients have very low incomes and are able to benefit from the "universal medical coverage" that covers all their care at no cost."

Many medical evacuations are organised, however, and about 1,000 patients a year are sent to France for treatment. Conversely, for example, in oncology, the private institutions on the island receive about 150 patients a year from the nearby island of Mayotte. "In the Indian Ocean, health institutions in La Réunion are the best-developed structures, so that 5% of our patients are foreigners."

While Metropolitan France is facing difficulties recruiting doctors, on La Réunion, heliotropism is playing a full and active part. "We are fortunate because the climate and quality of life on the island attract doctors. Here, about 25% of practitioners are Creole, 50% from metropolitan France and 25% are foreigners of diverse origin, from Germany, Europe in general, Madagascar, Lebanon, etc. We have natural business growth due to the increasing and ageing population of 2 to 5% per year. The doctors who settle are certain to have a patient base, without having to compete with their colleagues."

The private healthcare group Clinifutur manages the 3 clinics on Réunion that provide medical treatment, surgery and obstetrics, 2 clinics offering care and rehabilitation, 2 dialysis centres and 2 dialysis centres on the island of Mayotte. The group was later developed in metropolitan France with the acquisition of 3 additional clinics.