UEHP Newsletter - March 8th, 2017  
  March 8th, 2017  
International Women’s Day
UEHP Ladies first!
Gender equality for the present and the future
The UEHP Newsletter #6 is written by women. Cristina Contel Vice President of UEHP and President of the Spanish Private Hospital Federation, ASPE, is coordinating this issue. We propose to demonstrate respect for gender equality in our own organisation and to support the full implications of women at the head of major private federations in the healthcare sector. In Spain, Germany, Italy, Bulgaria and France, all succeed as team management leaders and promoters of human values. In this March edition of the UEHP newsletter, inspired by International Women's Day, which is celebrated on March 8 each year, we would like to highlight the place of female healthcare professionals and healthcare institution managers in Europe. How does gender equality and equity look in your country? We have asked the Presidents and female General Secretaries of private hospital federations to tackle the question.
Dr Paul Garassus
President of the UEHP
On 1st March, llaria Giannico, Secretary General of UEHP, spoke at the conference “Exploring areas and benefits of cooperation in cross-border healthcare to protect patients’rights”, organised by Active Citizenship Network and the EP Interest Group "European Patients' Rights & Cross-Border Healthcare", at the European Parliament in Brussels.
Active Citizenship Network, the European branch of Cittadinanzattiva, is an italian ONLUS working on health, patients' rights, civic participation, workers’ rights and education.
The conference was a concrete opportunity to debate for civic, patient and healthcare providers associations from different Member States, experts in the field of civil rights, Institutional representatives from the European Parliament and the European Commission, the National Contact Points and several stakeholders at EU level.
The panellists and the participants discussed about the necessity and benefits of fostering cooperation among Institutions, patients and care providers organizations, National Contact Points and the European Reference Networks to improve patients’ awareness and access to care abroad. They also explored ways of doing it practically, thanks to the presentation of case histories, experiences, good practices of efficient cross-border cooperation between some Member States.
UEHP presented its position on the Directive 2011/24/EU on cross border healthcare, as well as some real experiences coming from UEHP hospitals in different countries dealing with European patients.
All the stakeholders agreed on the need of developing a structured and harmonised communication to patients and care providers, of fostering cooperation and integration in healthcare to exploit the full potential of the Directive and help Member States and EU Institutions in the implementation of the Directive at National Level.

UEHP signed a cooperation agreement with Luxatia International, as supporting partner of the Healthcare Workforce Planning Summit that will take place on 18-19 May, 2017 in Berlin, Germany.
The healthcare systems are facing significant challenges, including an ageing population and an ageing health workforce; and an increased demand for health services with higher numbers of people requiring complex and long-term care.
With that in mind, the Healthcare Workforce Planning summit has been specifically designed to address these challenges. In addition to the individual presentations, the Summit will also provide an active networking platform for the participants to gather together and discuss about the future projections and the risks and potential behind new ideas. The purpose of the event is to create a perfect atmosphere conducive to developing strategies for future success and achieving real results.
UEHP members can benefit from a discount on the registration fees! For more information please contact Ms Ilaria Giannico, UEHP Secretary General, at: secretarygeneral@uehp.org.


Ilaria Giannico, UEHP Secretary General
The 8th of March – International Women’s Day – reminds us of women’s struggle for their economic, political and social rights in all areas. But what is the situation at the heart of Europe?
Certainly, the presence of women in positions of power in the Brussels’ “Eurobubble” is unequal! The leaders of the main political groups in the European Parliament, the heads of their cabinets and the three Presidents of the EU Institutions - the Commission, the Parliament and the Council — are all men. From a recent study of POLITICO, we see that women represent less than one-third of the College of Commissioners and one-seventh of the Council. Moreover, only 6 out of 28 Member States in EU have a female permanent representative, only 8 out of 40 Directors General of the European Commission are women and only 16 female Deputy Directors General out of 53.
Instead, the picture is different when it comes to the private sector in Brussels: the same study of POLITICO shows that 8 of the most influencial lobbying firms as well as the most active and powerful NGOs in Brussels are run by women.
This difference between the two sectors suggests that women are given more opportunities in the private sector where success is measured by projects presented, objectives reached and results delivered, or in the young and dynamic NGO sector, which is often in contrast to the conservative and old world of diplomacy.
Still, we notice a positive shift in attitudes and numbers inside the EU institutions: during most of the 1970s and 1980s, women were usually relegated to secretarial roles without any possibility to climb to top positions.
UEHP seems to be perfeclty aligned with this shift in paradigm, having recently welcomed its new female Secretary General. Also, UEHP has a female Vice-President and 2 female members of the Board out of 8.
If the EU has been a positive force for gender balance, we must recognise that gender equality remains a work in progress. A strong political will and commitment, as well as targeted measures are needed if we really want to tackle gender inequalities from the core and reach a full deployement of women’s talents within the EU.

To apply gender equality and diversity criteria is beneficial for companies
Cristina Contel, President of the Alianza de la Sanidad Privada Espanola
In Spain, women are getting more prepared and they tend to be in the majority in universities, but a few really manage to reach important management positions. In addition, the average remuneration of Spanish women was 18.8% lower than that of men in 2014 (Eurostat). We still have a problem related to the integration of professional and family life, since it is still women who normally take longer periods of parental leave and are generally those who are more involved in childcare.
They put aside their careers in favour of raising children more often than men. In this sense, the health professions imply long working days and schedules that are difficult to combine with family life.

It is necessary for private companies and the government to see the need to create a working and institutional environment where the distribution of power reflects society, one in which half of the population is under-represented despite their verified qualifications, preparation and willingness. Only in this way will it be possible for women not to feel compelled to choose between reaching the highest positions and developing a full personal and family life.
In addition, companies must realise that it is beneficial for their companies to apply criteria of gender equality and diversity at all levels of the organisation chart.

Is your current Health Minister a man or a woman?
Currently, the Spanish Minister of Health is a woman: Dolors Montserrat. Since 2000 we have had 6 female Health Ministers and 2 male Health Ministers in Spain. Curiously, the Ministry of Health has been led by women but this does not mean that there is greater female representation, given that in the current government of the 14 ministries only 4 are headed by women.
What is the percentage of women achieving their medical degree in your country each year?
According to the National Statistical Institute of Spain, in 2015 the female presence was very high in almost all professions analysed: doctors 49.1%, dentists 54.5%, nurses 84.2%, nutritionists, dietitians 88.4%, psychologists 81.7%, physiotherapists 66.8%,…
According to data from the Ministry of Health concerning the 2016-2017 call for specialised health training, 75% of the applicants were women, 63% in the case of tests for doctors.
Do you know the percentage of female doctors working in private hospitals in your country?
We don´t have that information for private hospitals.
Do you know the percentage of female directors of private hospitals in your country?
We don´t have sectoral data but the percentage of female managers in Spain is 31%, below the EU average (33%). Although we do not have specific data, we can say that hospitals, both public and private, are still mostly run by men in Spain.
Are there initiatives for male/female equality in the health sector in your country?
In Spain, the Ministry of Health, Social Services and Equality has developed a network of companies with a distinctive "Equality in Business" (DIE Network). Currently this network is composed of 127 companies from all sectors, among which are laboratories such as Janssen or MSD, insurers and clinics such as the Institut Catala d’Oncología.
Could you indicate the name of a female doctor, female researcher, female director of a private clinic or a great public hospital in your country, who is a striking person for you? Why have you chosen this person?
Margarita Salas, born in 1938, is one of the most brilliant Spanish biochemists. She was a disciple of Severo Ochoa and has excelled in promoting Spanish research in the field of biochemistry and molecular biology. She is a really amazing and admirable person, not only because of her awards and achievements, but because she was able to excel at a time when it was almost impossible for women to access specialist training and to participate in scientific research.

In the short to medium term, there will be an increase of females in top level managing positions in healthcare
Alberta Sciachi, International affairs office AIOP, President of UEHP General Assembly
In Italy, the analysis of the distribution by gender of the staff working in the health care sector reveals that 65% are women: 66% in the delivery of care positions and 71% in the administrative sector. It also shows a clear predominance of female staff in rehabilitation areas (82%) with 78% of female nurses. 35.6% of doctors are female, a significant percentage that also includes activities traditionally reserved to men, such as surgery.
The increase of women in recent years has been steady and transversal, embracing all categories in the health sector. With regard to executive positions, however, the presence of women has increased over the years by only a few percentage points.

This evolution is also dependent on the fact that women need to optimise the hours dedicated to each of the different roles they play in life, as well as requiring external help (families, nannies, cleaners , etc.), education facilities (kindergartens, schools) and residential facilities, when dealing with elderly or disabled people.
It should also be noted that, if most female doctors can afford such help due to higher average wages, other female professionals such as nurses and paramedics face less advantageous socio-economic situations, which limit such access.
In the field of nursing, then, although women are in the majority, executive positions are mainly held by men, due to the fact that women’s careers are to a greater degree negatively impacted by parental-time and work-time management. The gap between women’s and men's presence in management positions is mainly due to reasons of availability of time. The lack of services and the family dynamics mean that women often have to choose between family and career.
We also have to bear in mind that it takes around fifteen to twenty years of experience for a person to reach a top position in the field in which he/she works. Women have not yet achieved this level of experience because they only recently entered the healthcare sector serving in key roles. Therefore, it is reasonable to predict, in the short to medium term, an increase of females in top level managing positions in healthcare.
What are the specific contributions of women in the workplace and, in particular, in the health sector? Women can contribute significantly in terms of organisation and management skills, efficiency and effectiveness of processes due to their habit to deal in parallel with several functions. This predisposition is expressed above all in the overview, in the creation of networks of relationships, in rapidity of reaction and mediation skills that encourage teamwork.
A key aspect is the humanity, which is expressed in the patient's central role in the continuity of care; empathy, an essential quality in a medical world where more and more, family members must be involved in the relationship with the nursing staff and in communication with patients. In a survey launched by the Ministry of Health a few years ago, the majority of respondents claimed that women in healthcare should not follow the typical male behaviour patterns, but use their own specific characteristics such as tenacity, intuition and relationship skills.

Female doctors are in minority
Tsvetelina Spiridonova, MD, PhD, University Hospital, Sofia

Is your current Health Minister a man or a woman?
Our current Health Minister is a man, M Semerdzhiev. The previous one was a woman.
What is the percentage of women achieving their medical degree in your country each year?
We had 8-10% of female doctors achieving their medical degree in 2014, according to national statistics.
Do you know the percentage of female doctors working in private hospitals in your country?
Do you know the percentage of female directors working in private hospitals in your country?
Are there initiatives for male/female equality in the health sector in your country?
No initiative in this direction.
Could you indicate the name of a female doctor, female researcher, female director of a private clinic or a great public hospital in your country, who is a striking person for you?
The biggest private hospital in Bulgaria has been taken over by a Turkish company Adzhebadem, whose General Manager is a woman, Venelina Mileva, MD. She is from Varna, the third largest city in Bulgaria and the largest city and seaside resort on the Bulgarian Black Sea Coast.
One of our great and inspiring women in the medical field in Bulgaria is Professor Violeta Dimeitrova, surgeon and head of the surgical department of the University Hospital Alexandrovska in Sofia. She is a person with exceptional qualities.

We must collectively be bold and innovative in our recruitment options!
Élisabeth Tomé-Gertheinrichs, FHP Secretary General (French Federation of Private Hospitals) Béatrice Noellec, Director of societal and institutional watch, FHP

The observation made in the field of health is widely shared by society as a whole, including in sectors dominated by female workers, that the positions of responsibility and leadership roles are predominantly held by men. However, the situation is evolving in the private hospital sector, thanks to a number of catalysts: continuing education policies that permit positive professional development, and expansion of the recruiting pools for leadership positions. We must collectively be bold and innovative in our recruitment options!
These initiatives serving the professional advancement of women benefit everyone. Two changes should be conducted in a complementary manner: first, bringing men into the caring professions, where they are today largely under-represented, and secondly, enabling women to explore unhindered all those career opportunities in our industry to which they are entitled. This requires a real shift in perception – we’re working on it!
Female doctors are likely to become the majority within a few years because of the high proportion of women studying medicine. But also, without a doubt, remaining stereotypes still need to be overcome in the choice of specialities; not just paediatrics and gynaecology, but anaesthesia or surgery too... Also some clichés about female physicians working less , having harder lives: in reality, it is an entire generation, men and women alike, that aspires to reconcile harmoniously their private and professional lives. We must take these new aspirations into account in our private health care facilities, and offer our physicians the best framework for practice. It is, of course, our constant concern, in which lies the strength and the specificity of our model.

The place of women remains essential to express gender equality
Ségolène Benhamou, President of FHP-MCO (French Federation of Private Acute Care Hospitals) and President of Cercle Simone, association of female health facility managers
Ségolène Benhamou, President of the French Federation of Private Acute Care Hospitals, is also the head of a major healthcare partner in France: "My work is dedicated to the national healthcare sector, but I am also the Managing Director of the North Paris Private Hospital (HPNP) in Sarcelles. In the suburbs, the place of women remains essential to express gender equality. We are involved in sustainable development, respect of human beings and secularism. I fully support the UEHP initiative for International Women's Day!"

Training health care staff in caring for female victims of violence
Le Cercle Simone, an association of female health facility managers in France, has entered into a partnership with the organisation Gynaecologists without Borders (GSF), on a common project to launch a campaign in 2017 for training nurses in detecting violence against women. "Maternity and emergency services staff will be involved." It is not only in the last decade that the medical profession has become aware of violence against women. There used to be silence... While tremendous progress has been made, much work remains to be done. First of all, the emergency services must correctly assess and complete the paperwork appropriately. Legal action will depend on it. Then every facility should have a trained 'violence' specialist. Not everyone has the knowledge or the time to advise on action when violence has been diagnosed. Finally, in maternity wards, during pregnancy interviews, we must always ask the question, "have you experienced violence? "Violence transforms a normal pregnancy into a pathological pregnancy" explains Dr Claude Rosenthal, gynaecologist and President of Gynaecologists without Borders (GSF).

Women often do not trust themselves enough and underestimate their abilities
Since January 2016, large companies in Germany have committed themselves to appoint at least 30% of women to their supervisory boards. This rule does not apply to hospitals and universities, and one notices it: in the top healthcare positions, men are clearly at the forefront.
Currently 60% of medical students are women. Despite this, only 31% of specialist registrars (SpR) (Oberarzt) are female and 10% are consultants (Chefarzt). In medical faculties the number of women is even lower. However, it is clear that medicine is becoming more feminine and this development is forcing hospitals and universities to rethink. The lack of doctors in general can also be seen as an opportunity for women to access leadership positions.
According to a study published in January 2016 by PricewaterhouseCoopers, one in three leadership positions in healthcare is held by a woman. This ratio of 33 percent corresponds exactly to the average in the economy as a whole. According to Sevilay Huesman-Koecke, Senior Manager at PwC : “In view of the relatively high employment rate of women in this area, they are completely underrepresented. In top management, the situation is even more dramatic: there are only 15% women. There are certain fields in which women are often found in charge: these include the press, advertising and marketing. In scientific institutes, 69% of the executives are female, 58% in clinics. Another example is human resources in pharmaceutical companies with 55% female executives. In hospitals, women are strongly represented in the nursing and surgical and quality management fields. Their share is well over 60%.”(1)
“Women often do not trust themselves enough and underestimate their abilities. The potential is definitely there, only more women have to insist on their wishes and goals. Men tend to negotiate. Women should set an example and consciously work on their qualifications”, says Prof Dr Gabriele Kaczmarczyk, Vice President of the German Women Doctors’ Association (Deutscher Ärztinnenbund e.V. / DÄB), a network of women doctors and dentists from all areas of specialisation and activity.(2) Prof Dr Gabriele Kaczmarczyk is also co-founder of ProQuote Medizin(3), which demands that at least 40% of management positions in medicine be filled with women by 2018, on all hierarchical levels.
The Healthcare Frauen e.V. association is another platform, whose aim is to promote women in management positions in healthcare. One of its goals is to place the next generation of female protagonists and strong decision-makers in the market by networking experienced women from different disciplines of the healthcare industry, organising mentoring programmes, seminars, lectures, etc.
10 March
UEHP General Assembly
3-5 May
Healthio 2017
10-12 May
eHealth Week 2017
18-19 May
Health Workforce Planning Summit