May 23rd, 2017  
A green and sustainable future
UEHP is resolutely focused on the future. We are committed to "Smart Hospitals", quality for the patient, free access for European citizens, but also to the respect of the environment.
Sustainable development is a priority: all managers and health professionals should be encouraged to follow these principles, respectful of the present and the future. The issues are many: building construction, control of flows, potentially toxic waste, waste sorting (as evidenced by our participation in the European Waste Management programme), but also the conditioning and distribution circuit of health products.
The coordination of all stakeholders is the key to success. In Brussels, this ambition is shared by many of our interlocutors. But it is clear that nothing can be done without our participation: it is the stakeholders in the field who can guarantee the practical success of Community principles. We are a concrete Europe, one of achievements!
Private hospitals are a support for these programmes - so many professionals dedicate themselves to sustainable development and to respecting the environment in our institutions - but they also contribute to the dissemination of these achievements. We are the relay of these European skills which go beyond borders, enriching each other through the exchange of relevant solutions.
Sustainability includes long term engagement not only for ecology but for economy too, with relevant managerial solutions. A new European society is on the move, mixing human being responsibility and organisation performance.
This Newsletter is merely a brief summary of experiences in some Member States for the benefit of all. Our place is once again to be the "broker" of information for a real and concrete Europe, one of action and success at the service of the environment
Dr Paul Garassus
President of UEHP
On the occasion of the General Assembly of the European Union of Private Hospitals (UEHP) recently held in Lisbon, the opportunity arose to set an interview with the President of UEHP, Dr. Paul Garassus, by the journal of the Portuguese Order of Physicians.
For its timeness, relevance and depth, Dr. Garassus's interview is an interesting read for all of us. From the analysis of health systems to failures in the organization of health services, from the articulation between public and private to the existing constraints in regards to the development of private initiative, from new technological trends to health literacy and information to patients, from incentives to the actors of the industry to the management of health establishments, Dr. Garassus' reflections are interesting in their content but also in the way they position the private hospital sector. In this context, I dare say that it is quite significant that this interview has been given to the Order of Physicians and that it deserved first-page honours.
Without wanting to summarize the words of Dr. Garassus, I believe that one of the most significant answers is that "Private health establishments are under huge pressure to provide quality of care and patient safety. That is the only goal which moves us. What can we do in competitive terms? Always work - between managers and the medical team - to be among the best in terms of quality of care and relationship with the patient, but also in terms of training, certification and, of course, connection with specialists from other areas (Physical and Rehabilitation Medicine, general and family medicine, etc.). Success in a private hospital can be expressed in three words: quality, quality and quality!"
Author: Oscar Gaspar, President of APHP - Associação Portuguesa de Hospitalização Privada
Private hospitals discovering the latest innovations in healthcare
From l. to r.: Dr Lluis Monset, Dr Josep Ignasi Hornos, Cristina Contel, Ilaria Giannico, Ariadna Contel.
UEHP and ASPE (Alianza de la Sanidad Privada Española) participated to the HEALTHIO conference and exhibition, held in Barcelona on 3-5 May 2017.
This first edition of HEALTHIO was a platform for meetings and discussions where patients, citizens, health professionals and companies can explore and try the latest innovations in healthcare.
The conference was opened by Antoni Comin (Ministry of Health, Catalonia), Xavier Prats Monné (Director-General, European Commission’s DG for Health and Food Safety) and Jordi Serrano (HEALTHIO Co-founder).
The event featured innovative solutions to today's health needs, particularly focusing on : well-being, personalised medicine, chronic diseases and active ageing. For each of these four categories, a special itinerary was created for participants to follow different routes with many interactive activities and have practical demonstration zones. Also, the latest innovations in genomics, wearables, digital health, robotics, medical devices and 3D bio-printing were presented during the event.
The totally innovative format of HEALTHIO, compared to other healthcare trade shows, resulted to be successful: the conference saw a great participation, where patients and citizens, doctors, nurses and other healthcare professionals got first-hand knowledge of the latest medical developments and start-ups and companies introduced their new products, technologies and ideas for improving patients’ and citizens’ health.
In addition, there was an insight into the hospitals and healthcare of the future and it was possible for the participants to witness live surgical interventions through web streaming.
HEALTHIO definitely rounded off its offering facilitating knowledge-sharing and fostering business relationships in healthcare.
For more information about HEALTHIO, please visit: http://www.healthio-global.com and YouTube channel.
Data for Health: the key to personalised sustainable care
UEHP participated as supporting partner to the eHealth Week 2017, wich took place on 10–12 May 2017 under the Maltese Presidency of the Council of the EU. The overarching theme of this year edition of eHealth Week was Data for Health: the key to personalised sustainable care.
In fact, data lies is the core of health service delivery and the development of effective healthcare policies.
During the eHealth Week, speakers and attendees explored the changing ways in which personal health data is created, stored, shared and used, with the best examples coming from all over Europe.
Health IT offers important opportunities to improve the efficiency of health care delivery through innovative approaches to service delivery and public health, impacting the well-being of both individuals and populations.
eHealth is not only the future, is the present, it’s already happening and it will become necessary in the future for the sustainability of our National Healthcare Systems.
As Commissioner for Food and Healh, Vytenis Andriukaitis, pointed out during his opening keynote speech, “Our NHS will not be sustainable if we don’t use technology! Because life expectancy in Europe is growing and by 2030 Europe will be the oldest country in the world!”
There is a clear need for new systems, new models and more data security. In this, the newly launched ERNs, European Reference Networks, could serve as concrete platforms for sharing knowledge and data across Europe, always putting the patient at the center of healthcare activities and delivering the best possible service.
Also, eHealth is an opportunity to have a look to countries we have not yet looked to, which are doing very well in this sector.
To say it in Zsuzsanna Jakab’s words (WHO Regional Director for Europe) “We need a beautiful marriage between public health and ehealth. Health for all is a right!”
The eHealth Week 2017 also provided high-level delegates with the opportunity to understand more about Malta’s eHealth system and to visit the most important public hospital of the island, the Mater Dei hospital.
Visit of the Mater Dei hospital
UEHP took part into one of the organised visits to the Mater Dei hospital, an acute general teaching hospital offering a full range of hospital services and providing an extensive range of specialist services.
One of the most interesting thing about the visit to the hospital was the innovative way in which the hospital is trying to reduce its waiting lists for MRI, by giving appointments to patients round the clock with respect to the urgency of the cases. This means that the MRI department is working 22h/day with patients coming to the hospital at night to obtain their MRI (not urgencies), instead of waiting for months.
Malta’s Digital Health Strategy for the years 2017 to 2021 was also presented by the Maltese authorities.
For more information about the eHealth week please visit this link
Promoting vaccination: Commission launches EU Health Award for NGOs
The European Commission has launched the EU Health Award for NGOs 2017, which aims to reward NGOs that have contributed to a higher level of public health in the EU through vaccination.
Vytenis Andriukaitis, Commissioner for Health and Food Safety said "Vaccines are one of the safest and most cost-effective ways to ensure public health and avoid preventable disease. Decreasing public trust in immunisation poses a serious threat that needs to be addressed. Anti-vaccination myths and lack of knowledge can lead to people refusing vaccines, which in turn leads to insufficient group immunisation and avoidable death. We need the support of the entire community to ensure optimal vaccination rates, and NGOs play an enormous role. I want to recognise and reward outstanding initiatives by NGOs which have significantly contributed to higher levels of vaccination in the EU population."
Interested parties are invited to check the eligibility criteria and present details of their initiative by 30/06/2017 using the online form.
Applications could include one or more of the following aspects related to vaccination:
  1. Prevention: availability of vaccines and access to sustainable immunisation services
  2. Awareness and information: promoting vaccination/advocacy
  3. Countering growing vaccine hesitancy
  4. Engaging with health care professionals to strengthen education/medical curricula/training, advocacy and health care professionals’ communication skills
  5. Surveillance
  6. Tackling vaccination from a specific disease perspective (e.g. Human Papilloma virus HPV, seasonal flu, childhood immunisation, life-course vaccination/adult vaccination, synergies between vaccination and use of antibiotic)
  7. Other initiatives that can promote higher levels of public health in EU through vaccination.
The cash prizes, which are funded under the 3rd Health Programme 2014-2020 are as follows:
  • 1st prize: 20 000 €
  • 2nd prize: 15 000 €
  • 3rd prize: 10 000 €
The shortlist will be announced in September and the Award Ceremony will take place before the end of 2017.
For more information on the EU Health Award for NGOs 2017, please visit this link
Defining Europe’s environment and health priorities in the 21st century
According to WHO, each year, almost one and a half million deaths in the WHO European Region are caused by environmental risks that could be avoided and/or eliminated. Leading environmental determinants of ill health includes air pollution; inadequate water and sanitation services; hazardous chemicals; waste and contaminated sites and climate change.
The Sixth Ministerial Conference on Environment and Health, organised by the World Health Organisation Regional Office for Europe will take place in Czech Republic on the 13th-15th of June. It provides an intersectoral policy platform bringing together relevant sectors and partners to shape policies and actions on environment and health, support the implementation of effective evidence-based policies and advance actions on environment, health and well-being in the WHO European Region.
Who’s who in healthcare sustainability? Some national Initiatives.
Environmental issues do have no borders. Sustainable development becomes the focus of health policies in many European countries, this is the major challenge for the 21st century. Many national initiatives have emerged during the last ten years, encouraging audacious and innovative sustainable development dynamics in hospitals. Here are a few organisations and initiatives among UEHP member states.
"ÖkoKauf Wien" – programme for sustainable public procurement
For more than a decade, the City of Vienna has followed ecological criteria when buying goods and services - from washing powder to office supplies, from food for kindergartens and hospitals to construction materials.
Thanks to "ÖkoKauf Wien", the Vienna City Administration has applied ecological criteria to procurement procedures, thus cutting annual carbon dioxide emissions by about 15,000 tons and saving approximately EUR 1,5 million per year.

C2DS – Committee for sustainable development in healthcare
C2DS is an independent French non-profit organization founded in 2006 by healthcare professionals and federates in France 500 member hospitals engaged in a sustainable development process. Over the past ten years, the aim of C2DS has been to raise awareness among key players in healthcare sector and to promote the advantages of better practices in order to master the environmental, human and economic impacts of healthcare activities.

BUND "Friends of the Earth", label "Energy saving hospital"
The BUND Label "Energy saving hospital" is an award for outstanding engagement of hospitals in the fields of energy saving and climate protection.
Hospitals have to reduce their CO2-Output by more than 25% in the last five years and implement a long-term energy management plan to be awarded.
More than 40 hospitals have been labelled "Energy saving hospital" in the past 10 years in Germany.

Foundation ViaMedica
The foundation ViaMedica aims to work on hospital ecology, hygiene, climate change and sustainable pharmaceuticals. Its latest projects focus on climate manager training in hospital, energy savings with waste heat recovery systems, hospital hygiene and the place of cleaning personal in hospital.

Asklepios - Green Hospital programme
The Green Hospital programme launched by Asklepios private clinics group is an alliance of experts from the medical, economic and research fields. Together with partners from the industry, the programme aims to develop innovative products and solutions for the hospital of tomorrow, which are tested for their practicality, efficiency, innovativeness and quality in Asklepios clinics.

Luisen Clinic in Bad Dürrheim
An energy champion
The Luisen clinic is among the 40 hospitals, which are labelled "Energy saving hospital" in Germany, the only private institution. To this clinic for behavioural therapy with 230 beds belong a listed building from 1912 with an extension for the swimming pool and physiotherapy, the main building built in 1969 and two new ones erected in 2000 and 2010.
Since 2007, the clinic has been able to reduce its energy consumption by 73 %. This proud result has been achieved with very ambitious measures, adapted to each building.
One of the most effective actions has been the insulation of the facade and the flat roof of the main building, which has lead to 50% energy saving for this building. The installation of a wood pellet plant which covers about 70% of the eating needs helps the clinic to be CO2 neutral. The photovoltaic systems on the roof produces energy, which is resold to an energy provider but the clinic plans to install another photovoltaic system to produce its own electricity. The switch to LED light bulbs and the installation of movement detectors belongs to the measures, which have positively weighted on the electricity bill.
According to Sven Wahl, CEO, “Sustainability is first of all a social responsibility question. The return of investment is globally 10 years, 2 years for the lightnings as we have been subsidised. Our new buildings are eco-constructed, we pay a great attention to the eco-quality of the chosen material. We hope to be able to drive ‛clean’ soon with the purchase of an electric car.“
Asklepios group presents ROOM 2525®, the patient room of the future
More than two years of research and development have led to the ROOM 2525®, a patient room full of innovations and technical highlights. Together with the company partners of its Green Hospital programme, the Asklepios Clinics group has developed the patient room of the future, available for patients since spring of 2016 in the Asklepios Clinic St. Wolfgang at Bad Griesbach in Lower Bavaria.
It combines modern and elegant design, high-quality materials, intelligent lighting and acoustic concepts, an atmosphere of well-being and patient friendly barrier-free accessibility, barrier-free designer bathroom, as well as the highest hygienic requirements and optimal conditions for medical and health care delivery. Digitally interconnected, the ROOM 2525® offers quite new possibilities to integrate solutions in the field of hospital treatment and care, like telemedicine. From the light control to the air conditioning and on to communication: intelligent technology facilitates the patients’ everyday life in the clinic.
“During a clinic stay, the patients want to be accommodated in a professional and competent environment, which supports their emotional and physical well-being at the same time. Comfort, security, individuality, protection of privacy and services one knows from the hotel sector are becoming more and more important. This also contributes to a faster and, in the end, better recovery“, according to Dr. Wolfgang Sittel, head of the architecture and construction division of the Asklepios group.
The Clinique Bois-Bougy acts for the planet
The Bois-Bougy psychiatric clinic in Nyon does not waste time. Barely inaugurated in 2013, it quickly set up its CSR (Corporate Social Responsibility) roadmap, which is embodied in concrete actions based on the three pillars of sustainable development (ecological, social and economic), to improve the well-being of patients and collaborators.
The building is Minergie labelled, a label focused on energy performance, and solar panels have been placed on the roof. The clinic also works on the management of its waste, in particular the problems of paper consumption and recycling, as well as nutrition and the fight against food waste. Of course, the CSR programme also includes a section for employees with physical activity and relaxation sessions proposed by the management and to combine pleasure with practicality, hives have been installed in the park of the clinic, Biodiversity being an integral part of the reflection and concerns of the teams.
Clinique Pasteur, Toulouse, a sustainable clinic
The Pasteur Clinic of Toulouse received the "Clinique Durable" (Sustainable Clinic) award at the 2016 Trophies of the French Federation of Private Hospitals for its CSR project "A responsible corporate clinic". This prize crowns the maturity of the projects undertaken for years by the management and the teams of the establishment, a pioneering work in the environmental, societal and economic fields.
As the only establishment in France to be simultaneously certified ISO 14001 and registered with EMAS, the Pasteur Clinic, which prepares ISO 26000 acknowledgement programme, works on all registers and was able to develop over the years a corporate culture that is 'binding', people oriented, focused on patients and employees well-being and health. Numerous projects have been accomplished: pedagogic programmes in schools, roof garden and gardening club, nutritional quality of meals, labelling of purchased ingredients and dietary support, low carbon menus, campaign against endocrine disruptors and against noise, recycling of precious metal, free sport sessions for employees and patients, support for smoking cessation, professional integration, concierge, solidarity events, computer workshops, internal social network, start-up acceptance, exhibitions, etc.
As part of the 2017 European Sustainable Development Week, 100 000 low carbon meals will be cooked in a single day in the hospitals and collectivities of the Grand Toulouse.
Other exemplary private hospitals recognised for their work on sustainability: The Saint Roch and Clementville Clinics in Montpellier belonging to the OC Santé Group headed by Max Ponseillé. They have just renewed their registration for the next 3 years and are among the less than ten private, private non profit and public hospitals in France, which are EMAS registered.
CAHPP - The green label, a guide for eco-responsible sales
CAHPP, the leading French private and public hospital purchasing body and associate member of UEHP, is rating its suppliers according to environmental criteria. Green A+++, A++, A+, the grade depends on how virtuous and engaged the organisation is. This green label bears testimony to the sustainable development actions implemented in areas such as general management commitment, purchasing policy, products and eco-design, reduction of the impact of the use of products, waste management, ordering and distribution.
In France, clinics and hospitals buy each year products and services for an amount of 18 billion Euros (40% of their budget). Sales are one of the governing principles of a comprehensive green approach.
Toxicity of medical devices: CAHPP launch the Operation transparency
In November 2015, CAHPP launched a survey among its 172 medical devices suppliers to know the level of DEHP and ethylene oxide contained in the products listed. 66 suppliers answered the survey, 42 provided transparent information, 24 declared to wait for information from their sub-contractors, 106 did not answer!
The study is still ongoing. According to CAHPP “It is urgent that the manufacturers provide the necessary transparency. CAHPP will not let go of this subject. We have to make the market more responsible.“
Homemade and Organic
Cardio-Thoracic Centre of Monaco (98)
For the last three years, at the Cardio-Thoracic Centre of Monaco, 20% of the products for the catering are labelled organic. "Fruits, vegetables, starchy foods and even certain types of meat are organic. In addition, we buy our products locally or in the smallest possible perimeter. The meat comes from the centre of France, the yogurts from the Alps, other products from near Italy but most of our products are of French origin" explains Marc Guglielmi, Head Chef.
The five chefs at the centre have all been traditionally trained as cooks, a skill they practice today in collective catering. "The term collective cooking should not be viewed in a pejorative way. We cook 350 meals a day, but for us, quality is paramount and we bring a lot of fancy in the processing of food and in the composition of menus." With sea views, the meals have a holiday flavour!
The pioneers in terms of environmental management systems
Everywhere in Europe, Many healthcare institutions choose to follow a programme to develop and formalise their own environmental management system. The international certification standard ISO (International Organization for Standardization) 14001 which helps organisations to evaluate and manage the environmental impact of their activities is the most common one.
The European programme Eco-Management and Audit Scheme (EMAS) provides a framework for voluntary eco-management initiatives. Since 2010, the ISO 26000 standard provides a guidance on social responsibility and is by far the most ambitious programme hospitals can choose.
Spanish hospitals have very soon been pioneers in terms of environmental management systems (EMS). Those EMS, which can lead to a certification (CEMS) are also linked to the “general system of environmental management” of some Spanish Autonomous Communities, so that Spanish hospitals which commit to a global EMS, also take into account quality, risk prevention and the environment.
A recent report published by the University of Valencia and two other organisations* called “Introduction of voluntary environmental management systems into the Spanish hospital network: current state (2015)” provides an overview about the implementation of environmental management systems (CEMS) in Spanish hospitals : “We found that 18.9 % of hospitals had CEMS (ISO 14001 in all cases): 149 out of 787 hospitals, in the National Hospitals Catalogue, especially in Madrid (40) and Andalusia (37). Eighty-one of the certified hospitals are private. Only 23 had EMAS: 12 are public and 11 private.
An other study published in 2016 by Nefrologia**, the Spanish society on Nephrology, reveals that “Of the 210 hospitals with a dialysis unit (all status), 53 (25%) have the ISO 14001 and 15 of these also have an EMAS. This constitutes 30% of all hospital dialysis chairs in Spain: 1,291 (of 4,298). Only 11 outpatient clinics are recorded, all with the ISO 14001. ”
PVC-free blood bags are coming soon!
Since their introduction in the 1950s, blood bags are made of PVC and contain phthalates, endocrine disrupters, initially integrated to soften the plastic and which, surprisingly, help to stabilize the red blood cells in blood bags!
Launched in 2011, the "PVC-free blood bag" project, funded by the European Union and led by the Swedish Jegrelius Institute for Applied Green Chemistry with the Karolinska University Hospital (SE) Melipé (DK), Wipak (Fin), Primo Profile (PL), Haemotronic (It), aims to manufacture PVC-free blood bags which meet all essential safety and certification requirements. The project is nearing completion and a final report will be published in 2017.
The phthalates contained in the blood bags dissociate from the plastic and migrate into the body during transfusion. The amount released depends on storage time, temperature, lipid concentration, etc. Also, as the project progressed, polyolefin plastic films were produced and a first prototype blood bag was recently tested at the Karolinska University Hospital in Stockholm.
The first results are promising, PVC-free blood bags do exist, but additional tests will have to be carried out to find the best additive, the two tested do not fulfil their mission to keep the red blood cells up to 42 days.
The other challenge for the lead organization will be to support the demand for PVC-free blood bags after the pilot phase. "We need the support of organizations and associations and all stakeholders involved in health to promote this new technology, which we believe is important in advancing sustainable health for patients," said Lena Stigh, Project Leader. "A clear and sustained demand from healthcare institutions for PVC-free blood bags would greatly facilitate the issue of large-scale production and marketing. On the other hand, an evolution of legislation at European level on endocrine disrupters, that is to say their phasing-out in medical devices, is likely to favour the marketing of PVC-free blood bags."
It should be noted that until now, none of the many projects initiated in Europe and the United States have succeeded in eliminating PVC blood bags.
25-27 May
Intercare - International Medical Tourism Exhibition
31 May – 1 June
BDPK German Federation National Congress „Das Spannungsverhältnis von Medizin und Ökonomie“
6-7 June
OECD Forum 2017
8-9 June
Congress of Specialties of the French Federation FHP "2017 Together"