Europe is changing under the pressure of events! At the Brexit endgame, new perspectives concerning effective governance in EU are on the table. The impact on civil society is growing, as recently observed at the Paris Forum organized during the First World War centenary ceremony. All efforts are required to stabilize European cohesion, and to maintain social protection and free healthcare access. Looking ahead to the upcoming Parliament election in May 2019, UEHP is preparing a questionnaire dedicated to MEPs Candidates to include Health at the center of the European debate.

Europe matters in healthcare and data protection, as confirmed by a recent judgement in Portugal concerning the GDPR application. An important fine was applied to a hospital failing in personal data protection. Cooperation between professionals is necessary to include legal constraints and to share efficient solutions. We build the future now altogether. That is the core message we expressed during our recent Master Class dedicated to Risk Management with European experts, meeting organized with SHAM in our Brussels Office. UEHP supports healthcare professionals working together!

The award has been handed to its President Cristina Contel, also vice-President of UEHP. In her speech, Cristina Contel highlighted the importance of the collaboration between private and public healthcare sectors in Spain, placing the Spanish NHS at the top of the European health systems ranking list.

Among the reasons that have made ASPE worthy of this distinction, is the co-creation by ASPE of Spaincares, a health tourism cluster, which promotes the quality of Spanish healthcare facilities and tourism around the world, encouraging the venue of medical tourists in Spain.

Likewise, the fact that the President of ASPE was elected Vice-President of the European Union of Private Hospitals (UEHP), the attendance of ASPE Secretary General Carlos Rus at a healthcare leader meeting in Mexico, or the organization by ASPE of the 1st Iberian Summit of Private Health, have also been strong reasons to obtain this award.

The Spanish Private Health Alliance federates more than 600 health facilities and represents about 80% of the private hospital sector in Spain. The private sector represents 56% of the total number of Spanish hospitals. ASPE strives to give value to the private healthcare sector in Spain, which employs more than 260.000 professionals and represents 3.5% of Spanish GDP.

Representing all the hospitalization in France, and given the importance of health issues, the presidents of the four hospital federations have called together the President of the Republic, the Prime Minister and the Minister of Solidarities and Health to make their proposals heard and preserve hospital budgets.

While they welcome the orientations of the "My Health 2022" plan launched by the President of the Republic, the French hospital federations have however recalled the context of economic fragility of all institutions: the means provided are insufficient and the effects of this plan will only be felt in a few years. However, health establishments must to have sufficient financial means to ensure patients daily and continuous equal access to care of proven quality.

After suffering a decline in hospital fees for six consecutive years, the situation of health facilities is precarious. Also, in order to find room for manoeuvre to carry out their mission of care and to follow a real social policy, they ask for a rise of hospital tariffs, which are today not any more in adequacy with the reality of care costs and French health issues. This rate increase is a real necessity to preserve the financial balance of these establishments.

Health facilities have respected the planned spending targets in 2018 and have even under-executed them : the hospital federations are asking for the full refund of the hospital credits frozen as part of the prudential reserve.

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FEHAP - Federation of Private non Profit Hospitals and medico-social institutions
FHF - Federation of public hospitals
Unicancer - National Federation of Cancer Treatment Centers
FHP – Federation of Private Hospitals

The Congress also featured a large exhibition area where health companies showcased various products such as clinical and management technologies, medical devices, pharmaceutical industry, etc.

Oscar Gaspar´s presentation entitled "The future of the health sector in Portugal – Where are we heading to? - Trends and challenges in the health sector and in the NHS", highlighted the strong growth of private hospitals (due to factors such as orientation towards innovation and digital technologies, focus on the patient, the emphasis on value and quantification of results regarding each patient and their comparison with the associated costs) and gave some information on health challenges (demography, technology, knowledge, sustainability) which are currently being addressed in Portugal. Mr. Gaspar concluded that more investment in health will be necessary, that health should be a national priority, that the sustainability of the Portuguese health system requires new solutions and that the articulation between institutions and sectors will be fundamental.

The second event, the FIS - Health Innovation Forum which took place on the 12th of November in Rio de Janeiro, was organized by CBEX - Brazilian College of Health Executives. Oscar Gaspar was invited to share the Portuguese experience of PPP - Public Private Partnerships in Health. Information on the terms and results of the 4 hospitals managed under PPPs in Portugal was made available, pointing out that the model allowed hospitals which are part of the National Health Service, to use the investment capacity and management methods of the private sector with, as a result, significant savings for the State. Ten years after the beginning of the contracts, evaluations show that objectives have been achieved (hospitals built without any financial or time slippage, control of health care expenditure, guaranteed access, clinical excellence) and recent hospitals in PPP reach the top of clinical excellence in the NHS. A very valued aspect in the Forum was the "experience" of citizens in hospitals and the good example of PPP hospitals in this area, with various inquiries showing that people feel they are welcome, well treated and well accompanied.

These 2 events show that the private hospital sector is very strong and dynamic in Brazil. Assembling about 3,000 people in 2 events, sharing experiences and engaging foreign speakers is commendable and gives cohesion to the industry.

The mobilization achieved, the absolutely professional organization, the scope and level of the debates and the examples and experiences presented show that Brazilian private hospitals are capable to highly contribute towards the challenges that the Brazilian health system, with its specific characteristics but like any other, faces.

What is the place of your hospitals group within the Swiss healthcare system?

Swiss medical network is one of the two leading private hospital groups in Switzerland. With 19 clinics and medical centers located in the three language regions of the country, patients from Switzerland and abroad receive first-class hospital treatments, care and nursing. With our presence in 11 cantons, our hospital group is an important partner in political discussions and negociations at federal level.

What are the lastest news and projects in your clinic group?

We recently took over the surgical activity of the Siloah clinic in the canton of Bern. As part of this acquisition, Swiss Medical Network will safeguard jobs and will invest CHF 5 to 10 million in infrastructure development over the next three years. The services and regional positioning of this interdisciplinary site will be strengthened by the integration of those activities into a group with strong national roots.
In parallel, we also acquired the two medical centers of MedGate (Solothurn and Zurich Oerlikon). We attach great importance to the development of integrated services.

Which topics will occupy you most in the coming years?

In general, we are closely monitoring the development of healthcare and seeking innovative solutions that address the needs and expectations of patients.

In the short term, there is the question of financing outpatient care. The financing patterns for inpatient and outpatient care strongly differ from each other, especially with regard to the part supported by the state (i.e. the cantons). Paradoxically, this situation benefits inpatient care and disadvantages ambulatory care. This also contributes to the explosion of healthcare costs and significantly burdens the insured persons’ budget.

In your opinion, in which way does your group best contribute to public health in your country?

The health system in Switzerland is complex. Federal laws are enforced by the cantons. So we have 26 cantons and potentially as many different systems. Our intercantonal activities give us a very good overview of these divergences, positive and negative. Our contribution is to point out the dysfunctions and to change some of the cantonal health practices. For this we favor private-public partnerships. In this way, we aim to demonstrate to the population and the authorities the complementarity of both private and public sectors, in order to create a fair competition and stabilize costs while maintaining a high quality of services.

Swiss Medical Network Group ensures that the identity of each of the clinics belonging to the group is respected. Each clinic maintains and even reenforces its regional integration in order to provide high-level quality of care to the local population. The group membership offers new perspectives: networking, exchange of experience and digitalization support.

What should be done to increase the proportion of private clinics in Europe?

In Europe as well as in Switzerland, health systems are in full development. The various stake holders question their role in the future. Respecting the needs of current and future patients, investing in innovative solutions and ensuring that efficiency and cost-effectiveness are always paramount, is essential for anyone wishing to play a role in the future. In this regard private clinics, or at least some of them, today seem to be better positioned.

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