MEMBER'S CORNER
SPAIN
The healthcare private sector is an economic engine
According to the 2019 Global Medical Trends report, the Spanish private healthcare sector will represent 4% of GDP in 2019, 0,5% more than in 2018.
According to Cristina Contel, President of the Alliance of Private Health in Spain (ASPE) and UEHP Vice-President, "the private healthcare sector is a key player in Spain and an indispensable partner of public health that ensures the proper functioning of the National Health System. It also plays a very important role in the Spanish economy. If we take into account the sectors indirectly involved like construction, textile, food, technology, transport, etc., there is no doubt about its potential as an economic sector now and in the future."
For this reason, ASPE reminds us of the importance of not politicizing healthcare or taking decisions that put at risk a growing sector. "We can not forget that more than 260,000 professionals work in the private healthcare sector or that the Spanish healthcare system would not work without the collaboration of the private sector", recalls Cristina Contel.
Policy measures can have serious consequences if they are not taken according to factors such as efficiency and the improvement of the functioning of the healthcare system. For Cristina Contel, "It is important to maintain the efforts so that the Spanish private healthcare sector continues to be the engine at both health and economic levels, and is recognized as such."
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.
ITALY
AIOP presents its yearly Report on Health and Hospitals to the Senate
On the 16th of January in one of the Senate’s seats, the Italian Association of private hospitals presented the yearly Report on Health and Hospitals to politicians and to journalists.
The research (promoted by AIOP and elaborated by Ermeneia, an important research center) analyses the Italian healthcare system from the double point of view of consumers, relating to the access to services and to quality of treatments, and of providers, concerning their answers to the health needs of the population thanks to efficient management and productivity with the available resources.
One of the main results of the Report is that about 20 millions of Italian citizens (38% of the population) experienced the difficulty of waiting lists for the access to specialist examinations or hospitalizations, the first cause for waiving the right to treatments. This inefficiency of the Healthcare system contributes to increase the out of pocket expenses and the interregional mobility for 30% of the patients and it is one of the causes of the inappropriate access to first aid services.
In this context, as the radical structural changes require more time and political consensus, it is obvious that the Italian system urgently needs to become more efficient in its daily functioning. This is possible if both sectors that make up the system, accredited public and private hospitals, have the same responsibilities, controls and remuneration criteria, in the interest of the population. In this respect 90% of people are convinced that private accredited hospitals are an essential component of the system like the public ones and that their choice is not depending on the juridical nature of the institution but on the quality of services provided.
In order to promote this required efficiency, the national Association of private hospitals suggests:
- to go back to the payment by DRG’s also for the public sector, as provided for by law but never enforced, in order to balance costs and operating revenues also in public hospitals
- to introduce incentives and disincentives depending on the functioning of the health institutions
- to promote a virtuous competition among public and private providers within the same process of accreditation
- to create a third and independent control institution to overcome the conflict of interests for the public sector, which is at the same time controller and controlled.
Barbara Cittadini, President of AIOP
Concluding the meeting Barbara Cittadini, President of AIOP, declared:
“In order to defend the solidarity principle of the universal access to services, it is absolutely necessary to reorganize and to make our National Healthcare Service more efficient from a double point of view: the same quality treatments provided in all Regions and the economic and financial efficiency. The situation described in the Report “Health and Hospitals 2018” must induce us to recover the fundaments and the principles inspiring the foundation of our Healthcare National Service forty years ago. We must update them taking into consideration the changes of the health and demographic and economic situation in order to respond to the real needs of the population looking for an adequate answer to their health expectancy.”
Written by Alberta Sciachi, AIOP International Relations
GERMANY
Hospital Barometer 2018
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The economic situation of German hospitals remains difficult. In 2017, every third hospital wrote red numbers (30%), + 1% compared to the previous year. The share of hospitals with an annuel net profit is 60% and the one with a balanced annual result is 11%.
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The economic situation of the departments of obstetrics in hospitals is a main topic of the current hospital barometer. Around 57% of hospitals reported that in 2017, the income generated by obstetrics were lower than costs. This means that the majority of maternity wards do not cover their costs.
The German Hospital Barometer is an annual representative survey of German hospitals on current health and hospital policy topics. The results are based on a written survey of accredited hospitals from 100 beds in Germany, which took place from April to mid-July 2018. The survey involved 249 hospitals.
MAJOR EUROPEAN PRIVATE HOSPITAL GROUPS
FRANCE
SantéCité, a French cooperative group
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What characterises an independent private hospital?
First of all, an independent private healthcare institution faces the same challenges as other hospitals such as economic return, adaptation, innovation and competitiveness but with one distinctive characteristic, the sustainability of its development. An independent private hospital manager has a long term view and an economic model based on investments. Our cooperative establishments want to be in business for the long term.
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Stéphan de BUTLER d’ORMOND, President of SantéCité*
In our model, the manager is one with the institution. Some have founded their hospital, all represent it with energy and share the risks with their practitioners and employees. We are, each of us, rooted in our territory, each manager is responsible for its employees. We all have one vocation, to provide care, and we are fully engaged with the institution because we rely less on external factors. We cultivate the culture of a « Company with a Mission».
In France, the number of independent private hospitals is decreasing. How do you see the future of your model?
We would like to make it a model for the future. SantéCité is a cooperative group with its own values. Many important private hospital groups can be proud of what they have achieved. We do not act in opposition towards these models but rather out of preference. Our model is based on responsible managers who embody their values and who operate closely with their teams and who create, for their physicians, excellent working conditions while first and foremost respecting their independent status.
We would like to develop SantéCité as a brand image and position it on the market so that it becomes a more institutional brand and a label recognized by healthcare professionals and patients. Also, SantéCité identifies with societal challenges such as corporate social responsibility (CSR).
How does the Cooperative Group SantéCité operate?
Our particularity is that we are at a crossroads between the business model, a private limited company for example, and a cooperative business approach. We wanted to further professionalize our organization, which was built by many entrepreneurial initiatives and aspirations. All our co-operators show an inclination for the pooling of actions, the "benchmarking" of the best organizations, so that our cooperators can accelerate their growth. We are doing joint action on purchasing, research and wish to develop many other new projects. The cooperative spirit is the pooling of actions and its collective energy, while maintaining one´s managerial responsibility and operational autonomy.
SantéCité has developed a simple and light structure to better serve its cooperators who are engaged at a personal level and with their employees in the collective actions of the Group. The first strand of my program is the improvement of the performance of the cooperators. This involves consolidating the purchasing subsidiary with Pierre MALTERRE, its President.
The second strand aims to accelerate the sharing of best practices via benchmarking in particular. Innovation is our third key action: digitalisation, Article 51, for example, are at the center of our concerns. We have acquired a HiLab and work on the HOP´EN project. SantéCité cooperators can also work together on research projects within our CGS SCERI, chaired by Thierry ROYER, a structure which has allowed those who are engaged together in clinical trials and publications to pool their actions.
The fourth strand concerns capital. We want to give the ability to a cooperator to run his organization in line with its independent status. Beyond that, we could be able to develop a capitalistic vehicle. SantéCité is not intended to become a capitalistic group but it could become a transition vehicle, a vehicle for carrying and transmitting knowledge.
SantéCité in numbers:
133 cooperating establishments, € 2.6 billion of cumulative budgets (2017).
Our structure is light with 2 employees at headquarters for overall coordination, 2 to 4 people in charge of purchasing and 2 in charge of research.
*Stéphan de BUTLER d’ORMOND, is the CEO of the private hospital group Groupe Santé Victor Pauchet in Amiens. He was elected on 7 December 2018 President of SantéCité, the first French cooperative group of independent private hospitals.
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