Friday, 29th March 2019  
UEHP supports gender equality
To celebrate International Women’s Day (8 March), UEHP launched a poster featuring women surgeons working in private hospitals in Europe. Gender Equality was the key message. Equality between women and men is a fundamental value of the EU and UEHP is proud to actively support this major societal principle.
We were fortunate to have the participation of more than 160 Women Surgeons working in European Private Hospitals and to publish their photos illustrating that real life includes gender equality. It is not merely a statement, it is a fact!
Cristina Contel President of ASPE (Spanish Private Hospital Association) and Vice President of UEHP, and myself, Paul Garassus President of UEHP, will be both signing this Editorial today as a demonstration of our common commitment to include gender equality in our everyday professional life.
We had the enthusiastic support of all our Member delegations to develop this communication project but we particularly want to thank our female colleagues who have so graciously agreed to participate. This issue is the expression of our consideration and sincere admiration for their involvement.
Please visit our website and diffuse this poster dedicated to this major common action.
Cristina Contel
President of the Alliance of Private Health in Spain (ASPE)
Dr Paul Garassus
President of UEHP
International Women's Day 2019: Women surgeons working in private hospitals in Europe
For the International Women’s Day 2019 UEHP launches its photo campaign, proudly presenting the women surgeons working in private hospitals all around Europe.  
In a traditionally male-dominated sector such as surgery, the key role and the strong presence, actual and concrete, of women is a added value to our common patients.
Thank you to our members and the female surgeons all around Europe who engaged in this important UEHP initiative to support gender equality and women empowerment in the medical profession
Download the photo campaign here: photo 1 and photo 2.
“Knowledge and good management should be your calling card”
Cristina Contel, President of the Spanish Alliance of Private Health (ASPE)
What piece of advice would you give to young women who wish to embark on a management career in the health sector?
First of all, they should prepare themselves professionally with a strong education in business management in general, not necessarily applied to the health sector, but also to sectors related to science or humanities. In my opinion it is necessary to have a broad overview of the various and numerous transversal sectors that converge with the health sector: economics, law, human resources, markets analysis…
My advice to young women is: Be good professionals, without making your gender a differentiating element, neither positive nor negative. Knowledge and good management should be your calling card.
But for that, we do have to fight in order to have the same opportunities as men, on equal terms, in order to be able to demonstrate our skills, ability and professionalism.
During my entire career in the health sector, I have to say that I met many women, who would have been fully capable of holding management positions and have top-level responsibilities in the health sector, but were not given the opportunity to do so.
What should be done today to ensure that there are more women in high-level positions tomorrow in healthcare institutions?
Personally, I am against the definition of "quotas" that require the presence of a certain number of women in organizations or in positions of responsibility. I believe that the fact of being a man or a woman should not be used as a discriminating principle, neither positive nor negative. The criteria that should be used as a filter to access positions of responsibility should be education, experience and personal skills, regardless of the gender.
However, today, as machoism continues to prevail in the first levels of responsibility, preventing personal values and the professional merits necessary to access such positions to be key selection criteria, “quotas” are necessary tools to enhance the presence of women in high-level positions.
Another objective instrument in achieving this milestone would be the "blind curriculum" in which candidates applying for high-level positions would be chosen without knowing their gender, name or condition. It would be also useful to anonymize applications and focus the choice on professional qualities and skills that have nothing to do with the gender. This would also help to alleviate the negative effects of the "wage gap" that occurs between men and women under equal work conditions and responsibilities.
The creation and joint participation of a Commission on equality is also an important means to create awareness within entities. This Commission should be supported and encouraged by the Directorate, ensuring that the management of teams is carried out by people trained in the principles of equal treatment and opportunities between men and women, as well as non-discrimination. Personnel recruiters should be sensitized and trained in matters of gender equality.
But the best way to ensure the objectivity and equality of opportunities between men and women is to raise awareness and create a “culture” showing that professionalism is not gender dependent and that the choice of professionals should be based on objective criteria related to the position.
“The ability to project yourself into the future, keeping in mind your history”
Barbara Cittadini, President of the Italian Association of Private Hospitals (AIOP)
Since May 2017 and for the very first time since its establishment, the Italian Association of Private Hospitals (AIOP) has a female President, Mrs Barbara Cittadini. Born in Palermo (Sicily), graduated in political science at Universita’ Cattolica del Sacro Cuore in Milan, she holds a Master in "Executive heath management" at the Bocconi University in Milan. Since 1994, Mrs Cittadini has been president and legal representative of the Casa di cura Candela, since July 2016 president of AIOP Sicily and since June 2012 National Vice president of AIOP.
Among other tasks, Barbara Cittadini is a member of the thematic group Health-Life Science of Confindustria (the Association of Italian Industries). Last November 8th, she was awarded the recognition of Cavaliere del Lavoro by the President of the Republic of Italy, Sergio Mattarella, for her commitment in making the health system in Sicily more efficient, with the aim of improving the access to health care by the local community.
Mrs Cittadini, can you please summarise your experience as a woman entrepreneur in healthcare?
The role I hold is for me source of pride but, above all, of responsibility. It represents a recognition that combines the pride of being a woman, Sicilian and entrepreneur, with the ability to operate in such a sensitive sector as healthcare which protects a constitutionally-guaranteed right like health; in addition, the wonderful but complex region where I live, Sicily, makes "doing business" a very difficult and challenging job. I started working when I was twenty-two and I have never experienced the difference of being a woman in the work environment. I am aware that I had the privilege to start my career with a role and decision-making autonomy that made things easier for me, but I never experienced any particular problems of integration at work.
Concerning my role as President of AIOP, I am very proud to represent 550 private hospitals, members of our association. I see this experience has an opportunity to always seek for a better balance between efficiency and effectiveness and the economic sustainability of our NHS.
It is crucial for me to stress the importance of our hospitals - the private component of our NHS - which have a great responsibility in the protection of citizens’ health. We are at the service of the entire population and its demand for health. This is such an important and delicate task!
The first objective that I envisaged to achieve during my mandate is representing the interests of all AIOP hospitals and clinics - large, medium and small - respecting and valorising their diversity, because the uniqueness of every single hospital is an asset for us. As President I will continue working to create new forms of collaboration to strengthen the entire health chain and the role of AIOP.
Every day,  AIOP hospitals are committed to satisfying, in an efficient and effective way, the health demand of the Italians, who continue to choose us for the quality of the care we provide. In fact, we must always bear in mind that health is the most valuable asset that each of us has. Therefore, the perpetration of a health system that is struggling to function is unimaginable.
What advice would you give to a woman willing to start a career in healthcare?
Beyond the approximate theories about the differences between men and women, which I am not particularly fond of, I am convinced that what really rewards a professional path, of any kind, is training, competence, commitment and tenacity in the pursuit of your objectives. I am convinced that as women we have sensitivity, we develop empathy and we have a propensity to be determined in what we see as priorities in our lives; we struggle to find a balance between professional roles and family commitments, which is not always easy to find.
The peculiar characteristics of being a professional in healthcare are based on communicative competence, organizational capacity and systematization of commitment, on the quality of the human relationships, on the efficiency of the teamwork, on the management of networks of relationships and on the ability to mediate between different positions.
These attitudes seem to me the effective keystone to be able to facilitate the shift, already in place in healthcare, from the "cure" to the "taking care" of the patient. As a matter of fact, in the last fifty-sixty years, many women have shown professional skills in the world of medicine, from general surgery to any specialized branch and, when appointed, they have shown equivalent skills and competencies as Director general or health directors.
Women in surgery in Italia
The Italian Association of Women Surgeons (WIS Italia) project begins in operating theatre back in 2015 from two women surgeons inspired by each other.
The big challenge in male/female ratio among Italian Universities and Residency programs has been well documented since the last decade and, in a close future, surgical departments will be populated by as many women surgeons as men. Hence, it is necessary to be prepared to what is expected.
WIS Italia aims to represent and support every woman surgeon in Italy from medical school to leadership position, through mentoring and research programs, high level surgical training and networking across the surgical community. We completed a national survey in 2016 (non published data) where the feeling of gender-based discrimination was confirmed at any level of surgical training and surgical career. Moreover: lack of women as a mentor in surgery plays a role in deterring young medical students to pursue a surgical career; childbearing is an unconfessed fault that puts mother surgeons in a crucial crossroads forcing them to choose between family and professional fulfilling. Therefore the need of administrative and social support (flexible hours and duties, in-hospital child care, maternity and paternity leave, ..) is high and goes together with a deep cultural change that will probably take some years.
WIS Italia has the full support of Italian Association of Surgery (SIC) that was helpful, since the begin, to reach the vast majority of Italian surgeons: after three years we count 82 active members, scientific activity in progress and collaboration with other similar association across the world. Moreover, the Association motivate its members to play a proactive role: the annual grant for a course of laparoscopic liver surgery (IgoMILS) is assigned to the best project regarding women and surgery. For year 2019/2020 we announced The WALL, focusing on new ideas for plans and strategies to break down gender stereotypes in surgical work place.
The presence of a growing number of women in a male dominated field like surgery will bring a necessary re- modeling of surgery on women (not the other way around!).
For any information or contact, email to womeninsurgeryitalia@gmail.com
Isabella Frigerio, MD PhD
Co-founder and Past President WIS Italia
Pederzoli Hospital – Peschiera del Garda
Gaya Spolverato, MD
Co-founder and President in Charge WIS Italia
University Hospital of Padua
Dr Isabella Frigerio
French National debate: private hospitals and clinics have contributed
The Federation of Private Hospitalization (FHP) has taken part in the national debate initiated by the French Government in a period of social tensions. In this context, FHP gave the floor to its members, directors of private hospitals and clinics, through an online consultation, composed of twenty questions, opened from January 31 to February 28 2019.
Many directors contributed, delivering their perceptions and expectations on the four main themes of the national debate, related to the topic of "health": organization of the state and service to the public, taxation and public spending, democracy and citizenship, ecological transition.
FHP identified the proposals of the directors of private health institutions and put forward their ideas for concrete actions in a document that was sent to the French Minister of Solidarity and Health and to the main public officials and institutional of the country. The result of this consultation resonates with the aspirations of French citizens and will feed public authorities’ reflections on the transformation of our healthcare system.
The main proposals formulated by FHP are as follows:
  • Simplify administrative procedures in healthcare system;
  • Dissociate the functions of regulation of care and management of public hospitals;
  • Enable health institutions of all statuses to perform public service missions;
  • Preserve the hospital budget once it has been voted (compared to other out-of-hospital expenses);
  • Increase transparency and equity in health spending;
  • Have a public employment policy that promotes the recognition of professionals;
  • Strengthen the social and societal role of private health establishments in the territories;
  • Increase the involvement of private health institutions in decision-making by public authorities;
  • Harmonize at the national level the policy of support and financing of companies to meet the challenges of the ecological transition.
Download the document : here
ADSE makes its relationship with private hospitals in Portugal unsustainable
The Portuguese health system is mixed. In terms of organization and provision, there is a national health service (Beveridge-inspired) and a private sector which has shown high dynamism in recent years, with private hospitals now accounting for about one third of the hospital capacity of the system (in terms of beds, specialty consultations, surgeries, etc.). On the demand side (patients) the system is also mixed since about 40% of the Portuguese have health coverage beyond the NHS: such as private insurance (personal or professional) or health subsystems for certain companies or specific sectors.
Among the various health subsystems, the largest (ADSE) concerns the majority of civil servants. ADSE covers one 1 200,000 citizens including workers, retirees and direct family members, who pay 3.5% out of their income for the exclusive financing of this coverage. ADSE is therefore a relevant part of the health system, it represents 18% of the activity of private hospitals, it shows significant financial results in recent years and is highly valued by its members (membership is voluntary, among the eligible universe of civil servants).
Unfortunately, the relationship between ADSE and the providers has not gone well. ADSE sees itself as part of the State, does not accept dialogue and too often imposes administrative rules that are not justified and some are even illegal (for example, it imposes DSO of 120 days when Portuguese and European law prohibits terms of payment above 60 days). On 14 December 2018, private hospitals were confronted with a new measure: ADSE notified private providers that they had to pay 38 million euros for health services provided in 2015 and 2016. In general terms, ADSE argues that during those years some providers (which ADSE does not identify, nor does it specify the motive or frequency of the occurrence) invoiced ADSE for certain drugs and medical devices at a lower price and therefore all other providers have now to adjust their price to this lower rate. Everyone realizes that this reasoning is unacceptable: providers do not know and cannot know the price charged by competitors, invoices have been checked and paid and the lowest price cannot be simplistically taken as fair value.
Portuguese private hospitals challenge this process but also point out that the biggest problem is not the value but the rule: it is not acceptable to provide health services and then, after 2 or 3 years, the payer keeps the right to retroactively adjust the price to pay. An essential issue for the activity is predictability and the stability of the contractual relationship is called into question.
In view of these developments, several Portuguese hospital groups publicly announced that they would no longer work under the ADSE agreement scheme. APHP has been alerting ADSE and the Portuguese government to the serious consequences that a unilateral and administrative decision of ADSE may have on citizens' access to health care. According to Oscar Gaspar, President of APHP, the main issue lies in the need for both sides to become partners and to establish a relationship of mutual respect between payers and providers.
The current situation in Portugal is related to the broader issue of private participation in the health system and the respect that must exist for those who invest so that society can have access to the most appropriate therapies and treatments and the most recent technologies. This is the good fight that Portuguese private hospitals are fighting.
HM Hospitales, a growing private hospital group
What is the position of HM Hospitales in Spain (in the healthcare landscape)?
The HM Hospitales group is one of the leading private healthcare operator in Spain with 15 general hospitals, 21 polyclinics and 4 specialised centres in Oncology, Cardiology, Neurosciences and Fertility, located in Madrid, Barcelona, Galicia, León and Toledo. 4700 professionals work for the group, which offers healthcare excellence in addition to research, education, constant technological innovation and publication of clinical research results.
Dr. Juan Abarca Cidón, President of HM Hospitales.
What are the latest news of your group ?
In 2018 HM Hospitales took a step forward with the creation of a healthcare project at the national scale thanks to the establishment of the group in Barcelona with the incorporation of Hospital HM Delfos. With its presence in Catalonia, the HM Hospitales group has extended its healthcare network to a Spanish geographical area with the biggest population and the most prevalent rate of double insurance. The HM Hospitales group gave rise to a private health project centred on the patient and with a true national dimension.
What are your main goals ?
The HM Hospitales group’s main goal is to provide to its patients the highest quality of care through an unwavering commitment to research, education and permanent technological innovation. In our hospitals, all these aspects operate in a coordinated manner to offer a comprehensive coverage of healthcare needs. One of the hallmarks of HM Hospitales is the network operation of all its hospitals so that the processes, care delivery and protocols are the same for all patients, regardless of their geographic location.
What are your projects/perspectives for the upcoming years ?
HM Hospitales aims to consolidate itself as a Group of private hospitals of reference in Spain with a national project that offers health services of the highest quality level to the Spanish population with double insurance. To achieve this goal, the Group is firmly committed to the continuous training of its health professionals, to the incorporation of innovative technology and the promotion of research. In this area, all the research activity is centralized through the 'Fundación de Investigación HM Hospitales’ (HM Hospitals Research Foundation), which aims to turn HM Hospitals into one of the world's leading hospital companies with the greatest scientific impact. In fact, HM Hospitales has reached 1245,671 points of cumulative impact and an average impact index of 5.85 caused by the 213 scientific publications produced in 2018.
Finally, in order to keep up with the evolution of time, HM Hospitales have been undergoing a Digital Transformation Plan with a 20 million euro investment directed to the transformation of healthcare and administrative processes through the use of the latest technology with the main objective of improving efficiency and the transparency in its relationship with the patients.
In your opinion, how can a private group like HM Hospitales, best contribute to public health in your country ?
HM Hospitales sees itself as an effective part of the health ecosystem in Spain, composed of  public and private institutions. In this sense, the Group offers an alternative to more than 10 million Spanish citizens who voluntarily decide to contract a private health insurance. A fact that, by all accounts, contributes to the sustainability and viability of Public Health in Spain.
Dr. Juan Abarca Cidón, President of HM Hospitales.
7 June 2019
UEHP Council Meeting
11-13 June 2019
HIMSS & Health 2.0 European Conference 2019