Monday, 29th April 2019  
Health as a European priority!
European elections represent for UEHP a major event, and we have prepared for all candidates in all Member States a questionnaire dedicated to healthcare perspectives to be debated in the next elected Parliament. Is Health really limited to a subsidiarity concept, or is it a question open not only to Politicians but to citizens themselves? We will present a summary of all answers we obtain, including specific position on patient free-choice, strategic investment, and performance concerning the private sector. An open mind on efficiency in healthcare is at the center of the discussion.
Dr Paul Garassus
President of UEHP
„Believe in Your Human Intellectual self!“
Can you please summarise your experience as a woman entrepreneur in healthcare?
Regarding my experience as entrepreneur - I do not have my business, I am running a business, which is a slight difference. Nevertheless, of course I have to understand and forecast as accurate as possible external driving forces that influence the business that I am running. So, active role in society, communication with all stakeholders is a must for a person in top managerial position.
Olga Schiopu, CEO at Medpark International Hospital
I have to accept that communication with some stakeholders is gender biased in my country, and probability for a woman to be less efficient than man specifically in this aspect could be significant. Inside of the organization, hospital in my case, there are no gender conditioned outcomes.
Which pieces of advice would you give to young women who wish to undertake a managerial career in the healthcare sector?
Biases regarding gender inequity are generated by people, by us. If you strongly believe in equal chances and capabilities regardless of gender, like I do, it is very improbable that you'll experience difficulties because you're a woman. Coming to women in managerial roles in the healthcare sector, especially in the European region, there are plenty of opportunities. Successful managers in healthcare usually adopt participative type of management, are focused on collaboration, have strong transformational leadership features - all of these characteristics are proven to be genetically more pronounced in women. I'd say that the healthcare sector should have a women leaders/managers domination, this is a very logical way.
What needs to be done today to ensure that there are more women in senior positions tomorrow in health facilities and more female doctors in senior positions in hospitals?
Maybe to talk less about gender inequity for women in top positions and to talk much more about successful women that transform the European healthcare landscape, being managers or physicians. It is important to change the society perception that a person in a senior management position is more frequently a man than a woman. The top- manager choice for the stakeholders in the healthcare sector would be much simpler, based upon his/her capabilities regardless of the gender. We are the decision makers and the stakeholders.
Message for the women that want managerial career in the healthcare sector: „Be professional and compete only on professional level, this is the most important and do not forget to communicate efficiently with everyone around you, because no communication = no leader. Believe in Your Human Intellectual self!“
Directive on work-life balance for parents and carers
On 4th April, the European Parliament plenary adopted a new proposed Directive on work-life balance for parents and carers, which will repeal of the existing Framework Agreement on Parental Leave, made binding by Council Directive 2010/18/EU (the Parental Leave Directive).
The law sets minimum requirements for all Member States, in a bid to boost women’s representation in the workplace and strengthen the role of a father or an equivalent second parent in the family. This would benefit children and family life, whilst reflecting societal changes more accurately, and promoting gender equality.
The main novelties introduced by this Directive are:
Minimum of ten working days paternity leave paid at the level of sick pay
Two months of non-transferable paid parental leave
Five days of annual carer’s leave
Flexible working patterns, including remote working
Next steps
The informally agreed text will have to be confirmed by a plenary vote, which is planned for the second plenary session in April.
If the text is approved, the directive enters into force on the twentieth day following its publication in the EU Official Journal. Member states will have to comply with the rules within three years.
You can find more information, as well as the text adopted HERE
Tools and methodologies to assess the efficiency of health care services in Europe
On 11 April, the EU Expert Group on Health Systems Performance Assessment (HSPA) published its report titled "Tools and methodologies to assess the efficiency of health care services in Europe: an overview of current approaches and opportunities for improvement".
The report aims at supporting National health policy-makers in their ongoing efforts to improve their set of tools and methodologies to assess the efficiency of their health care systems, as a means to help them design more effective, evidence-based policy interventions. It also presents a selection of opportunities for European countries to improve their methods (and their use) to assess the efficiency of health care services. The report is the result of the yearly work (in 2018) of the Expert Group on HSPA, which focused on identifying tools and methodologies to assess the efficiency of health care services.
Over the course of 2019, the Expert Group will focus on the identification of tools and methodologies to assess health systems resilience.
Benefit of EU action in health policy
Heading towards the end of the current legislation, the European Parliament takes stock of its achievements in the 5-year mandate by publishing the study “The benefit of EU action in health policy: the record to date”.
This study provides a non-exhaustive overview of the added value achieved so far through European Union (EU) action in the field of health policy. The study, requested by the Coordinators of the European Parliament's Committee on the Environment, Public Health and Food Safety (ENVI), covers the benefits of EU action in the following sectors: the EU Health Programme, cross-border healthcare, pharmaceuticals regulation, medical devices, and prevention and vaccination. The study provides a brief overview of the EU legal framework, policy tools and best practice in each area.
The analysis demonstrates that, within the limits set by the EU Treaties in health matters (subsidiarity), the EU does acquit its responsibility and utilises its capacity to act on behalf of EU citizens in this policy area. The study furthermore concludes that EU health policy clearly achieves European added value. European health policy measures taken to date are highly beneficial to and relevant for European citizens, economies and the Member States.
Survey on the expectations of Europeans in health
A few weeks before the European elections of May 2019, Mutualité Française* asked Harris Interactive to carry out a survey on the expectations of Europeans in health.
What is the Europeans' view of the health system of their respective countries? What types of interventions do they expect from the European Union on the different topics related to the field of health?
The survey was conducted online from February 27 to March 8, 2019 with a sample of 7056 Europeans, representative of the population aged 18 and over in France (1000), Germany (1012), Greece (1002), Italy (1027), Poland (1012), Portugal (1003) and Sweden (1000).
Main lessons of this survey:
The Europeans' view of their health care system is very different from one country to another. French, Swedes and Germans have a much more positive perception than average, while the Poles and especially the Greeks are much more defiant and expect more intervention from the European Union to improve things in this area.
  • Overall, the majority of European citizens surveyed in this study consider that the health system of their country benefits the greatest number, that is to say everyone or a large majority of people. This is particularly the case in France (80%), Sweden (75%) and Germany (71%), to a lesser extent in Italy (63%) and Portugal (59%). On the other hand, most Poles and Greeks consider that their health system benefits only a minority of citizens (69% in Poland, 67% in Greece).
  • In the same way, the citizens of Western and Northern Europe feel, for the most part, well protected by their national health system. This is mainly the case in France (85%, 23% of whom feel they are "very well protected"), in Germany (83%) or in Sweden (73%). On the other hand, it is again the Poles (35%) and the Greeks (27%) who are only a minority to feel well protected.
  • Compared to other countries, the French are particularly convinced to be better protected by their health system than elsewhere in Europe (77%, the highest level among the 7 countries), ahead of the Germans (64%). On the other hand, some are much more pessimistic: this is the case of the Portuguese (50% of them feel they are less well protected than elsewhere) and especially Poles (64%) and Greeks (71%).
  • In line with the above, citizens in Western and Northern Europe are the most confident about the future of their national health care system, but they are not convinced in absolute terms. Thus, 62% of Swedes and 58% of Germans express confidence in the future of their health care system, compared to slightly more than one French (55%) and one Italian (54%) out of two. On the other hand, the Greeks are by far the most pessimistic: 8 out of 10 Hellenes do not trust the future of their health system, and 31% say they are "not at all confident".
In addition, the attitude towards the European Union with regard to health is clearly affected by these differences of consideration with regard to national health systems. On the one hand, the inhabitants of the wealthiest countries (France, Germany, Sweden, Italy), who are more positive than the others with regard to their health system, have more confidence, to improve it, in the capacity of action of the public authorities of their country than in that of the European Union.
  • It is precisely the opposite for the others (Poles, Portuguese and Greeks), who would call in priority to the EU to intervene more to improve health in all member countries (69% for this option in Greece, 68% in Portugal).
  • European citizens expect priority from the European Union for harmonization of social rights, as well as directives in the field of health (such as mandatory vaccines for all Europeans, group purchases of medicines at the level of Europe ...). It should be noted here that the Greeks and the Portuguese are the most convinced of the need to set up a procedure for the harmonization of social rights (57% in Greece, 65% in Portugal).
Among other fields, Europeans express a strong concern about Ecological and health concerns and the majority, in all countries, wish that the European Union is more involved in environmental matters (especially water and air pollution): Portugal (95%), Poland (88%), Greece (87%) and Italy (87%), but still above 70% in all the others country.
European citizens also express increased vigilance with regard to the protection of personal data and occupational health. However, some of them are also worried about the use that could be made of these data (between 62% and 72% depending on the country). Europeans are also divided on the legal framework of this use of data, although they are generally satisfied with the level of protection of health data in their country. From the Portuguese (90%) to the French (63%), a majority is expressed in each country to ask for an increased intervention of the European Union in this field.
*Mutualité Française represents most of French top-up health insurances
A strong private healthcare sector
The Romanian private healthcare sector rose by 12% in 2017, to 1.7 billion euro, according to an analysis by Romania-based medical services comparison website Mediprice. The number of private hospitals in Romania thus doubled between 2011 and 2016 to reach 200 units while the number of private medical centres tripled to over 600. A reversal of this upward trend is not in view.
The growth of the private healthcare sector is mainly due to the instability of the public healthcare system and its structural and financial weaknesses : low healthcare expenditure in percentage of GDP (4.95% in 2015- Eurostat), underperformance and under-spending on healthcare, lack of access and availability of healthcare facilities,...
According to Cristian Sas, Chief Executive Officer at Clinica Anima "The Romanian private healthcare sector is driven by private investments, private corporate subscriptions and fees for services from patients, who very often favour the private sector for the quality of care. Nonetheless Romanian patients pay much more out of pocket than other European citizens in average, which is a huge problem. The payment systems from the NHS based on diagnosis-related groups (DRGs) severely underpays complex pathology fervently below cost, discouraging hospitals to undertake complex cases, for which they would be not paid properly. On top not all private hospitals are under contract with the the NHS. The private sector is working closely with patients associations, political bodies, the health Ministry in order to impulse some positive changes, for the sake of our patients."
Pact with Ministry of Economy recognizes the importance and dynamism of the private health sector in Portugal
At the end of March, a Pact for Competitiveness and Internationalization was signed between Health Cluster Portugal (HCP) and the Portuguese Ministry of Health - This Pact recognizes the current and future strategic contribution of the health sector to the Portuguese economy.
Pedro Siza Vieira, Portuguese Minister of Economy, Salvador de Mello, President of Health Cluster Portugal (HCP)
Indicators of Health Cluster Portugal, which has 172 members, including the Portuguese Association of Private Hospitals (APHP), show that the health sector represents 279 000 jobs and a turnover of 27 billion euros, with tendency to grow, as Pedro Siza Vieira, Portuguese Deputy Minister of Economy, explained.
"There is a very significant possibility of growth, both in terms of the contribution of the sector to research and development in Portugal, but also in what may be the increase in production in the field of pharmaceutical services, in order to reduce the trade deficit that we continue to face in this sector, "assured the Minister.
APHP considers that this is the recognition of Health as a factor of competitiveness of the country and, as a member of HCP, "welcomes this step forward and considers that the signing of a Pact should positively mark the relationship between public entities and private entrepreneurs so that we can have more investment and thus a wider and more differentiated offer. "
"Ensuring equity and equality in access to healthcare for the whole population at any time" and "improving contractual mechanisms to achieve better health outcomes and with more efficiency" are two assertions mentioned in the Pact and considered by APHP to be strategic for the future of the sector, as is the commitment, also made in this pact, to review the licensing mechanisms. The revision of these procedures is essential to remove costs of context and barriers for investment.
Signed in Lisbon, in the presence of the Portuguese Prime Minister, this pact with HCP was one of the three sectoral pacts signed by the Ministry of Economy, which also included the Portuguese AgroFood Cluster and the Cluster AEC - Architecture, Engineering and Construction.
According to Pedro Siza Vieira, the areas chosen were very specific: "We wanted to start with some sectors that, because of the significant weight they already have in exports or because they face particular challenges at the moment, could show how we want to work with companies from now on".
SAVE THE DATE – 2nd Iberian Summit of private Hospitals - 30.05.2019
FHP - Creation of a “skills operator” dedicated to health
After several months of intense negotiations with social partners and many meetings with representatives of the French Government, a “Skills Operator” (funding body for continuing vocational training and apprenticeship) specific to health sector was created and officially approved by the French Ministry of Labor.
This is a real success for health professionals. A specific “skills operator” is essential to carry out a strong policy in favor of job attractiveness and to develop training for health professionals. The health sector needs it to fight against the shortage of staff and thus ensure a better medical follow-up of patients treated in our structures.
This “Skills Operator” brings together several employers' federations from healthcare, social, and home support sectors. It will also welcome other health professions and support services for vulnerable individuals.
The creation laid the foundations for full recognition of the health sector. In a political and social context of professional “branches” merger, the constitution of this “skills operator” will help building a true cohesion among health sector that will benefit to our organizations, professionals and patients.
CAHPP Meets UN goals for Sustainable Development
UEHP partner CAHPP has been engaged in a sustainable development approach since 2012 and is adapting its 2018-2020 policy to the 17 Sustainable Development Goals of the UN.
In August 2015, 193 countries adopted the new sustainable development agenda converging around 17 UN goals as well as a global agreement on climate change (Paris Agreement adopted at COP 21).
Furthermore, CAHPP is the only consulting and referencing center in France having obtained the 3rd level (out of 4) of the AFNOR's AFAQ Focus CSR Responsible Purchasing International certification.
What are CAHPP actions ?
In addition to regular internal training for its 70 employees, monthly webinars are organized with the industry to ensure a consistent increasing power of all actors. Information and exchange seminars are organized at least twice a year with healthcare establishments. Finally, each year, CAHPP awards 4 scholarships to institutions to reward them for their action in sustainable development.
Informed buyers
CAHPP analyzes and evaluates the sustainable development strategy of its suppliers referenced via a "green index" (A, A +, A ++) dispayed on CAHPP product and service catalogs to manufacturers who meet the strict specifications.
This CAHPP online evaluation tool has been in use since 2012. The evaluation is based on more than 33 questions grouped into 6 themes that suppliers can answer over a defined period. 3 questions are disqualifying. A CAHPP control cell then checks each answer and the required proofs. The online tool gives a score to each supplier and service provider, as well as areas for improvement for the following year. Since 2013, the evaluation also takes into account the evolution of the quantified indicators supplied by suppliers from one year to the next.
SDG n°12
Since 2018, CAHPP has come down to the product level with the program "CAHPP is committed" on the promotion of products and services analyzed with regard to health and the environment. It thus meets Sustainable Development Goal number 12 "Responsible consumption and production".
Progressively CAHPP actions will be developed in accordance with each of the 17 SDGs.
“The most important job in the world” campaign by Helios private hospital group
At the opening of its second Nursing Congress in Berlin on 29 March 2019, Helios launched its nationwide caregivers recruiting campaign "The most important job in the world" (www.wichtigster-job.de).
"Our nursing staff needs attractive working places that we want to further develop in close dialogue with Helios healthcare professionals," said Helios CEO Franzel Simon. More than 20,000 caregivers are employed in the 86 clinics of the Helios hospital network throughout Germany. "The nursing staff is by far our largest professional group, followed by the medical one with about 12,000 doctors. To ensure good medicine, both groups must work closely together, today more than ever, because good medicine only works hand in hand with good care" emphasized the Helios chairman. "Our primary goal is to keep our caregivers and attract new ones for the future."
During Helios two-day care congress, 1,300 company nurses discussed with doctors and hospital managers in forums, workshops and plenary events, aspects of their working conditions, challenges in everyday work and concepts for improving their work situation. The objective is to render the caregiver working place more attractive in order to be prepared for current and future challenges in healthcare. Helios seeks caregivers in particular in large metropolitan areas such as Berlin and Munich. Nurses, nursing assistants and medical assistant for the operating room are the focus groups.  
“I am very proud of my work. I like my job very much”
The attention-grabbing campaign "The most important job in the word" is starting in 13 German cities with posters, advertisements and on the internet. In a second phase, the Helios clinics will adapt the campaign to their respective territories by adding the name of their city like for instance "The most important job in Krefeld."
Helios aims then to recruit around 1,000 nursing personnel in 2019.
Helios Group
Helios is Europe's leading private hospital operator with more than 100,000 employees. Together with Quirónsalud in Spain, Helios Kliniken in Germany is part of the Holding Helios Health. Around 19 million patients opt for medical treatment at Helios every year. In 2018, the company generated total sales of €9 billion in both countries.
Helios Germany operates 86 acute care hospitals, 126 medical care centers (MVZ) and 10 prevention centers. Every year around 5.3 million patients, of which 4,1 million are outpatients, are treated in Germany. With over 66,000 employees, Helios generated sales of approximately €6 billion in 2018. Helios is a partner in the "Wir für Gesundheit" (We for Health) hospital network. Helios Germany is headquartered in Berlin.
Quirónsalud operates 47 hospitals, 57 outpatient centers and around 300 occupational risk prevention centers, and treats approximately 13.3 million patients annually, of which 12.9 million are outpatients. Quirónsalud has over 34,000 employees, and generated sales of about €3 billion in 2018.
Helios Germany and Helios Spain are part of the Fresenius healthcare group.
Foto credits: Helios Kliniken GmbH/Thomas Oberländer
7 June 2019
UEHP Council Meeting
11-13 June 2019
HIMSS & Health 2.0 European Conference 2019