Monday, 27th May 2019  
Awareness facing uncertainty
A new European Parliament is elected! As representatives of the civil society in Brussels, we are really looking forward to working with the new MEPs representing the democracy in EU. The “day after” we remain vigilant to observe the new orientation in a complex world, with threats coming from outside and important changes which could occur in the European space itself. The future of Brexit is still uncertain, the roles of political groups we solicited before the elections will be cleared by facts, decisions and votes in the new Parliament. We will follow with major attention the nomination of new Commissioners and the end of the process of Spitzenkanditat designation. And with the end of bipartism, we will see how a balance between policy makers will be created in order to find the right way for the future of Europe.
The future of social protection depends on efficiency, reducing unnecessary costs and limiting waste, as well as on increasing the global performance of the system. The private sector is clearly a positive way to respect strategic investments in health and to offer a modern perspective breaking the borders in a global perspective. We are engaged to orient the debate on the quality of services delivered to European citizens together with all European partners, including patients associations. We represent the private hospitals’ sector and we will be partner, in this fragile new world, of all positive initiatives dedicated to modern services.
Dr Paul Garassus
President of UEHP
„We also need to eliminate the barriers disproportionately placed on women“
Can you please summarise your experience as a woman entrepreneur in healthcare?
To give you an accurate account of my journey as an entrepreneur, I have to begin by admitting that I started my entrepreneurial career without a clear-cut picture of what this entails. I am a diagnostic physician trained in laboratory medicine.
Dr Alida Gogescu, Secretary General of Palmed (Patronatul Furnizorilor de Servicii Medicale Private)
Opening a small medical laboratory with just five employees back in 2001, I thought that the most substantial part of my work will take place in front of a microscope. However, I realised soon after that in order for the company to develop, I had to trade the microscope for business strategies which I had to think through and put into practice. I belive that I grew into the role by learning quickly and thinking through every decision as the challenges unfolded.
By 2015, the moment when MedLife, the largest private provider of medical services in Romania, bought the majority of shares in the company I developed, I had succeeded in growing the business to incorporate five medical laboratories, two clinics and a small hospital providing day-care hospitalisation. Now I am the General Director and minority stakeholder of MedLife Oltenia, a region in the South-West of Romania
To reflect on the experience of being an entrepreneur in the healthcare sector, I think it is very important to mention that my generation laid the groundwork for the development of the medical system in Romania and opened up paths for private medical providers.
It might be difficult to imagine, but the national health insurance body was founded just a year before my debut as an entrepreneur.
So not only was the private provision of medical services in its infancy, but the whole system of regulations for healthcare insurers and providers was patchy. This motivated me, as a member of PALMED to design and suggest policy solutions that would help the medical system in Romania provide wider coverage and be more responsive to patients’’ needs.
Was my journey influenced by the fact that I am a woman? I think so, because I was aware of the need to be patient, diligent and brave. Especially in a society that was going through a substantial transformation, being persistent and consistent can be difficult and frustrating at times.
However, you have to belive me that the challenge was also very enjoyable.
Which advice would you give to young women who wish to undertake a managerial career in the healthcare sector?
First of all, I should mention that there are a considerable number of women entrepreneurs who own small or medium businesses in the healthcare sector in Romania. Quite a few of them run successful businesses and combine a good understanding of medical science with entrepreneurial skills.
I would say to the young women wanting to pursue a managerial career in the healthcare sector that they need to know that the time of autodidactic entrepreneurs is gone, so they should build adequate professional skills.
They should strive to gain a good understanding of the healthcare system, including the institutional and legislative environment in which healthcare managers and providers function.
I would also encourage them to be daring, as they have a lot to accomplish in the context of a healthcare system that is slow to improve its performance.
I would tell them not to give up in the face of obstacles, because the satisfactions of achieving in this sector are not easily comparable to other fields of activity. Healthcare is about human beings and the most essential aspects of their lives. Providing services of high quality to a wide range of customers is not only in your benefit, but in the interest of patients and the wider society. These are not just words, but a testament to how important is to remain focused and motivated.
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 ? (Would you be in favor of quotas for women ?)
There is a well known problem that even though there are proportionally more women than men in the medical sector, a more significant percentage of them occupy positions at the bottom of the professional pyramid and significantly less hold positions in top management.
I strongly believe professional competence for both women and men should be the primary basis for promotion.
However, while we need to ensure that there is a solid base of capable women who are able to work their way up to senior positions in health facilities and in hospitals, we also need to eliminate the barriers disproportionately placed on women. And for this, we need to have some pressure from the top-down, at least until we reach a tipping point from where promoting skilled women becomes a more self-sustainable process.
Therefore, I tend to be in favour of temporary quotas or targets that would pave the way for capable women to accede to top positions. After working with several highly competent and diligent women in my company, which I promoted to managerial positions, I can say that there definitely is a group of skilled and determined young women who deserve the opportunity to grow professionally and rise up to their responsibilities, just as men are allowed to grow into their senior positions.
Publication of the paper “Proposed Guiding Principles for Reimbursement of Digital Health Products and Solutions”
The European Commission published the paper “Proposed Guiding Principles for Reimbursement of Digital Health Products and Solutions” as one of four working papers developed collaboratively by members of the eHealth Stakeholder Group (eHSG), the EC’s expert group on European digital health policy.
UEHP is member of the eHealth Stakeholder Group (eHSG) and actively contributed to the drafting of this document together with other European stakeholders such as MedTech Europe (leader), COCIR, the European Society of Cardiology, the Pharmaceutical Group of the European Union (PGEU).
The paper outlines four recommendations that address the special nature of digital health technologies and their difficulty in entering funding and reimbursement pathways in Europe:
  • Specific criteria are needed to make appropriate reimbursement decisions for digital health products and solutions.
  • Relevant digital health products and solutions should benefit from either EU or national funds within innovation investment funds.
  • European guidelines for relevant and fit-for-purpose evidence generation for digital health products and solutions should be developed.
  • The specifics of digital health products and solutions must be considered when developing instruments for assessing and rewarding the value they provide for patients, healthcare actors, health systems’ sustainability and society.
Lack of adequate reimbursement pathways, alongside lack of interoperability and other factors, are among the most important barriers for the digital transformation of health and care.
You can download the document HERE
Ethics Guidelines for Trustworthy Artificial Intelligence
The High-Level Expert Group on Artifical Intelligence set by the European Commission (AI HLEG) has just published the Ethics Guidelines for Trustworthy Artificial Intelligence. .
Based on fundamental rights and ethical principles, the document lists seven key requirements that relevant systems should meet in order to be trustworthy. Aiming to operationalise these requirements, an assessment list is presented to provide guidance on the requirements' practical implementation. This assessment list will undergo a piloting process to which all interested stakeholders can participate.
I kindly remind you that UEHP is member of the Artificial Intelligence Alliance set by the European Commission. Therefore, do not hesitate to contact me should you have any feedback on the document or should you wish to participate in the piloting process to test out the practical assessment list provided by the European Commission in the document (more information and how to register your interest here: https://ec.europa.eu/futurium/en/register-piloting-process).
Private hospital care in a new era
A new legislative framework, denationalization through acquisitions, the positions of the political parties in view of the elections, and changes to the form of care as we move towards 2025
By Grigoris Sarafianos, President of the Panhellenic Union of Private Clinics and Member of the Board of Directors of the European Union of Private Clinics (UEHP)
The New Legislative Framework
The Institutions' demand in the framework of the fourth evaluation for a new legislative framework for the operation of private clinics, merging together the various Presidential Decrees and Laws into a single new law for the purpose of unified treatment, led to the voting of Law 4600/2019, which establishes new rules, especially for clinics to be created in the future, in a framework that is completely bureaucratic and strictly limits new investments, to the extent that based on a quick definition of costs, it can be calculated that no amortization and profit creation of any sort is achievable.
Such limitations and insubstantial time-consuming bureaucratic procedures even for the simplest issues, which do not aim to upgrade the level of health care services offered to patients, suit regimes with a controlled economy.
Fortunately for the currently operating clinics, care was taken for only 24 articles to apply, since the application of the rest is impossible, when the vast majority operate within the urban fabric of cities, any intervention in buildings is impossible and costly, and in fact, yields no return in periods of tight budgets.
The ultimate result is the opposite of what was expected, and in a sentence, instead of 3 Presidential Decrees as until now, clinics now operate with the 3 Presidential Decrees, but with a new law added!
Denationalization through Acquisitions
A few months after the end of the memorandum era for Greece, with everyone expecting the start of a new era, we see that the health care sector has also been affected by the consequences of the decade-long recession, regression, and the dramatic changes in the business climate.
The end of operations of dozens of clinics, approximately forty, acquisitions of private hospitals of well-known groups, in fact with a low level of financial dependence on the National Organization for Health Care Services, and offers and moves made to purchase other groups, and competition procedures for others comprise a backdrop that will be completely different by the end of the year, compared to two years ago and of course, before the start of the economic crisis.
And the questions emerge reasonably.
Why is there such interest on the part of foreign funds in investing in Greece and in particular in the health sector? Do they see it as a sector that will return to profitability immediately? Will increased value be recorded by the treatment center buildings? Will there be an excessive concentration of the sector and therefore, a redistribution of the pie among few operators? How will that happen, however, when the National Organization for Health Care Services is functioning in a framework of closed budgets, which are unrealistic compared to the real needs of the population, with private insurance companies covering a small percentage, approximately 12% with its health care programs, with a population that declares itself unable to pay privately to cover its hospitalization expenses?
Of course, the need for health care will continuously increase.
Although one of the consequences of the economic crisis is the reduction of life expectancy by two years, at the same time, the low birth rate, increased unemployment, the aging population, expensive new treatments, expensive new diagnostic tests, and the high cost of new medication create a negative balance for the finances of health care. This problem, the need to increase spending on health care, is something that we face not only in Greece, but in every European country.
The Positions of the Political Parties in View of the Elections
In a pre-election year like this one, which are the positions of the European and Greek political parties on health care?
All the parties talk about free public health care, kowtowing to voters, when of course they know what the condition of public health care is, especially in our country, and when the cost of public health care is a multiple of the cost in the private sector.
Everyone in Greece and Europe should understand the valuable complementary role of the private sector in all national health care systems and entrench free access and choice for patients in the member states of the European Union to the doctor and hospital that they trust in order to deal with the problems that they face, without waiting lists, and with costs that are accessible for their means but also much lower for the social security system.
Health is valuable, and at the European Union there should be a minimum unified policy, and the Commissioner for Health should be exclusively responsible for health care and not also other areas.
Changes to the Form of Health Care Moving Towards 2025
However, health care is evolving rapidly, medical technology is moving ahead at a very fast pace and discovering new innovative diagnostic and treatment machinery whose purchasing cost is prohibitive for the conditions in Greece, taking into consideration the low values of reimbursement for medical treatment and the financial means of both insurance funds and patients.
Still, we will need to develop, we will need our health care units to involve, and to invest, in order to cover the ground lost during the last decade, in our efforts, but also in our vision to provide health care services that are suitable for a developed country in Europe like our country, but also with a high level of responsibility towards our patients and fellow humans.
In order for this to become reality, we will need to readjust our health care budgets in accordance with patients' choices. If health care services cost more in the public sector and the state cannot at the same time act as a successful entrepreneur by taking risks, it is not a bad thing to consider public-private sector partnerships, with the concession of the operation of clinics of National Health Care System hospitals or even entire hospitals to the private sector. The state will be rid of loss-generating activities, so that it can exercise social policy without interruptions, and citizens will enjoy high-quality, efficient, safe, and immediate services, when they need them and not months later, when it may be too late for their lives.
Let's leave ideology and political cost and see which solution is more affordable for the state and is in citizens' interest to a greater extent, and let's proceed forward.
Health care has a cost, and we have never designed a national patient-centered strategy over the long term.
Let's implement reforms in this sector.
Health care services in the private sector, with a lower cost and incomparable levels of quality and service, and the obligation for the state to limit itself to inspecting the operation of the facilities in terms of the safety of services, and not bureaucratic issues by consistently raising obstacles.
After all, health care is changing its form, moving towards new standards of continuous and individualized care. The way that we provide our services is changing along with it, creating new conditions of treatment and individual care.
By 2025, technology is expected to change everything that we know about health care to this date radically, in terms of patients, private insurance, and even public health.
Information technology, machine learning, nanotechnology, and electronic systems will play a significant role in restructuring the sector.
Artificial intelligence, robotics, nanorobotics, the Bionic movement, brain – computer connections, virtual reality, and 3D-printed medicine have entered our daily life, and we will need to examine and study the impact of this technology on our businesses and invest in adapting them to the future, in order to continue to be competitive and profitable in the new environment that is taking shape.
In 2025, “digital assistants” will perform medical diagnoses, will measure vital signs, will implement doctors' orders, and will communicate with patients through computer-based vision and voices, with automated learning and the use of digital data.
We are experiencing the new revolution of technology. We need to be aware of this and adjust the way that our businesses in this sector and workers operate.
We should not lose the opportunity for this technological reform that coincides with leaving behind the memorandums and attempts to chart a course for growth.
And let's not forget that health care should remain in Greek hands and not be sold out to foreign funds with investment capital of unknown origin and only profit-seeking objectives.
FHP at “Paris Healthcare Week” : meetings, roundtables and interviews on the FHP’s TV studio set.
The Federation of Private Hospitalization (FHP) was present this year again at the international congress "Paris Healthcare Week" (PHW) from May 21st to 23rd in Paris. This must-attend event for the profession, organized by the French Federation of public hospitals, usually gathers around 30,000 visitors and 850 exhibitors.
From l. to r. : Pascal Maurel (presenter), Philippe Juvin (MEP), Dr Paul Garassus (UEHP President), Amah Kouevi (French Institute of Patient Experience)
During this meeting which brought together a great number of actors from the health sector, the FHP’s president, Lamine Gharbi, and his team welcomed the visitors on the federation’s exhibition stand, which was located in the Institutional Space of the congress, close to the Ministry of Health’s stand.
A TV studio set, called "#FHP Direct" and animated by the journalist Pascal Maurel, allowed many personalities to express themselves. These debates were then rebroadcasted on Twitter, Facebook and LinkedIn.
Key topics for the french hospital sector were discussed at roundtables, such as the new health law, digital health, quality of care, or the medical practice of tomorrow.
Preceding the European elections, one of the roundtables was devoted to the theme "Can Europe be the future of patients?”. It was attended by Dr. Paul Garassus, President of UEHP.
Consorzio Ospedaliero Colibrì: United we are stronger
What is the place of your hospital group within the Italian healthcare system?
The Consorzio Ospedaliero Colibrì is a network of private hospitals and health and social care facilities operating in the Emilia Romagna Region (Italy), committed to create a new local and regional community welfare, able to give qualitative answers to increasingly complex needs, in a network with the territory, citizens and stakeholders.
Averardo Orta , President of Consorzio Ospedaliero Colibrì
The group has seen the quality of entrepreneurial initiatives grow as the new project, which is unique in its kind, involves the construction of a range of diagnostic-therapeutic and assistance paths for patients, in collaboration with Bocconi University. A result that comes thanks to a constant investment in scientific research, technologies, staff training at all levels.
What are the latest news of your group?
This year, the Consortium completes its first 10 years of activity, a goal made of qualitative growth and improvement of services. In recent years, our model has been the focus of study programs and visits by managerial delegations from all over the world. The challenge we are working on, taking advantage of the expert advice of the Bocconi University Management School, is to create and offer courses for the care and assistance of the citizen, in a regional network of services and structures connected to each other.
What are your main concerns?
In recent years, our organization has chosen to invest in quality, research, innovation and improvement of management systems without making any profits, in order to ensure the best provision and supply of services. Our motto "E pluribus unum" (by many, one) indicates the strength that each consortium represents for the other, as in an increasingly global context it is not possible to go forward as individual parts, but it is essential to unite, to reach increasingly ambitious goals together, benefiting the community, the territory, the economy. This is the model, difficult to replicate, on which Colibrì bases its policy.
What are your projects/perspectives for the next years?
Our projects are numerous, and range from scientific research to innovation, giving a look at virtuous models of health throughout the world. This is made possible thanks to a program of Study Tours, carried out every year, with the direct involvement of the consortium members: worth mentioning is the visit to the Baylor Scott & White Health of Dallas. It was subject of evaluation both on the rehabilitation and cardiology aspects, with interesting thoughts by the Consortium experts in their own fields of competence (clinical-assistance and organizational-management). We are convinced that the exchange of knowledge and experience at a global level can greatly increase our reality.
In your opinion, how can a private group like yours, best contribute to public health in your country?
Consorzio Ospedaliero Colibrì is part of the National Health System (SSN). Public and private are different and complementary sides of the same coin, as health is common goods and a right for everyone. All the consortium members, in line with Colibrì’s philosophy, are united by the commitment to take care of users and patients in an increasingly punctual, complete and innovative way. Each structure has its own history and experiences, its own cultural and professional know-how, which flow into the healthcare offer of the region and the country. In our opinion, this is already a contribution to the growth of the country's well-being.
7 June 2019
UEHP Council Meeting
11-13 June 2019
HIMSS & Health 2.0 European Conference 2019
11 October 2019
UEHP Council Meeting