28th April 2021  
Build Back Better
The COVID-19 crisis will be a scar on the World face.
We must “build back better”, demonstrating that Europe is not a problem but a solution, delivering cohesion and solidarity.
Two recent initiatives show the vitality of European democracy. First, on March 31st, the Commission launched a public consultation on the Health Emergency Preparedness and Response Authority (HERA). Part of the EU's answer to the pandemic and a strong European Health Union, HERA aims to improve Europe's capacity and readiness to respond to cross-border health threats and emergencies. It is a major issue for all of us.
Then, more recently, the European Patients’ Rights Day commemorated on April 18th, an annual recurrence that celebrates patients' and civil society organisations in their efforts to advance patients' rights at the global and European level.
The future of healthcare needs responsible evaluation and scientific oriented decisions. For the sustainability of social protection systems, the accountability of spending decisions is a priority. Maybe the principle of hospital downsizing will reach a limit, demonstrating the usefulness of adequate capacity in hard times. But let's not forget that the human factor is central to all our common actions, for patients as well as for citizens.
Stay safe and get vaccinated, we need you to “build back better”!
Dr Paul Garassus
President of UEHP
Private hospitals in Europe fully engaged in the vaccination strategy
Vaccination, which is at the heart of the world´s coronavirus response, has now been ongoing in most of Europe, taking center stage. The European private hospital sector shows its engagement in the vaccination process.
Private Hospitals make a great contribution to overcome the crisis of the Covid-19 pandemic. Already in March 2020, the Rehazentrum Münster provided beds for patients with acute Covid infections. Since the second wave of infections in November 2020, Covid patients can be taken directly from public hospitals for further treatment after the acute phase. A multi-professional rehabilitation can be added in case of medical necessity. Through the cooperation between public and private health facilities, an ideal and continuous care can be guaranteed.
Furthermore, a vaccination site was established at the RZ Münster which can be used at short notice when larger amounts of vaccine doses are available. This was made possibly together with the municipality as well as the state.
The vaccine dynamic is made possible in the field by cooperation between all stakeholders. Each makes its contribution to its extent. For its part, private hospitalization is fully mobilized. Thus, after the opening of the vaccination campaign, several dozen vaccination centers were opened privately across the country.
The success of the vaccine strategy in our country depends on the mobilization of all. In this, the multiplication of effectors is a good thing. We are now at 10 million first injections, and everyone must throw all their strength into the battle to regain a life without Covid. In accordance with the public service missions they fulfill, private hospitals and clinics are fully engaged in the vaccine dynamic. They strive to be creative, in conjunction with other health actors in the area, to make it as easy as possible for the French to access vaccination. Reluctance to get vaccinated, which was a real concern at the end of 2020, is now less. According to an Odoxa poll published on April 8, 70% of people questioned are in favor of vaccination. This is almost 30 points more than four months ago!
This commitment and their competence are greeted by the French: it is the health professionals, followed by the health establishments, which benefit among all the institutions of the country of the highest level of confidence.
The German National Covid-19 Vaccination Strategy consists of two phases depending on the availability of quantities of vaccine: in a first phase vaccinations against Sars-CoV-2 will be carried out in vaccination centres to which mobile vaccination teams may also be assigned (Phase IA: Targeted, centralised vaccination; Phase IB: Expanded, centralised vaccination). As soon as the conditions allow and sufficient quantities of vaccine are available with suitable storage conditions, the aim is to transfer vaccination activities to the regular supply system (Phase II: Widespread, decentralised routine vaccination via medical institutions, general practitioners and company doctors).
At the moment, hospitals – regardless of their ownership – are no primary providers of vaccination in Germany. But private hospitals stand ready to support the vaccination strategy. For example, in Hamburg where a model project already exists. Asklepios concluded a contract with the city Hamburg. If enough quantities of vaccine are available, seven Asklepios hospitals could vaccine more than hundred patients of psychiatry, geriatrics, oncology and early rehabilitation daily (see press release here).
In Bavaria like in other regions in Germany – hospitals are directly taking part in vaccinating their hospital staff. Vaccines are provided by the health care authorities to the hospitals no matter if they are public, private or private-non-profit organizations and no matter the mandate of supply.
In Munich the communication process works fluidly among the hospitals and with the health authorities, so that hospitals know beforehand, when they will receive the vaccines and in which quantity.
The Greek State officially designated the members of the Hellenic Private Hospital Association (HPHA) and only them from the private hospitals in Greece as COVID-19 vaccination centers, initially for their employees, doctors, and external service providers such as catering, security, housekeeping etc. The selection of our association members was because they are the major private hospitals operating in Greece and they are the ones participating in the state plan for the combat of COVID-19. Thus, in full alignment with the Ministry of Health, the members of our association have contributed with well over 140 ICU and 800 beds and one hospital for patients being moved from public hospitals to make space for the creation of COVID-19 units. We have also offered four hospitals that were transformed to COVID-19 units, physicians to support the public system, and ambulances to transport patients from public hospitals to our facilities.
For the vaccination, all hospitals of HPHA were asked to provide detailed lists of people to be vaccinated, including their social security number, to the Ministry of Health. Thus, the Ministry had an accurate count of doses required in each vaccination site and generated approved lists of inoculations.  The training of our physicians and pharmacists took place on Sunday 10 January at assigned public hospitals, and additional training was provided on Monday 11 January via web conferences. Vaccines, tablets for registering people approved for inoculation and the administration of doses, arrived at our respective facilities on Tuesday 12 January in the morning, and vaccinations started a few hours later. The vaccinations were carried out smoothly, and faster than scheduled.
The COVID-19 pandemic challenge gave the opportunity to the Ministry of Health to test, evaluate, and grade the private healthcare providers. Acknowledging our contributions, the Ministry of Health, extended our vaccination mandate to include the oncology and dialysis patients in our care.
On December 2, 2020, the Minister of Health, Roberto Speranza, presented the Guidelines of the Strategic Plan for anti-Sars-Cov-2/Covid-19 vaccination (updated with the Decree of January 2, 2021), prepared by the Ministry of Health, the Special Emergency Commissioner, the National Institute of Health, Agenas, and AIFA.
The Plan, approved by the Senate and the Chamber, provides for:
  • free vaccination for everyone
  • over 215 million doses available on the basis of the agreements stipulated, and after authorization from the EMA and AIFA (estimate updated on December 30, 2020)
  • start of vaccinations in Italy and Europe (Vaccine Day) on December 27, 2020
  • identification of the categories to be vaccinated with priority in the initial phase, limited by the availability of vaccines: health and social health workers, residents and staff of the assisted living homes for the elderly
  • logistics, procurement, storage and transport under the supervision of the Special Emergency Commissioner
  • governance of the vaccination plan, to be supported by ongoing coordination between the Ministry of Health, the organization of the Special Emergency Commissioner, the Regions, and Autonomous Provinces
  • an information system to manage the vaccination campaign in an effective, integrated, safe and transparent manner
  • pharmacosurveillance and immunological surveillance to ensure the utmost safety throughout the vaccination campaign and the immune response to the vaccine.
Many of the health and social-health facilities associated with Aiop have already administered the vaccine to their health workers in different Regions at different times, notwithstanding the great difficulty in obtaining the vaccine.
The National President of Aiop, Barbara Cittadini, has been engaged in and continues to have various discussions related to policy in order to understand to what extent the associated facilities may offer their services to the country and be part of the "system" along with the entire Health Sector, in order to provide the Covid-19 vaccine throughout Italy.
With the appointment of the General Francesco Paolo Figliuolo as the new Covid-19 Emergency Commissioner, the National President of Aiop, Barbara Cittadini, reiterated that the network of health facilities associated with Aiop, situated throughout Italy, is ready to assist with increasing the number of vaccines. These healthcare facilities are already operational and ready to become vaccination centers for the people of Italy.
Since a large amount of vaccine doses is expected to arrive in Italy in the next few weeks, the Commissioner's organization has asked for indications regarding which facilities may be relied on and to what extent, in order to map out each one's operational potential and to deliver the appropriate quantities of vaccines to be administered to the general public.
Specifically, the Commissioner's organization asked Aiop to provide information for each Region on:
  • the number of potential Vaccination Centers (VCs) available
  • their location, with details of the Region, Province, City/Town, address and contact person
  • the largest weekly schedule for the activity (days/hours per week) possible
  • the composition of the health teams that will work in them (doctors, nurses, healthcare professionals and others)
  • the estimated daily vaccination capacity of each VC
  • the presence in the VC of equipment, devices, aids, medical furnishings and drugs
  • and administrative/IT support for vaccination records.
The survey carried out to determine which facilities could become vaccination centers and the number of vaccines - daily or weekly, in case they are only able to schedule vaccinations on certain days of the week - that each facility will be able to administer, using its own internal resources, indicates that approx. 200,000 vaccines may be given nationwide weekly at the beginning and that this number could subsequently double in size.
Subsequently, a specific Agreement with Aiop at the national level will constitute the reference framework to be applied by means of operational agreements with the Regional offices.
The involvement of the Aiop associated facilities with vaccination activities would make it possible to immediately increase the number of daily vaccines given, scrupulously following the indications related to the need to give priority to specific categories and operating in complete safety.
Patients have always been and must continue to be the focus of attention and the priority for those operators whose mission it is to "provide care and help others", especially during this emergency period.
Administering the vaccine as soon as possible is an ethical and deontological choice for Aiop, one that provides security not only to healthcare workers and the most at-risk patients, but also to all other citizens, helping the country to recover quickly and return to a long-awaited normalcy.
This is an opportunity that offers further witness to the importance of increased integration of the public and private components of the NHS for the benefit of all Italians.
On January 12, the Portuguese private hospitals presented the Government the availability to collaborate in the vaccination plan.
Private hospitals said that they could vaccinate citizens based on the list sent by the authorities and that the vaccination would be registered on the national vaccination platform. Vaccination would have no cost to citizens.
The government answered on January 22 thanking the availability but saying that "at the moment the shortage of available vaccines advises not to disperse vaccination points, but when this shortage ceases to be a strong limitation to the vaccination process, your support will be welcome ".
To this day, the process continues to be carried out only by public health institutions.
Supporting the vaccination campaign in Romania has been a top priority for the local private sector.
Similarly to other European countries, the vaccination process in Romania has been organized in three phases: healthcare employees; population at risk and essential workers; and the general public.
1. Involvement in the vaccination campaign from the very beginning
Private players have been involved in the vaccination process even from the start of the campaign, committing important resources to help sustain the efforts of local authorities. Tens of private clinics and hundreds of healthcare workers from main cities in Romania are engaged in the campaign and have been throughout the three phases. The first major private player involved was Regina Maria – The Private Healthcare Network, who began vaccination as early as January.
2. Opening of on-site vaccination clinics, in partnership with local companies
Regina Maria also opened the first on-site vaccination clinic in partnership with one of its corporate clients: Continental, the auto components manufacturer. The facility is located inside the premises of Continental’s industrial park in Sibiu, one of the major cities in Romania, and is open for the company employees, their relatives, as well as for people living in the region.
3. Education and information campaigns; live webinars
Another major pillar in the vaccination campaign was education and continuous information. Private player Regina Maria has done this through live online webinars for both its corporate subscribers and the general public, where doctors explained the benefits of vaccination, compared available vaccines and answered main questions regarding immunization. The live webinars were attended by thousands of participants.
4. Setting an example through medical staff
In order to build trust regarding the safety of vaccination, Regina Maria carried out an online campaign, quoting its top doctors and nurses who had been vaccinated. They posted pictures from the moment they were inoculated, encouraging people to also get vaccinated, for everyone’s safety. The immunization level of Regina Maria hospitals’ staff exceeds 90%.
This endeavor was also supported by the Romanian Royal Family, who received their COVID-19 shot at Regina Maria and promoted this online.
5. Clinical studies of post-vaccination antibodies
Top two players on the market, Regina Maria and MedLife, have both begun studies on the immune response of the human body after vaccination, measuring antibodies blood levels one month, three and six months following inoculation. The studies are still in progress, although preliminary results have already been announced.
In northern Romania, the Pelican Hospital is the only private hospital in this region conducting the RO-VACCINARE vaccination campaign.
The Pelican Vaccination Centre in Oradea is the only vaccination centre in northern Romania to operate as a private facility with the necessary infrastructure to provide specialized medical services for people receiving the COVID-19 vaccine.
Several factors contribute to the excellence of the Pelican Vaccination Centre in Oradea. In this facility, the safety of people receiving the vaccine is ensured, in addition to the medical staff involved in delivering vaccines, by emergency squads and the personal assistance and supervision of in-house epidemiologist Dr. Budea Adina.
The presence of emergency squads and the in-house epidemiologist, ready to intervene immediately, has led to a progressive increase in the number of people registering at the centre. Approximately 3,000 people are currently on a waiting list for the first and second dose of vaccine.
Since the start of the RO-VACCINARE campaign, undertaken by the Romanian state across the whole country, the Pelican Vaccination Centre has administered 17,000 doses of the vaccine, 90% Pfizer–BioNTech vaccines and the remaining percentage Moderna vaccine. At present, the vaccination centre administers only Pfizer–BioNTech vaccines.
The workflow at the Vaccination Centre helps accelerate the campaign undertaken by the Romanian state, thus helping people to receive the vaccine against COVID-19 as soon as possible. The Pelican centre administers 150-200 doses per day.
Since the start of the RO-VACCINARE national campaign, none of the people who received the first and second dose of the vaccine at the Pelican Vaccination Centre in Oradea have experienced any side effects, apart from the typical ones.
The Spanish Ministry of Health has left in the hands of the Autonomous Communities the planning of the administration of vaccines in their respective territories, therefore, in the absence of a national plan that contemplates the collaboration of private health as part of the National Health System It is each one of the regional health administrations that decides whether to do it or not.
So far, the Community of Madrid has officially approved the incorporation of private health into its vaccination plans. It has done so through the publication of an order in the Official Gazette of the Community of Madrid by means of which "the health authorities have the capacity to enable and have adequate spaces and facilities, public or private, to develop the vaccination campaign against Covid-19, as well as to make available to private health centers and their professionals for this task during the health emergency ".
In addition to this region, Catalonia, Andalusia, the Canary Islands and Murcia have expressed their intention to do so as more doses of the vaccines that Spain should receive through the European Union become available. Thus, the Catalan Government has recently verified that it will rely on private healthcare, at least through subsidized centers. And the Canary Islands, for its part, will have the private health infrastructure to vaccinate certain essential groups such as pharmacists, physiotherapists and dentists, among others. These five autonomous communities account for 56% of the Spanish population.
However, the Spanish Private Health Alliance continues to constantly reiterate to the Ministry of Health the willingness to offer all its resources and infrastructures to help speed up the administration of vaccines under the guidelines of public health.
Hirslanden operates seven COVID-19 vaccination centers in Switzerland
As the operator of seven COVID-19 vaccination centers in Switzerland, the Hirslanden Group, member of the Swiss Private Hospital Association, assumes health policy responsibility in the fight against the coronavirus and is actively involved in the Swiss vaccination strategy.
Efforts to date to deal with the Covid-19 pandemic have shown that the protection of the population can only be ensured through fast and cooperative interaction between all those involved. As a system-relevant partner, the Hirslanden Group of clinics, member of the Swiss Private Hospital Association, is therefore committed to containing the pandemic on a broad front with its vaccination centers, repetitive testing, and inpatient and intensive care treatment of affected COVID-19 patients, thus contributing to a gradual return to normality as soon as possible.
In collaboration with the cantons, Hirslanden operates vaccination centers in the cantons of Geneva, Thurgau, Vaud, Zug (in cooperation with the Zug Cantonal Hospital) and Zurich. Thurgau was the first canton to entrust Hirslanden with the establishment and operation of COVID-19 vaccination centers in Frauenfeld and on the Lake Constance ship MS Thurgau, which docks at the ports of Romanshorn, Kreuzlingen and Arbon. On April 6, 2021, the COVID-19 vaccination center in Weinfelden began operations as the third and largest vaccination center in the canton of Thurgau. Also in operation since April 6, 2021, is the vaccination center Messe Zürich. With 30 vaccination lines and up to 4,000 vaccinations per day, it is the largest vaccination center in the canton of Zurich and one of the largest in Switzerland. The next vaccination center will begin operations in Lausanne on April 26th.
As the largest medical network in Switzerland, Hirslanden is able to operate the vaccination centers very flexibly in terms of capacity. Utilization is driven by vaccine capacity and follows efficient business management principles.
To effectively control and stop the coronavirus pandemic, it is important to quickly vaccinate as many people as possible. This will reduce severe disease progression and deaths and help maintain hospital capacity. In addition, vaccination contributes to herd immunity over time, which also protects other vulnerable people who cannot be vaccinated, e.g. for medical reasons, from infection.
Focus on people's quality of life
"Thanks to increasing vaccine availability, we have the most prospectively effective tool available, in addition to testing and tracing, to prevent infections and human suffering. It is Hirslanden's stated vision to maintain and improve people's quality of life. We are pleased that with the rapid implementation of the vaccination strategy by means of vaccination centers we can make a further contribution to this," says Daniel Liedtke, CEO Hirslanden Group.
As a healthcare provider throughout Switzerland, the Hirslanden Group offers integrated medical care along the entire life cycle, the so-called Continuum of Care. In addition to consultation, therapy, and follow-up care, this also includes prevention, among other things through COVID-19 vaccinations, as well as medical diagnostics, among other things through preventive, repetitive testing.
UEHP at MedTech Forum 2021
Last 21 April, our President, Dr Garassus, was invited to join the panel "Unlocking the Value of Diagnostic Information – or how to make European Health Systems more resilient?" in the framework of the MedTech Forum 2021
The context - The value of health-related information such as those derived from diagnostic testing never became clearer as than during COVID-19 pandemic. Diagnostic tests have proven to be an indispensable source of information to tackle the unprecedented circumstances of the SARS-CoV-2 outbreak. By identifying the responsible infection agent, testing allows to detect the existence of SARS-CoV-2 and to distinguish between COVID-19 and other respiratory tract infections (viral or otherwise) with similar presentation. As such, the use of diagnostic information does not only contribute to minimize the risk of the virus spreading but also improves disease management in terms of accurate diagnosing and targeted treatment.
Taking the example of respiratory tract infections against the backdrop of the COVID-19 pandemic, panelists discussed how better leveraging diagnostic information can enhance health systems’ resilience. Panelists outlined suggestions to health policymakers at both the EU and national level that can unlock the potential of diagnostic information for more efficient healthcare.
The discussion was enriched by the presentation of the Value of Diagnostic Information (VODI) case study. 
Dr Garassus brought the voice of private hospitals in Europe to the discussion with a focus on care coordination, disease prevention and high quality health services. 
UEHP supports the European Patient’s Rights Day
Last 18 April we celebrated the 15th edition of the European Patients' Rights Day, organized by Active Citizenship Network.
The European Patients’ Rights Day, has become a regular annual event on the European and national political agendas to inform, discuss and take commitments to improve patients’ rights in Europe and in each Member State. It has been recognized also in different official documents of the European Parliament.
This year again, the European Union of Private Hospitals was asked to send a message of support and commitment on the protection of the health of European citizens. Our Secretary General, Ms Giannico, participated to this initiative by stressing the importance of protecting people’s health and patients’ rights in all Member States; the commitment of European private hospitals to constantly innovate care delivery and pathways; the crucial role the private sector played during the outbreak of the COVID19 pandemic when all hospitals across countries teamed up to save lives; the full support and commitment of private hospitals towards better healthcare for our common patients.
Watch the full video message here.
The EU Health Coalition meets the Vice President of the EU Commission
Last 8 April, the EU Health Coalition virtually met Mr Margaritis Schinas, the Greek Commissioner for Promoting our European Way of Life since 2019, and Vice-President of the European Commission
Mr Schinas’ current portfolio covers migration, security, culture and sport, religious dialogue, equality and diversity, but also coordination of the Skills Agenda and European Education Area. More importantly, he is responsible for the development of a European Health Union, which entails some key initiatives: Crisis preparedness and response measures: Strengthening crisis coordination, new mandates for the ECDC and EMA, and creation of HERA; The Pharmaceutical Strategy: Fulfilling unmet medical needs, supporting industry, enhancing resilience, and promoting high standards for medical products globally; Europe’s Beating Cancer Plan: Prevention, early detection, diagnosis and treatment, and improving quality of life for cancer patients and survivors.
The meeting was very productive, as the partners of the Coalition had the chance to present to the European Commission their  recommendations on the future of health, with a focus on the following ones: 
  • Support the measurement and collection of standardized health data, including outcomes relevant for people and patients, throughout health systems;
  • Facilitate multi-stakeholder partnerships with regions and cities;
  • Invest in Europe as a true research and innovation hub;
  • Coordinate research efforts across Europe to be able to jointly tackle emerging complex health challenges;
  • Accelerate the creation of a European Health Data Space Health data and digital health.
Mr Schinas expressed his interest in knowing more about the Coalition and working more with this multi-stakeholder platform. He praised all partners for creating such an alliance and being so involved and committed all together to make healthcare a priority in the EU agenda. 
The EU Coalition looks forward to fostering a dialogue with the European Commission and between all actors, including regional and local health authorities, while avoiding duplication of efforts and in the full respect of the competencies of the EU in the healthcare sector.
More on the EU Health Coalition: Home - EU Health Coalition
Roadmap on the evaluation and revision of the general pharmaceutical legislation
On March 31, the European Commission published a roadmap on the evaluation and revision of the general pharmaceutical legislation.
The revision of the general pharmaceutical legal framework, aims to ensure access to affordable medicines in the EU. It aims to foster innovation including in areas of unmet medical need (such as in antimicrobials) and to enhance security of supply while adapting to new scientific and technological developments and reducing regulatory burden where possible. Drawing lessons from the COVID-19 pandemic, it will support a future-proof and crisis-resistant pharmaceuticals system.
The document is now open for feedback for 4 weeks, until the 27th of April (deadline: midnight, Brussels time).
If you have any inputs please send them to me. If there’s a shared consensus among all members we can envisage an official UEHP reply.
More information is available here.
Public consultation on HERA
The European Commission launched a public consultation on the newly established HERA, the European Health Emergency Preparedness and Response Authority. 
HERA is set to become a central element for a better EU preparedness and response to serious crossborder health threats.
Have your say on how to turn HERA into a strong institution of the Health Union! 
More information is available here.
Horizon Europe program to support research on coronavirus variants
I am writing to inform you that, following the communication on the European biological defense preparation plan against COVID-19 variants, called "HERA Incubator", the European Commission has published 4 measures relating to the Horizon Europe program that will support research on coronavirus variants.
The calls published by the European Commission complement the previous actions taken by the EU for the development of treatments and vaccines against COVID-19.
The new calls for proposal, which opened yesterday, 13 April, will support the development of large-scale COVID-19 groups and networks that go beyond the borders of the EU, creating links with other European initiatives, and will strengthen the infrastructures needed for sharing data, expertise, knowledge and research among researchers and research institutes.
Projects benefiting from funding must:
The selected consortia will have to collaborate with other relevant projects and initiatives at national, regional and international level to optimize synergies and complementarity and avoid duplication of efforts.
The calls aim to develop actions to address looming threats in the short and medium term and, at the same time, to prepare for the future.
The selected projects will contribute to the establishment of the European Health Emergency Preparedness and Response Authority HERA, which will allow the EU to better anticipate and deal with future pandemics.
HERA will set up a dedicated structure to support the development, production and dissemination of medical countermeasures in the event of natural or man-made health crises.
I really encourage you to share this information with your members hospitals which might be interested in presenting a project proposal to the EU.
A voice heard
Interview with Christine Schibler, General Delegate of FHP (French Federation of Private Hospitals)
What I retain from the year 2020 marked by the Covid crisis, is the increase in public-private cooperation, as well as the agility of the sector, which has taken on Covid patients up to 30% in some regions, well beyond normal critical care capacities. The same agility can be observed in other sectors, which made it possible to double ICU capacity during the first wave in the spring. The mobilization of everyone was unprecedented.
During the first wave, we faced a total deprogramming of hospital activities, the second wave was rather mixed depending on the regions and the third wave which currently impacts us is strong with different deprogramming depending on the regions. It should be noted that public-private cooperation, hesitant in March 2020, is now operational, and that the responses to the crisis are adapted and carried out jointly by the various establishments in a same territory for the care of Covid patients but also of other patients, consequently avoiding delays in care. This unprecedented situation has fundamentally changed the image of the service that our establishments provide to the public, our "service to the public" is recognized.
A financing guarantee
This recognition by the population is coupled with that of political authorities. It was first expressed by an immediate commitment from the Minister of Health from mid-March 2020 on a guarantee of funding for establishments regardless of their nature, public and private. Then, concretely, support on Covid surcharges, gross margin losses, revenue losses, etc. were guaranteed equally  to the private and public sectors.
Recognition of our staff
At the same time, the efforts of our staff were recognized initially by the payment of a Covid bonus in May-June 2020 to both the public and private sector equally. Secondly, our staff benefited from an increase in salary of 160€ net per month as part of the "Ségur health reform" measures, whereas public sector employees received 183€. Finally, the third fundamental mark of recognition is a point of principle, as a categorical upgrading of paramedical professions under negotiation will be put in place by the end of 2021. On this point, France was lagging behind, we were ranked 26th by the OECD, and we climbed back to 19th place, which is not bad.
A voice heard
The third major finding is the strength and weight acquired by the voice of the private hospital sector. We put forward proposals to the government that are now being considered. The proof is in the numerous proposals retained in the framework of the "Ségur health reform": 20 out of the 33 proposals selected are the result of our contribution.
Another observation is that our historic commitment to overcome the shortage of caregivers through a solid training effort has been taken into account. 100,000 posts are currently vacant in the health sector alone in France. We have taken many steps to highlight our role as a very dynamic economic player, anchored in the territories, creating jobs that cannot be relocated. The private health and medical-social sector has thus obtained a financial envelope of €92 million to develop training as part of the recovery plan.
The challenges before us are to reinforce and consolidate in the long term the principle of equity between the public and private sectors in the decisions and financial allocations that are granted to us. This will require the consolidation and recognition in terms of image. The regionalization of care will also be strengthened, through additional regionalized funding. Other points will have to be advanced for the transformation of the health system at the level of governance, data management, development of foresight, training policy, etc.
Furthermore, we are satisfied with the increase in the quality funding envelope to 450 million, this is certainly not enough out of 92 billion, but it is an important step.
Finally, I hope to see an acceleration of the digital transformation in our sector. It would be good if, in the midst of this crisis, in view of all the innovation that has emerged, we could keep up this pace so that in health there would be more innovation and therefore more circulation of information, more evaluation, more efficiency. We really need to have a transfer of competence from sectors of activity that are further ahead than health.
I note a real awareness that our sector should not be considered as a budgetary burden but as a real economic opportunity, including questions of sustainable development, economic sovereignty, etc. We have a role to play. These are the lessons of the crisis.
German patients highly rate private clinics
Interview with Thomas Bublitz, CEO of BDPK (German Association of Private Hospitals)
BDPK has just released the results of a survey* it had commissioned on the image of public, private, and private-non-profit hospitals in Germany. What are the findings?
First of all, we have been surprised by the high level of knowledge of the population about the functioning of the health system in general and that of private hospitals. They know that private clinics are affiliated to the public health system and that they welcome all patients, regardless of the type of their health insurance.
Moreover, the nature of ownership of health establishments is a secondary consideration for patients, who are primarily looking for the best possible care.
Overall, it emerges that patients are very satisfied with their stay in private hospitals: 93% satisfaction rate (88% for all hospital types). Freedom of choice is paramount for all survey respondents (95%) and the decision to choose a hospital is respectively guided by its specialization (95%), the recommendation of the attending physician (92%) and the reputation and standing of the hospital (90%). Internet reviews are less important (44%).
In the opinion of BDPK, the high level of satisfaction with the quality of treatment and services and the particularly good overall evaluation of private hospitals clearly shows that competition in terms of quality has a positive effect on healthcare structures. These very good results contradict certain received ideas which say that the private sector’s major objective is to increase profitability at all costs. Patients have a good image of the private healthcare sector because their own patient experiences have been positive.
A few months before the elections in Germany, BDPK co-signed the thesis "Making Health Regional" in favor of the regionalization of health management, what are the main lines?
Gaps in healthcare mostly appear on the ground at regional level and ideally, solutions, cooperation and integration of healthcare services should emerge locally. Centralized management with uniform federal specifications dictates the expenditure and the way hospitals work. Financial flows are managed in a very centralized way too. Healthcare would be delivered differently if the regions had control over its organization. BDPK therefore advocates a greater regionalization of care and has proposed testing new remuneration models with the regional health fund model. There are examples at regional level which prove that it works. We would like our government to launch pilot projects and to adapt the legislation. The organization between regions does not have to be automatically identical, it just has to be right.
How are German hospitals going through this pandemic period?
Private hospitals in Germany have the same public health service missions as public (municipal) and charity (religious, …) hospitals. Therefore, they faced the same difficulties, at the beginning the lack of experience in the face of such a pandemic: How to treat a Covid patient in an intensive care unit? Should a patient be artificially ventilated when putting a tube into the trachea poses a high risk of infection? All the caregivers in the intensive care units have faced these challenges, they had to learn, as have all other caregivers in the world.
The second is financial. We have an activity-based payment system and the desertion of patients for fear of contamination and the government's request for deprogramming elective surgery has had a significant financial impact. All hospitals have on average treated 20/25% less patients last year. Some hospitals are more affected than others. The government solved the problem with compensatory aid, which continues today. The problem is the lack of visibility because the funding is planned for a limited time. Moreover about 50 % of German hospitals recorded a deficit before the crisis, so that we can say that no hospital will emerge stronger from this pandemic. The discussions to come after the elections will be on the future of the sector with possible hospital closures among the 1,900 German hospitals. Perhaps the private sector will be more agile, but we see already that there will be no winner in this pandemic. The future will tell who survived the crisis and who did not.
* Representative results
The majority of survey respondents (85%) spoke from their own experience and had been patients themselves; for almost half of them, their own hospital stay was no more than five years ago. A total of 1,079 men and women aged 18 and over in the Federal Republic of Germany were randomly selected and interviewed for the study. The results are therefore representative and can be applied to the entire adult population in Germany. When commissioning the survey, BDPK was particularly interested in the importance of hospital ownership among the population and the population's views on the competition and efficiency in the health care system. Of those respondents who had been patients in a hospital in the past five years, about half (54%) had most recently been in a public hospital, 23% in a charity hospital and 18% in a private hospital. This distribution roughly corresponds to the number of beds currently provided in Germany by the various operators.
A strong private hospital sector
By Oscar Gaspar, president of the Portuguese Association of Private Hospitals (APHP)
April 7 was World Health Day and this year the World Health Organization launched the motto “Building a fairer, healthier world” and, even in a time when COVID19 prevails, private hospitals are fully aligned to create more and better health conditions. To reach this goal, the private hospital sector invests and, step by step, establishes itself as one of the pillars of the health system.
With regard to World Health Day, the Portuguese National Statistics Institute (INE) published the most recent data on care activity in Portugal and the conclusions are unequivocal as far as the evolution of
Portuguese private hospitals in the last two decades are concerned:
  • The number of hospital beds increased by more than 3 000 beds, which was an essential contribution to ensuring the country's hospital response:
  • Reinforcement of the relative weight of the private sector in terms of medical consultations (from 15.6% to 37.3%)
  • Reinforcement of the relative weight of the private sector in terms of surgeries (from 22.4% to 29.8%)
  • Reinforcement of the relative weight of the private sector in terms of hospitalizations (from 15.3% to 24.1%)
  • Reinforcement of the relative weight of the private sector in terms of emergency care (from 4.2% to 17.3%).
For World Health Day, the Portuguese Association of Private Hospitals (APHP) would like to acknowledge and congratulate all health professionals in Portugal and in all of Europe, and all those who, in their various initiatives and activities, spare no effort to improve the health conditions of all citizens. You can always count on the engagement and availability of the private hospital sector.
UEHP presents its Board Members
Interview with Kostas Stergiopoulos, Representative of the Hellenic Private Hospital Association
How would you summarize the place of the private healthcare sector in your country?
The Greek healthcare system is characterized by the coexistence of a public health system, compulsory social insurance (EOPYY), and a strong private healthcare.
The Hellenic Private Hospital Association represents all major private hospitals with a capacity exceeding 5,300 beds. While directly employing more than 20,000 people, we support more than 25,000 jobs through indirect partnerships and invest in sustainable development, new infrastructure, new medical protocols, and new technologies.
Covering well over 30% of the health services, the association retains critical scientific resources in a country that is facing brain drain, and significantly contributes to GDP. Offering specialized medical procedures not available in the public health system, strengthens the healthcare system of Greece.
The COVID-19 pandemic is a challenge for both the private and public health sectors. It was the common problem that gave the opportunity to the Ministry of Health to test, evaluate, and grade the private healthcare providers.
Acknowledging our contributions, the Ministry of Health designated Hellenic Private Hospital Association members as COVID-19 vaccination centers, for our employees, doctors, external service providers, as well as for our oncology, and dialysis patients.
In full alignment with the Ministry of Health, the members of our association have contributed well over 800 beds in the Athens area for patients being moved from public hospitals to make space for the creation of COVID-19 public units. We have also offered two hospitals that were transformed to COVID-19 units, physicians to support the public system, and ambulances to transport patients from public hospitals to our facilities. We are preparing for similar actions in northern Greece, should the need arise.
All members of the Hellenic Private Hospital Association are fully certified and/or accredited for Quality for the totality of their services, in contrast with most public hospitals that have not been certified.
Although the health status of the Greek population has improved significantly, the development of the health care system suffers from structural gaps, regulatory barriers, and inefficient allocation of national budget for healthcare.
Why did you apply to become a UEHP Board member?
I have been following UEHP activities for more than a decade.
Now that scientific, and medical affairs are in flux in Europe and on the planet, I believe that it is more important than ever to participate in UEHP, exchanging ideas on health policies, and adopting best practices from other member states.
What would you like to achieve?
I would like to attempt to reduce some of the structural gaps that exist in the healthcare system in my country by capitalizing on the experience of the other member countries represented on the board.
UEHP presents its Board Members
Interview with Carlos Rus Palacios, President of ASPE (Alliance of Spanish Private Healthcare)
How would you summarize the place of the private healthcare sector in your country?
The Spanish healthcare system is made up of two great allies, the public and private systems, where private healthcare complements, integrates and assumes, as a flexible and strategic ally, the needs of the SNS.
At the level of staffing and infrastructures, 58% of Spanish hospitals (460) are private, which represents 32% of the existing hospital beds (52,000). The private hospital sector performs 37% of surgeries, 30% of emergencies, 26% of consultations; and 44% of MRIs.
Based on these data, there is no doubt that private health has its own role based on freedom of enterprise; but it also acts as a support and complement to download the National Health System in times of need. Therefore, the complementarity of public and private healthcare is a key management tool that helps to guarantee healthcare provision and assistance, maintaining its quality thanks to the collaboration of all its stakeholders.
Why did you apply to become a UEHP Board member? What would you like to achieve?
We wanted to be part of the UEHP Board of Directors because Europe is playing an increasingly important role and there are very attractive European models that we are interested in knowing and even extrapolating to our country. In Europe they are more advanced in understanding and understanding private healthcare.
We would like to achieve greater capacity at the political level in the European institutions because from there we can promote things that are often more difficult in our country due to the existing ideological problems. We would like to have a very clear vision of the different models of the different countries of the European Union and of the weight that private healthcare has in them. That knowledge would be very useful to us to put ourselves in value and to be able to compare ourselves. Europe for us is the great opportunity.
How can UEHP best help you to defend the private healthcare sector in your country?
The UEHP can help us reach the European institutions by proposing initiatives that are beneficial to all, for example, the issue of health VAT or the deduction of health insurance. It can be a great help if it generates an agreement between the different countries to establish an agenda in which we all agree, that have a legal connotation and in which we can move forward.
4 June 2021
UEHP Virtual Council meeting