24th June 2021  
The Challenges ahead
Summertime has arrived and we are now waiting for a break after such a long engagement in the COVID-19 crisis. But Hospital Managers are already preparing for the fall. The challenges are massive. We must be able to adapt our facilities to a new period after emergency care and ICU reinforcement. Our rehabilitation and psychiatric sector will have to offer more services to long COVID patients and support patients whose mental health has been severely affected by social restrictions and loss. Personnel recruitment, working conditions in such difficult times are important questions to solve. The human factor is central in hospital management and the workforce must be stabilized and secured.
If we remain optimistic and believe that the vaccine will successfully limit the spread of the disease, we could soon be facing a difficult period with patients on waiting lists for chronic conditions. A major question will be “are our hospitals ready to deliver all relevant solutions for people after a long delay due to the crisis”? Summer will be the time to plan for this challenge in order to be ready after the holiday break.
Concerning the EU, we have passed on the information regarding the EU Consultation on the Cross-border directive 2011/24/EU evaluation taking place from 4 May to 27 July aimed at assessing the reality of a more open Europe for citizens. But we have to keep in mind the recent publication of a European poll expressing the lack of confidence by the majority of European citizens after the EU crisis management: “Public faith in EU institutions has declined due to their handling of the covid-19 pandemic and vaccine procurement”. As a stakeholder supporting cooperation, we expect more and more attention by authorities. As care givers directly engaged with citizens, we are greatly involved in the promotion of European values.
Europe is not only a concept, it is a reality with actual stakeholders providing solutions! When a patient passes through the hospital doors, they have to know that the EU is working to guarantee supply, to distribute vaccines, and to support the professionals delivering care.
Dr Paul Garassus
President of UEHP
Covid-19: Best strategies and how the pandemic might play out after the summer break

Regarding the evolution of the pandemic, what could be the possible scenario after the summer break?
I quite like the way the question is phrased, you are not asking me for a prediction but rather a scenario. I provide daily forecasts for the 209 countries and territories around the world that report daily data on Covid-19, but we cannot predict beyond 7 days. Instead, we can look at possible scenarios for the start of the new school year, and I am going to suggest two, without knowing which one has the highest probability of happening.
Scenario 1 – Type "summer 2020“: after a summer break which every European will have been able to fully enjoy, both in July and August, the start of the new school year in September, with the mixing of holidaymakers and their viruses and variants, would then be complicated and cause a fourth wave of contamination fairly early in the season (September-October) reaching children and young people, as well as all the non-vaccinated. Depending on the proportion of non-vaccinated people over 50 and of younger people with underlying health conditions, we would see an increase in hospital admissions for complications of varying degrees, but which would still have the potential to saturate intensive care beds.
Scenario 2 – Type "Change of strategy by European governments“: the epidemic decline observed in June throughout Europe would be accompanied by a significant change of strategy by European leaders, whether explicit or not. Health authorities would henceforth ensure, throughout the summer, the systematic and exhaustive search for the chains of contamination, thanks to the notable decrease in the epidemic. They would dismantle them as soon as they were identified, thanks to strict, controlled and effective isolation and quarantine measures, and would also ensure effective and rigorous sanitary control at the borders, in particular of passengers coming from areas at high risk of importing variants. Here and there, unavoidable cluster outbreaks that slip through the cracks of this health watch would require brief, but strict, local lockdowns. Autumn and winter would probably see the epidemic pressure rise, but authorities would retain control over the pandemic and the waves would not exceed the resources deployed to maintain this control. Systematic sequencing of all positive cases would be possible because the virus circulation would remain sufficiently low and thus no room would be left for silent multiplication of variants in the territory. The continued vaccination, including now in children, would aim at ensuring a large vaccination coverage and the last percentage which would make it possible to obtain collective immunity would be particularly difficult and long to obtain and would require the deployment of important means (social marketing, incentives and strategies aiming at gaining the confidence of hesitant, socially excluded or isolated people in society, and whose access is particularly difficult).
Looking back at the last 18 months, which strategies have been the most effective in controlling the pandemic?
Three types of strategy have been implemented: mitigation (in Europe and America), also known as "living with it", characterized by a late reaction with strong measures when the curve is already high, essentially and as a last resort, to avoid overcrowding hospitals, particularly intensive care units. Suppression, also called "low virus circulation", advocated by the Japanese and Koreans, but also Finland, Norway and Denmark. Interventions are more pro-active, much more premature, as soon as the contamination curve rises (that the R persistently exceeds the value of 1). In Japan, for example, which has twice the population of France, the peaks of their waves have never exceeded 6,000 cases per day, which is lower than the levels of the decreases targeted by the authorities in France (less than 5,000 cases/day). And finally, the elimination strategy, or zero Covid, advocated in particular by China, Taiwan, Australia or New Zealand, Iceland, New Caledonia and two maritime provinces of Canada (Nova Scotia and New Brunswick). They implement interventions even earlier, as soon as they spot the slightest case circulating in their community.
In health terms, if we look at Covid mortality (or excess mortality), clearly the best performers are the zero Covid countries, with less than one death per 100,000 inhabitants since the start of the pandemic, then the suppression countries with less than 20 deaths per 100,000 and finally the mitigation countries with more than 80 deaths per 100,000 (and often much more, Germany 108, France 164, USA 182, UK 192, Belgium 220,)
In economic terms, the suppression or elimination countries have shown positive growth (China, Taiwan, Vietnam, around +3% in 2020) or are less impacted than the EU countries in mitigation (e.g. Japan, Korea vs. France or Italy).
In terms of social life, life has been less confined, schools closures have been less frequent, and barrier gestures have been required for less time in countries with elimination or suppression strategies.
One difficulty encountered by elimination countries and to some degree suppression countries is the closure of their borders, which they have most often instituted and from which they find it difficult to exit. Another problem is the slow roll-out of vaccination, which they have experienced, although these two points are not linked. The combination of these two elements makes it somewhat difficult for them to emerge from the crisis while the rest of the world is still experiencing intense circulation of the virus in some areas.
What are the main lessons from this health crisis?
On this point, I will invite you to refer to the book I wrote on the subject ("Covid, le bal masqué", published by Dunod). Indeed, in the last chapter (epilogue), I try to draw 10 lessons from this crisis and I present them in detail. It would be a bit long and redundant to do it again here.
UEHP members reports
Vaccination in Europe

Like all over Europe, Austria started the vaccination process late December - early January with the older age group. There was a shortage of vaccines at the beginning but, by the end of May, more vaccines were available.
3,5 million people have already been vaccinated at the beginning of June and politicians are convinced that the country will reach herd immunity during the summer.
At the moment, with a population of 9 million, the country registers 300 new infections /day.
The role and involvement of private clinics during the pandemic was quite difficult. They were available and willing to treat covid patients, but the demand was low.
In 2020, there was one private clinic which treated Covid patients and this year there are several private clinics which participate in the vaccination process.
Most clinics involved in the vaccination process carry out vaccination for larger private companies and can charge their services to the public sector.
Almost all private hospitals for rehabilitation in Austria are currently also treating long-covid patients.
There is an ongoing discussion between the Austrian association and the government regarding the differences between the public and the private sectors in the healthcare system. Currently the Austrian association is trying to eliminate the different treatment by additional Covid bonuses for employees depending on whether the employer is private or public.
Regarding the pandemic, the epidemiological situation in France has improved and the lifting of the lockdown measures is being done gradually.
The private health sector remains mobilized and is taking part in the vaccination campaign. An important issue is to continue to take care of patients with pathologies other than Covid. The main concern today is the lack of health professionals for both the public and private sector.
From an operational perspective:
  • All during the pandemic the role of the private sector has been essential. To give an example: France was cut short in terms of ICU beds (5000 beds total which is 10 times less than in Germany) and in a matter of few weeks, the country had to double its capacity. It would not have been possible without the involvement of the private sector.
  • Vaccination campaign: Many private hospitals are very much engaged to speed up the vaccination process. In some regions the private sector vaccinates more people than the public sector because it is more efficient.
  • We evaluate today the shortfall of nurses and caregivers to 10%-20% due to different phenomena: the vaccination campaign requires paramedics so they are no longer available to do their regular jobs and it is creating a problem, The pandemic also had a very heavy psychological impact on caregivers and for that reason there is a growing number of them who are reorienting their professional path and it is very concerning because it takes 3 years to train a new nurse. So, we can say that this shortage of health professionals, especially nurses is one of the biggest concerns today. FHP is trying to find solutions and it will certainly be a challenge.
Regarding compensation, there is good financial support from the French government to the private health sector.
Regarding communication, the President of FHP, Mr. Lamine Gharbi is regularly active in the media.
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).
Yet, as of June 7th prioritization was abandoned at federal level. On regional level prioritization may however still be valid, e.g., due to special local requirements.
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 already exists a model project. 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.
However, hospitals are directly taking part in vaccinating their hospital staff. Vaccines are provided by the health care authorities directly to the hospitals no matter if they are public, private or non- government/not-for-profit organisations and not matter the mandate of supply. In this way a very fast vaccination of hospital staff is possible. Usually, hospitals receive early information on how many vaccines and in which quantity will be available. So they know beforehand, when they will receive the vaccines and in which quantity. This is very helpful to prepare the vaccination process. Nevertheless, it is experienced that every time, vaccines are available, they are not spent completely. With the permission of the health authorities, hospitals may use these vaccines on people who are not members of the staff in order to avoid that those vaccines expire unused.
As of June 17, 24.657.569 persons of the population (29,6 %) have received a complete vaccination. 41.662.903 persons (50,1 %) have received their first shot (see: https://impfdashboard.de/).
Vaccinations in Greece are progressing rapidly based on the age. It is estimated that by the end of June, the ages 18-29 would have been vaccinated.
Until now, 5,000,000 vaccines have been given and those who have received both doses are estimated at 2,000,000. In the European Union, Greece is 4th in vaccinations and 5th in those who have been fully vaccinated.
Until today, vaccinations were given in State health units, but vaccinations will also take place in Private Clinics, Private Diagnostic Centers.
This will help in the faster creation of the immunity that we all seek to prevent a new wave of the pandemic so that we return to normality by September.
The Greek government officially designated the members of the Hellenic Private Hospital Association (HPHA) to become COVID-19 vaccination centers. Initially for their employees, doctors, and external service providers.
Hospitals provided a detailed list of people to be vaccinated, to the Ministry of Health. Vaccines, tablets for registering people approved for inoculation and the administration of doses, arrived at the respective private facilities. The vaccinations were carried 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. HPHA Hospitals are participating in the vaccination of the general population.
Acknowledging their contribution, the Ministry of Health, extended the private sector vaccination mandate to include oncology and dialysis patients in its care.
Members of the Hellenic Private Hospital Association have contributed with:
  • 140 ICU and
  • 800 regular beds,
  • one hospital for patients being moved from public hospitals to make space for the creation of COVID-19 public,
  • 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.
A gradual return to normalcy is now expected.
On December 2, 2020, the Minister of Health, Roberto Speranza, presented the Guidelines of the Strategic Plan for the Covid-19 vaccination, prepared by the Ministry of Health, the Special Emergency Commissioner, the National Institute of Health, Agenas, and AIFA. The Plan provides for:
  • free vaccination for everyone
  • over 215 million doses available based on 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.
  • Pharmacological 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 relating 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 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 centres 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 Centres (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 centres 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 relating 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.
In Poland, the worst moment during the pandemic was at the end of March this year with 900 people dying every day and with 35 000 new cases daily.
Now the situation has improved. At the end of May, the country registered 572 new infections and 99 deaths daily.
There are still at the moment 2,8 million active cases and 75 000 people have died.
The vaccination process started in January this year and so far, out of a population of 38 million, 21 million people have been vaccinated (of which 7 million with the 2 doses). 27% of polish citizens are safe. Health professionals and older people were vaccinated in the first phase.
The impact of Covid-19 on private hospitals:
  • Private hospitals had to reorganize
  • No new contracts for health services
  • Pressure from the government who requisitioned doctors from the private sector
  • 1100 beds only dedicated to covid patients
  • 2020: decrease of 3,3 % in activity
  • 2021: increase of 10% in activity
The private sector plays an important role in the vaccination process. In big cities big vaccination points are established in conference halls and there are also other smaller vaccination points.
The Polish government is presenting a new referendum regarding public hospitals to help use EU funds. It is not clear now how much of this money will come to private hospitals.
During the pandemic, the private sector contributed with:
  • 1100 ICU beds
  • 850 rehabilitation beds
  • 150 vaccination points
90% of the workforce has been fully vaccinated.
There were some problems because the Polish Minister spoke on TV about the lack of participation of private hospitals during Covid. There is a constant battle between the Polish Association of Private Hospitals (OSSP) and the Ministry of Health, but the reality is that the private sector was very much active in the fight against the pandemic.
In terms of the pandemic, January and February were the worst months in Portugal since the beginning of the pandemic and the Portuguese health system was under maximum pressure, almost reaching its limits. Under these conditions, the private sector was called in and contributed plenty during the first trimester of 2021. Now the situation is quite under control with an average of 66 cases per 100 000 inhabitants.
Regarding the vaccination process in Portugal, 23% of the population has been fully vaccinated and 43% have received one dose of the vaccine. The process itself is going very well, with an average of about 100 000 people vaccinated per day.
90% of the staff in the private health sector have been vaccinated but private hospitals were not mobilized to participate in the vaccination of the general population so it feels that more could be done if the Ministry of Health says the involvement of the private sector is needed.
In terms of treatment of COVID-19 patients, the private sector could have done more but it did a lot in terms of patients with other pathologies.
The 2020 activity decreased by about 12% for surgeries, 14% for outpatient consultations and about 40 % for emergency episodes so it was a very tough year for the private sector, but it started 2021 stronger and the private hospital sector has recovered faster and better than the public sector.
Regarding the vaccination process, Romania is currently at stage 3 which includes the vaccination of the general population.
In some cities, people can just walk in and ask to be vaccinated, without any previous scheduling. There are even drive-through centres, in addition to vaccination centres.
4,4 million people have been vaccinated which represent 27,4% of the population.
Even if vaccination is currently slowing down, Romania is still the first country in the EU to start vaccination for the 12-15 age group.
The private health sector has been involved in the fight against Covid-19, especially in the PCR testing process.
The private sector is also involved in the vaccination process but unequally at the regional level because its involvement depends on local decisions.
The sector also received financial support from the public authorities.
There is an ongoing discussion between the Austrian association and the government regarding the differences between the public and the private sectors in the healthcare system. Currently the Austrian association is trying to eliminate the different treatment by additional Covid bonuses for employees depending on whether the employer is private or public.
COVID-19 numbers are better every week in Spain with currently about 120 cases per 100 000 inhabitants. The situation is improving.
Regarding vaccination, the goal of the government is to have 70% of the Spanish population vaccinated by August. At the moment, Spain has about 38% of its population vaccinated with at least one dose.
Regarding the contribution of the private healthcare sector in the Spanish vaccination process, it was previously announced that the private health sector was going to participate in the vaccination of 56% of the Spanish population but, unfortunately, vaccination has been carried out primarily by the public health sector. Despite the willingness and availability of the private sector to participate in the process, out of 17 communities, only two are using the private sector.
The government establishes the vaccination process, but the autonomous communities can decide if they use the private sector or not. It is unfortunately a political issue and not an organizational one.
At the beginning of the vaccination process there was a shortage of vaccine, which the government used to explain the non-involvement of the private sector, but it is no longer the case.
The Minister of Employment made an agreement on vaccination with non-profit Mutual Funds.
The private health sector asked for a similar agreement, but the Spanish government chooses to use only the public resources.
In Switzerland, most actions during the pandemic were well coordinated between sectors. Some partnerships even increased. There is no discrimination.
Regarding the vaccination process, the Federal government organized the logistics, and the Cantons organized the distribution and defined priority groups.
One of the big private hospital groups plays a big part in the vaccination process.
At the moment, 20% of the population in Switzerland is fully vaccinated but it is about 80% for the age group of people over 70.
No data on the vaccination of health professionals is available but it is estimated that 80% of health professionals that asked to be vaccinated have been fully vaccinated.
Today the country sees a drop in daily cases, hospitalization, and mortality rates and restrictions started to be lifted.
One area that has not been resolved yet is the fair compensation for the cost to the private hospitals of the reserve capacity and additional costs during March and April of 2020.
The Swiss Association of Private Clinics is publishing a press release on a study by PWC on the 2020 hospital activity and which shows that the loss of income and additional costs totals 1,3 billion EUR for all hospitals, public and private combined; this represents approximately 5% of turnover. Private hospitals in particular have not been fully compensated for these losses and demands have been made to remedy this.
Increased cooperation of member states on health technology assessment (HTA)
The European Parliament and Council negotiators reached a provisional agreement on the increased cooperation of member states on health technology assessment (HTA) at EU level.

The key elements of the agreement are:
  • Enhanced coordination, transparency and impartiality: The regulation establishes a new “Member State Coordination Group” - each EU country will designate its representatives in the Coordination Group as well as in various subgroups. The agreed text underlines that all representatives and experts must not have any interests in the health technology developers’ industry which could affect their independence or impartiality. Parliament negotiators ensured that a clear voting mechanism for the Coordination Group is in place regarding political strategic issues and scientific technical issues.
  • Wider stakeholder dialogue: In order to ensure the inclusiveness and transparency, the Coordination Group is expected to engage and consult widely with relevant stakeholders, including organisations representing patients, healthcare professionals, clinical experts, HTA developers, consumers. Negotiators agreed that a stakeholder network should be set up in order to facilitate this dialogue.
  • Greater transparency in joint work: Parliament successfully secured greater transparency of reports and work in relation to joint clinical assessments, joint scientific consultations and other joint work, as well as clear criteria on diverging scientific opinions to ensure that the legitimacy of reports is not questioned. Several other key aspects include the introduction of clear safeguards on the uptake of joint clinical assessments to ensure that they are annexed to national assessments and that member states must report on their use in national HTAs; setting clear criteria on the selection of joint scientific consultation to ensure a level playing field for all relevant actors; as well as a shorter timeline for the full implementation of the scope of health technologies.
Next steps
The European Parliament and the Council are now expected to endorse the content of the agreement.
Health technology assessment (HTA) is a research-based tool to support decision-making in healthcare. HTA assesses the added value of new or existing health technologies – medicines, medical devices and diagnostic tools, surgical procedures, as well as measures for disease prevention, diagnosis or treatment – compared with other health technologies. The HTA process is performed by currently about 50 European HTA agencies. The regulation proposed by the Commission in January 2018 aims to strengthen EU-level cooperation among Member States for assessing health technologies. In March 2021, the Council agreed, after three years of discussions, on a mandate for negotiations with Parliament.
More here
UEHP - Health First Europe
UEHP re-elected member of the Executive Committee of Health First Europe

Last 17 June, Health First Europe (HFE), a non-profit alliance of patients, healthcare workers, academics, healthcare experts and the medical technology industry, held its annual General Assembly.
During the Assembly the HFE members voted for the renewal of the association's Executive Committee and our Secretary General, Ms Ilaria Giannico, was re-elected as one of the EXCOM members on behalf of UEHP for the third consecutive mandate. 
At UEHP we believe in this long-lasting partnership with Health First Europe which gives us the opportunity to cooperate at EU level on a number of subjects requiring cooperation, integration and coordination of care. 
UEHP - Active Citizenship Network
Award ceremony - European Civic Prize on Chronic Pain - Collecting Good Practices - III edition 2020-2021

Last 17 June Active Citizenship Network hosted the virtual award ceremony for the European Civic Prize on Chronic Pain.
The prize, which has reached its third consecutive edition, aims at highlighting existing good practices in several European countries in terms of struggle against chronic pain. This third edition allowed all actors involved to continue expanding the "agora" of operators of good practices on pain, encouraging the exchange of experiences among health professionals, healthcare providers, institutions, civic associations, and patient advocacy groups. Exceptionally for the III Edition, the prize recognized also outstanding initiatives that have been put in place, modified or updated to face and mitigate the COVID-19 pandemic consequences on chronic pain patients' life. 
The winners of the 2020-2021 edition are:
  • Winner for the category PATIENTS' EMPOWERMENT: (Good Practice "SIP's pledge to uphold and implement the European Pillar of Social Rights"), Belgium: "Good example of European collaboration of multiply stakeholders across Europe to challenge an area which all people with chronic pain have to deal with. Works on creating an environment in which governments pay more attention to the situation of chronic pain".
  • Winner for the category INNOVATION: (Good Practice "From venomous animals to innovative pain treatments") Austria.
  • Winner for the category PROFESSIONAL EDUCATION: (Good Practice "Musculoskeletal pain: knowledge and attitudes of physiotherapy students“) Portugal.
  • Winner for the category CLINICAL PRACTICES: (Good Practice „ NO a la Guía INSS ") Spain - "Very good project which shows that collaboration of stakeholders can make a difference and can change things for the best of those concerned. The addressed issue of reproductive can be questioned is every country has its own system and its own unique way of approach".
  • Winner for the NEW category "Covid-19 special action": Good Practice "Pain Management in COVID-19" Italy.
UEHP supports this initiative from its very first edition and is a jury member of the European Civic Prize on Chronic Pain organized by Active Citizenship Network. 
EU - European Alliance for Value in Health (EAVH)
Virtual event on health system resilience through a value-based approach

Last 17 June the European Alliance for Value in Health hosted its first public webinar to launch its position paper and discuss lessons from the crisis to realign health systems towards a more resilient and value-based foundation.
The importance of resilient health systems has been put to the fore by the COVID-19 crisis, and European institutions have taken several measures to improve the crisis preparedness of health systems at EU and Member State levels. But how is health system resilience currently defined in the health policy discussion, and are we interpreting this broadly enough?
The European Alliance for Value in Health argues that we should not only focus on measuring resources and capacity building needed for pandemic preparedness, but also look at health system resilience through a broader scope. Making health systems more value-based and person-centred would not only make them better equipped to deal with health challenges in normal times, but also make them more resilient during a future health crisis. This includes optimizing the prevention and management of chronic diseases which have been a key risk factor in terms of COVID-19 outcomes.
About the European Alliance for Value in Health
The European Alliance for Value in Health is a group of associations that represents a broad range of stakeholders including patients, scientific and professional societies, healthcare managers and professionals, hospitals, payers and industry. We are working together towards our shared vision for a Europe, where health systems are value-based, sustainable, and people-centred. By connecting different stakeholders, our mission is to facilitate health system transformation, share knowledge and best practices, and engage with policy makers and stakeholders at European, national, and regional levels.
UEHP presents its Board Members
Prof. Gabriele Pelissero, representative and former President of the Italian Association of Private Hospitals (AIOP)
How would you summarize the place of the private healthcare sector in your country?
The private hospital sector in Italy represents 25% of the overall hospital activity of the National Health Service with a various presence in the 21 Regions, in some of which it exceeds 40%. The population appreciates our services very much. The private healthcare sector is not treated equally in all regions in Italy though and depends on administrative and political decisions of the State and the regional governments.
Why did you apply to become a UEHP Board member? What would you like to achieve?
Aiop was a founding member of CEHP, which later became UEHP. For many years, as President of the Italian delegation, I have been representing the continuity of this commitment, which will continue in the future.
How can UEHP best help you to defend the private healthcare sector in your country?
As a representative of Aiop, I appreciate the work of UEHP, which enables us to have a fundamental link with the other European private hospital federations, as well as a representation at EU level in order to make our EU stakeholders more attentive to our principles. UEHP is also a valuable opportunity to get to know personally all the delegates of the various federations, and this too is an important value for me and for the Italian delegation.
Gregorios Sarafianos, President of the Pan-Hellenic Union of Private Clinics
How would you summarize the place of the private healthcare sector in your country?
The private health sector in Greece is complementary to the public/state health sector and both compose the Greek health system. The private sector is a forerunner in matters of medical technology, new medical methods of treatment and hotel infrastructure. It responds to the preference of patients who want to have a free choice of doctor and to get faster recovery with modern methods.
Why did you apply to become a UEHP Board member? What would you like to achieve?
My application follows my long-standing participation in the UEHP Board in recent years and more generally my participation in the General Assemblies as a UEHP member. By taking part, it is possible to give a European dimension to the problems you are facing and at the same time you try to help your European colleagues to solve theirs. The participation of UEHP in European events and the representation it offers gives the possibility to internationalize problems and their solutions through a common effort.
How can UEHP best help you to defend the private healthcare sector in your country?
The internationalization and exchange of views with other European colleagues that UEHP makes possible help us to face the problems of the private health sector in Greece. Seeing how other countries deal with problems helps you to act accordingly. The European Union is united and the way of dealing with problems must be common just like it happened with the Covid-19 pandemic and the vaccine campaign. It was a good start that must be continued.
Working and serving in a pandemic year
The Portuguese private hospital sector in 2020
We are in 2021 and APHP is celebrating a remarkable milestone: 50 years of representing the private hospital sector in Portugal. What a journey it has been! Year after year, private hospitals have been fulfilling their role and making the investments that have led to clinical excellence, greater national coverage and today we constitute an increasingly respected sector.
COVID-19. The past year brought unthinkable challenges and limitations to the planned care activity. Generally speaking, the world was brought to a halt by the pandemic waves.
From the outset, Portuguese private hospitals were willing to participate in the national fight against COVID-19 and although there are many examples of effective collaboration, the activation of the entire health system was penalized by planning solely centred on the public health service.
Regrettably, the private hospital sector spent an important part of the year being the target of discrimination and dogmatic assessments, at a time when it was most necessary and obvious that all resources should be harmoniously coordinated to face a global threat.
One of the most impressive impacts of COVID-19 was the clear realization that Health is a priority, that all countries must seek solutions for the efficiency, access and sustainability of their health systems and that is why it is important for us to evolve towards a European Health Union, and that is why the recent Oporto Declaration is so important.
2020 was a very challenging year and it was painful for everyone including private hospitals.
2021 is a year to learn lessons and to have a clear strategy to implement. For us, a year to systematize who we are and what we do and to present the potential and capacity of private hospitals.
The Portuguese association of private hospitals wanted to produce a special document in which we report the contribution and participation of the private hospital sector in the fight against COVID and portray the health sector and its perspectives.
“Working and serving in a pandemic year” is the title that we think will convey what we feel in this very difficult year but it is also a way to celebrate the 50th anniversary of the association, which is why we also wanted to bear witness to what we have accomplished and show who we are right now.
Spanish private hospitals hired 5,000 professionals in 2020 despite the strong impact of COVID-19
The Spanish Private Health Alliance (ASPE) has measured in a complete report the impact of the pandemic in its 288 general hospital centers (those with the highest incidence due to the pandemic) during 2020. The study concludes that: the Spanish private health sector has faced extreme difficulties, with an unprecedented reduction in ordinary activity and dealing with extraordinary cost overruns related to COVID-19.
Despite the difficulties, general hospitals (62% of all private hospitals in Spain) increased their workforce by 6% in 2020 compared to the previous year, incorporating 5,000 new professionals, both healthcare (73%) and non-healthcare (27 %). However, the complexity of the situation experienced by private health professionals is manifest: 1 out of 4 (26.3%) have been sick due to COVID-19.
Carlos Rus, President of ASPE
Even so, the activity of private healthcare in the care of COVID patients has been enormously intense. In Spain, almost 1 out of 3 hospitalized patients have been treated in private hospitals during 2020 (either by insurance, mutual or derived from the public). In total, 63,246 were hospitalized (30%) out of the total of 211,064 collected in the official data of the Spanish Ministry of Health. Likewise, 29% of those affected who until December 31, 2020 have required ICU care in Spain have been treated in private (5,256 patients out of 18,251).
Almost 1 out of 3 hospitalized patients in Spain have been treated in private hospitals during 2020
On the other hand, all areas of ordinary care were affected in an unprecedented way over the past year: surgical interventions decreased by 14%; emergencies 26%; external consultations 9%; hospital admissions 14%; and ICU income 16%.
In addition, private general hospitals have invested 312% more in products related to the protection of professionals, in a context of hyperinflation that has meant paying an average of 1,100% more in the price of masks in 2020 compared to 2019.
The coronavirus crisis has proven to be the largest real public-private healthcare collaboration campaign in the history of Spanish healthcare. From the private health sector we have given ourselves thoroughly from the first day in making all our resources available to the health authorities: from infrastructures and personnel to suppliers and supply of material against covid-19, through the establishment of differentiated circuits for care for other illnesses. We have done it under a principle of unquestionable solidarity given the circumstances we were experiencing.
Once the most critical period of the pandemic has passed, and when the time has come to assess the structural damages of the crisis, we have asked for the compensations that we have considered fair, under the same criteria of solidarity and for the survival of our companies and their companies. Professionals, who have suffered a severe economic impact due to the intervention and paralysis of all ordinary activities that forced confinement.
The Government of Spain has recognized us for our strategic collaboration in the fight against COVID-19 but has left the decision on aid and compensation for the work carried out throughout the pandemic at the discretion of each region, alluding to the 'Extraordinary Covid-19 Fund 'of 16,000 million euros distributed among them and of which 70% should be used in healthcare and education. This has placed us in a complex situation of 17 different regional scenarios and in which, in most of them, it has still been impossible to reach agreements.
The Government of Spain has recognized our strategic collaboration but has left the decision on compensation at the discretion of each region
The main risks that threaten the current Spanish healthcare model are diverse: the increase in life expectancy, which translates into a noticeable increase in chronic diseases, and that represents more than 80% of current healthcare spending; the increase in waiting lists and the shortage of professionals. The future model must focus on the person, on their needs, on the population risks described, and employing digitization and new technologies to create effective information services. In short, putting the patient at the center of the system so that healthcare is integrated and make better use of the different resources.
Strengthening public-private collaboration in the Spanish National Health System is the only way to provide it with flexibility and make it sustainable. Our mission is to contribute to the strengthening of health in our country and to the survival of the health entities and professionals we represent, more than 312,000.
Klinik-Fakten (hospital facts) website goes online
One-sided or false information leads to distorted judgements. Klinik-Fakten.de counteracts this and uncovers false reports, rumours and half-truths in the health sector.
The website www.klinik-fakten.de, developed under the auspices of the BDPK, is now online. Experts from various disciplines provide factual, independent and non-partisan information on current topics in the health care sector.
With this new information offer, the BDPK wants to counteract biased reporting or misinformation, which often leads to distorted judgements. To this end, (mis)information, prejudices and half-truths in and about the health system are addressed and clarified on the portal. In addition to the main topics of quality, personnel, competition, responsibility and income, the website contains the sections "Headlines" and "Local", which deal with current media reports and representations. The focus is on publications concerning inpatient care, which are analyzed and, if necessary, corrected.
Initially, the editorial team consists of a national network of employees from the member institutions of the BDPK, who belong to different disciplines (medicine, economics, law, media) and bring their professional expertise to the various topics and issues of the BDPK.
Particularly in the case of polarizing or controversial topics, www.klinik-fakten.de aims to provide clarity and objectivity on the basis of verifiable, rational and objective facts. Although the initiative for the website was taken by the BDPK, the association would like to make it clear that with the creation of its own website, there will be no one-sided consideration or debate: No facts are to be created, but facts are to be presented openly. www.klinik-fakten.de
Good practices in the design of hospital space during a pandemic
A team of Polish scientists from the VITA Management design office and the Wrocław University of Science and Technology are looking for European research partners, as well as hospitals ready to share their own experiences in preparing for the safe treatment of patients in the current COVID-19 pandemic. The objective of the project is to develop guidelines for the creation of hospitals for future pandemics using the best European experience of hospitals created for the COVID-19 pandemic in 2020 and 2021.
For centuries, infectious diseases had a different area of ​​influence, they affected individual cities, countries and even continents. Their range was associated with social development, including the development of communication, technology, medical knowledge, and above all, with the adopted and implemented methods of limiting the spread of the disease. The most common and effective method of limiting the development of the disease was to isolate infected people from healthy people. In the history of the development of hospitals, various solutions for setting up hospitals for the purpose of isolating patients can be found.
So-called "temporary hospitals" were built as early as the 19th century to isolate groups of patients in order to prevent the spread of the disease. An example of a large temporary hospital built for the victims of the France-Prussian war in 1870 was the temporary hospital in Berlin Moabit (photo No. 1). This building, consisting of 30 pavilions, gave rise to the so-called pavilion hospital construction, which was continued for the next several dozen years. However, most often, in order to quickly limit the spread of infection, existing buildings were adapted for temporary hospitals. Various large-scale buildings with spacious interiors were used to accommodate the patients. For these purposes, industrial facilities such as production halls (photo No. 2) or public buildings such as theatres, sports halls, and schools were used.
The spread of the COVID-19 virus and the surge in infections made it necessary to look for a space to treat infected patients outside the overcrowded existing hospitals. Temporary hospitals built as makeshift facilities or created by adapting existing facilities have become a necessity in most countries affected by the COVID-19 epidemic (photo No. 3)
Designing, building, organizing, and operating temporary hospitals during the current COVID-19 epidemic is the subject of ongoing research work to determine the best solutions to be applied in the next potential epidemic.
A team of Polish scientists from the VITA Management design office and the Wrocław University of Science and Technology conducts research on applied solutions in the design and organization of temporary hospitals during the COVID-19 epidemic. Research on the solutions used and their effects in reducing and treating patients is to help create solutions that can be used in the future in the event of another epidemic.
Currently, research is conducted in Poland. The largest of the built temporary hospitals are analysed, as well as hospitals adapted for the treatment of COVID-19 patients.
The subject of the research is:
  • architectural assumptions of a temporary hospital or a hospital adapted to the needs of COVID-19 patients;
  • architectural assumptions of the hospital;
  • spatial organization of the hospital;
  • hospital work organization applied;
  • patient and staff safety systems used;
  • applied technical solutions, including hospital ventilation;
  • application of new technologies in the organization of hospital work;
  • costs of building and equipping a hospital;
  • operating costs of the hospital;
  • plans for using the hospital after the pandemic ends.
The authors of the study plan solutions in the organization of temporary hospitals applied in Poland to be compared with projects implemented in other countries.
The result of international research is to create guidelines for the creation of hospitals for future pandemics using the best European experience of hospitals created for the COVID-19 pandemic in 2020 and 2021.
The team is looking for research partners, as well as hospitals ready to share their own experiences in preparing for the safe treatment of patients in the current COVID-19 pandemic.
1st floor plan of the pavilion hospital in Berlin Moabit from 1871-1872.

Temporary hospital built inside a factory hall in Kamienna Góra in Lower Silesia for the needs of victims of World War I, a postcard from the collection of the Foundation for the Protection of Industrial Heritage in Silesia

Temporary hospital built in January 2021 in Wroclaw on the basis of a conference hall. Photo by P. Gerber, 04.2021

15 October 2021
UEHP Council meeting