28th September 2021  
The day after
Step by step, we can gradually return to a more normal life, provided we respect the recommendations in place.
For our Secretary General in Brussels, this is an opportunity to renew collaborative contacts with the representatives of all our partners in Brussels, but also at the European Parliament and soon at the Commission.
For us, it is an opportunity to get back to in-person meetings such as the recent FHP congress in Marseille. But also, at the international level, with our presence at the HBI – Healthcare Business International Meeting in London, where health experts and investors converge. May these anticipated steps be beneficial to all of us in terms of building and sharing projects. Other than efficiency, it is the warmth of human interaction that brings motivation to our professional spaces, which is useful to us.
We wish you all a good start for this new work season and we look forward to direct contacts among all European Member States.
Dr Paul Garassus
President of UEHP
Publication of the book "Ethics and Money in Health", co-authored by Dr Paul Garassus, President of UEHP
"Éthique et Argent en Santé, les enjeux du débat", préface by Frédéric Bizard, is published by Editions ESKA by Dr Paul Garassus and Prof. Christian Hervé.
This book is the result of six months of writing during the lockdown. It is the fruit of a collaboration with Prof. Christian Hervé, ethicist. As a doctor who is also constantly in contact with all the economic players in the sector, I asked myself how medical expertise and the experience of care can positively orient the performance of health systems? How can a practitioner who, in my opinion, should also have some training in health economics, impose and enforce his medical ethics? But being efficient is also ethical, so a systemic approach is required. Other questions also arise, such as the place of scientific speech in the medical and social debate: who and how to believe? What are the communication biases of scientists today under media pressure? What role can a physician play at the service of a worried and often doubtful population? This question of medical leadership has become particularly relevant today, and, with this book, we have sought to contribute, through positive dialogue, to reflect the commitment of health care providers combining ethics and economics.
State of the Union 2021
Last 15 September 2021, President of the European Commission Ursula von der Leyen made her annual speech on the State of the Union in front of the European Parliament reunited in the plenary session in Strasbourg
In the State of the Union address she outlined flagship initiatives which the Commission plans to undertake in the coming year. They will among others include:
  • Continuing the vaccination efforts in Europe and speeding up vaccination globally, as well as strengthening the pandemic preparedness
  • Working on closing the climate finance gap, together with our global partners
  • Leading the digital transformation that will create jobs and drive competitiveness, while ensuring technical excellence and security of supply
  • Ensuring fairer working conditions and better healthcare, and creating more opportunities for Europe’s youth to benefit from the European social market economy
  • Stepping up our cooperation on security and defence, and deepening EU’s partnership with closest allies
  • Defending European values and freedoms, and protecting the rule of law
On the same day President of the European Commission Ursula von der Leyen also sent a Letter of Intent to David Sassoli, the President of the European Parliament, and Prime Minister Janez Janša, as the Presidency of the Council, in which she detailed the actions the Commission intends to take in the following year by means of legislation and other initiatives: 
President von der Leyen also took stock of the achievements made in 2020 - 2021: in response, the European Union redoubled its efforts – particularly to procure vaccines for all Europeans, to strengthen international cooperation against the pandemic, and to lead Europe out of the crisis and into the recovery with NextGenerationEU, as well as Commission's work to deliver on all political priorities, from the European Green Deal and Europe’s Digital Decade, to actions on safety, democracy and health for Europe’s citizens.
Declaration of the G20 Health Ministers
During the G20 Health Ministers meeting held in Rome last 5-6 September, the G20 Health Ministers confirmed the need for a "strong multilateral cooperation" in order to continue the fight against the COVID-19 pandemic, prevent future health threats and support the strengthening and resilience of national health systems.
In line with the spirit and principles of the Rome Declaration of 21 May last (Global Health Summit 2021), the Ministers wished to reaffirm their commitment to global solidarity, equity and a multilateral approach, in particular through the work carried out by the World Health Organization (WHO).
The ability to build relationships of trust between different authorities by offering and exchanging scientific information and data in real time will be fundamental, in order to define the most appropriate policies with the related objectives and tools.
The ultimate goal is to be resilient in view of future challenges to national health services and respond to the needs of citizens starting from the three interconnected pillars of action and the basis of the work of the G20: People, Planet, Prosperity.
EU4Health programme – calls for tender to support the European Health Emergency Preparedness and Response Authority (HERA)
Following the launch of HERA earlier this month, work is now beginning in earnest on some of its key activities such as mapping, manufacturing, stockpiling and bringing medical countermeasures to market.
Three calls for tender focusing on COVID-19 therapeutics and antimicrobial resistance have just been published:
The European Commission is allocating €7 million from the EU4Health programme to these activities.
The calls for tenders will be open until 29 October 2021.
An online info day on these open calls for tender will take place in early October 2021.
Healthcare Business International conference 2021
Last 22 September, our President, Dr Paul Garassus, spoke at the Healthcare Business International conference 2021 in London, the only CEO-level global conference focused on health care services. 
Dr Garassus shared views on EU funding and recovery plans and the role of private players. 
Opportunities of the European Cancer Plan that can be implemented in Romania
Last 22 September, our Secretary General, Ms Ilaria Giannico, spoke at the event “Together we beat cancer: opportunities of the European Cancer Plan that can be implemented in Romania” organised by the Health Policies Journal in Romania and Palmed, the Romanian Association for International Medicine Manufacturers (UEHP member). 
The event was part of a wider project "Together We Overcome Cancer" [link] developed by the Romanian Association of International Pharmaceutical Manufacturers (ARPIM). The project aims to identify relevant aspects related to the management of cancer, in view to develop a set of recommendations for the National Cancer Plan, in compliance with the main pillars of the European Cancer Plan. 
The event brought together representatives from EU institutions, policy makers, health professionals and patient associations relevant to the oncology field. 
Ms Giannico shared the UEHP perspectives on cancer treatment and how the COVID19 pandemic has impacted oncology.
Those views will be published in our UEHP Factbook 2021 which will be launched at the end of October. 
IHF special Green Hospitals event
The International Hospital Federation (IHF) is organising a special event on Green Hospitals next 7 October.
The program of speakers will share their case studies of projects and initiatives tackling climate change around the world. They also have dedicated time for direct discussion with the experts as well as for networking with other participants to maximize your experience.
Keynote speaker: Dr Satoru Komatsumoto (Japan), Vice-President of the Japan Hospital Association (JHA), Chief Executive Officer, Director, of Ashikaga Red Cross Hospital, Tochigi, and member of the IHF's Governing Council – sharing his experience of designing a resilient hospital
Case studies:
David Lawson (UK), Chief Procurement Officer, Guy's and St Thomas' NHS Foundation Trust – Innovating for a greener supply chain
Rudy Chouvel (France), Director of logistics and sustainability at the Moulins-Yzeures General Hospital and Aline Coudray (France), Purchasing, Logistics and Sustainability Director at GHU Paris Psychiatry and Neurosciences – Sustainable food circuits for hospitals
Tide Voigt (Germany), Environmental Protection Officer at Charité University Hospital Berlin – Mobilizing the workforce to reduce hospital waste
Seema Wadhwa (USA), Executive Director, Environmental Stewardship at Kaiser Permanente – Investing your leadership in reducing energy emissions
Registration is open and access exclusive content about the keynote presentation is available now.
Participants also receive 1 month of free access to a healthcare eJourneys platform, featuring online case studies of innovation and best practice in the health sector.
IHF is looking forward to #TalkingGreenHospitals with you soon.
UEHP supports private clinics in territories under pressure during the Covid-19 fourth wave
The 4th wave of Covid-19 is hitting the Caribbean islands hard. What is the current health situation in Martinique (06.09.2021)?
While we were relatively spared by the first three waves, the one that is currently affecting us takes the form of a tsunami, a very violent groundswell called Delta. We had 35 Covid-19 deaths for the first three waves, we are currently at 430, for a population of 360,000 inhabitants. The contagiousness of the virus, coupled with the low vaccination coverage of the population, which is about 30%, linked to irrational reticence, has put us in a dramatic situation today. The funeral notices announced on the radio every morning at 6am currently last nearly an hour and a half, compared to 15 minutes in normal times, and the peak of the pandemic has not yet been reached!
Interview with Dr Nabil Mansour, President of the French Federation of Private Hospitals in Martinique, Chairman and CEO of Clinique Saint Paul in Fort-de-France (Martinique Island)
How is the reception and care of coronavirus patients organized?
The Fort-de-France University Hospital (CHU) is the gateway to all Covid emergencies. The infectious diseases department has 20 beds in normal times and today, for the CHU alone, about 340 beds are equipped with Covid medicine. The CHU started with 10 Covid ICU beds, then 20, then 30, then 40... then the army came in as reinforcement and today, the CHU manages 80 critical care beds.
The Clinique Saint Paul is the only acute care establishment on the island, and we were obviously asked by the Health Regional Administration (ARS) to alleviate the CHU and install post-Covid medical beds. The ARS then asked us to upgrade our continuous care unit to an intensive care unit. Today, on the 2 sites of the establishment, we have 80 beds dedicated to Covid care, including 10 ICU beds, equipped with our own material because I had anticipated it 10 months ago and acquired material for an ICU service of 15 beds. Among the 10 patients ventilated and intubated in this department, we have 2 young women aged 26 and 27 who have just given birth and who developed respiratory distress syndrome 3 days later, and a young man aged 24. The ARS is planning to evacuate ventilated and intubated patients to the mainland to free up space. There are about 120 patients in the CHU's medical beds who should be in ICU care, but who do not benefit from it due to lack of space.
We have a very good relationship with the ARS, which helps us a lot with logistics. The national reserve has provided us with medical and paramedical staff to be able to operate these 10 ICU beds. Our own staff was trained by very experienced personnel from the metropolis, especially from Nancy and Strasbourg, who had experienced a very intense first wave. Emergency physicians from Lyon, the East, Bordeaux... also came as reinforcements. Our temporary intensive care unit has been operating for a month with a 100% occupancy rate.
What about continuity of care?
Although we usually care for 18,000 surgical patients every year, our activity is currently limited to emergencies and continuity of care for cancer patients. 90 to 95% of the clinic's resources are put at the service of the population for Covid patients. We have deprogrammed all surgical procedures for a month, but I would like to resume a small part of our activity with a dedicated unit of 4 blocks and 1 recovery room, with vaccinated personnel of course. I have announced this to the ARS because the Covid situation is likely to last unfortunately and not all patients can wait.
The vaccination rate among our staff is over 60% and we hope to see, within the next two weeks, a good increase in the percentage of people who have received at least one dose of the vaccine. People are starting to realise the importance of getting vaccinated, so we have opened a vaccination centre at the clinic and attendance is starting to increase.
Interview published in the FHP-MCO newsletter on 6 September 2021
Merger control guarantees competition and quality
(© Shutterstock/Jan Engel/Bundeskartellamt)
The German Federal Cartel Office released on 2 September its Sector Inquiry into German Hospitals report 2021. The outcome of the inquiry confirms the important role played by competition in ensuring the quality of health care for the population. Existing regulatory requirements, such as hospital planning, fixed remuneration per case (DRG) and minimum quantity or quality requirements, do not prevent hospitals from differentiating themselves from their competitors through performance and quality. There is practically no price competition between hospitals in Germany.
The report shows that:
  • Hospitals compete with one another at the local level. Higher-quality hospitals attract more patients than other hospitals. Apart from the recommendations of the physicians established in the respective regions, the decisive competitive factor for patients is the quality of treatment. Almost 75% of the physicians recommend one or several hospitals - again mainly based on the quality of treatment. Approximately 75% of all patients follow these recommendations. In geographic terms, more than 80% of all cases treated at a hospital occur within a radius of 35 kms around the hospital.
  • Merger control and hospital planning go hand in hand. Hospital planning defines the hospitals’ scope of inpatient treatment, but has no influence on their operators. Any decline in quality can only be sanctioned by redistributing the number of beds, provided that there are other operators in the region which can carry out the required treatment. Only merger control can safeguard operator diversity as it can influence ownership of or control over a hospital and prevent competing hospitals from falling under the control of the same operator or group of companies. In this way merger control ensures not only operator diversity but also the scope of action of the planning authorities.
The results of the sector inquiry highlight the importance of consistent merger control in the hospital sector. The consequences of extensive concentration processes are irreversible. Once local operator diversity is eliminated, competition is harmed permanently and patients have less choice. Andreas Mundt, President of the Federal Cartel Office states that “if all local hospitals are operated by the same company, quality competition will suffer as the hospitals will no longer face the risk of patients choosing a competing hospital. In this case there will be a greater financial incentive to save money by reducing the quality of treatment, i.e. the number of staff or the quality of medical equipment. This is why competition is an indispensable controlling mechanism in the hospital sector as well.”
The inquiry is based on a survey of all hospitals in a representative corridor across Germany from Saarland to Saxony. It covered approximately 22% of all hospitals in Germany and analysed anonymised data on all their treatment cases. In addition, approximately 600 registered physicians established in the Darmstadt region were surveyed by way of example.
G20 Health Italia 2021- "Enhancing public-private partnerships for a more effective healthcare system"
Rome, 6 September 2021: "The importance of the synergy between the private sector of the NHS and the public sector has clearly emerged from the G20 on Health, in a joint effort involving citizens, health workers, institutions and companies.
Barbara Cittadini, President of Aiop, the Italian Association of Private Hospitals, adds: "This public-private partnership can make it possible to implement a virtuous model that will allow decisive action to be taken for the future of our healthcare system, which, as a result of the Covid-19, has entered a crisis, revealing structural and planning shortcomings.
“The synergy between the private and public components of the NHS must be emphasized”
Barbara Cittadini, President of Aiop
Aiop, which has been available since the first phase of the pandemic emergency for a concrete synergy in the territories, making available the professionalism of its operators and its structures all over Italy, is ready to continue its commitment to guarantee the right to health to all, in terms of access to vaccines, treatments, diagnostics and whatever else may be needed to give a significant answer to the demand for health".
Read the press release published by AIOP, following the statements made by the G20 Health Ministers at the end of the Health Ministers Meeting held on 5 and 6 September at the Capitoline Museums in Rome.
The Polish private hospital sector at a glance
The Polish Association of Private Hospitals (OSSP) has released its sectoral report 2021-2022, giving an overview of the position of its member hospitals within the Polish healthcare landscape.
In terms of GDP, Poland is listed as one of the four European countries that spend the least on health care at European level.
Despite many changes introduced in healthcare, the structure of current expenditure remains unchanged both at the level of public expenditure financed from the state budget, local governments and compulsory health insurance contributions, and at the level of disposers, where 85% is invariably the National Health Fund (NHF).
The structure of the hospital sector has remained the same for many years, with a clear 60% share of public hospitals. The hospital network introduced in 2017 by the Ministry of Health, to which 594 hospitals were qualified, of which only 13% were non-public institutions, did not change this situation. Contrary to assumptions, the reform focused on public hospitals did not increase the level of specialist care and the operating conditions of hospitals. Despite the guarantee of financing, the condition of public hospitals is deteriorating. Non-public hospitals adapted to the new conditions, moving towards one-day hospitalization.
The activity of PAPH private hospitals is financed from public funds at the disposal of the National Health Fund (NFZ). In 2019 the National Health Fund financed PAPH private hospitals at average level of 57%. The share of financing of benefits by insurers is increasing, which is the direction expected in health care.
In 2021 a complementary insurance program will appear on the market, which will complement the additional insurance popular on the Polish market and offered by employers to their employees as part of social packages. Complementary insurance provides access to modern medical technologies that are not reimbursed by the National Health Fund.
Market position
For several years, the structure of the hospital sector, broken down into public and non-public (private, local government, non-profit), has been stable, despite many changes, including the introduction of a hospital network, which included only 10% of private hospitals out of 593 medical entities.
The hospital market in Poland is subject to the same changes as the hospital market in Europe or in the world. Moving towards efficiency with the use of modern treatment methods, the number of hospitals and the number of beds are decreasing, the duration of the patient's stay in the hospital is shorter, and the occupancy of hospital beds is increasing.
The COVID-19 pandemic has highlighted one more aspect: the hospital market needs to be digitalized and flexible in terms of staff and equipment in order to respond in time in an emergency.
Financial situation
In 2019 the profitability of the average private hospitals affiliated to PAPH was higher than in the previous year: ROE increased from 10% to 11%, ROA increased from 3% to 5%, and ROS from 3% to 4%. Changes in the market, introduced by the hospital network, deprived PAPH private hospitals of the guarantee of a contract with the National Health Fund. PAPH private hospitals were financed by the National Health Fund at the level of over 60% of the value of revenues until 2016. New operating conditions created new opportunities. PAPH private hospitals turned towards one day hospitalization and outpatient specialist care, achieving a 20% increase in revenue in 2018, and then in 2019. The dynamics of income and net profit confirms the flexibility of operation of PAPH private hospitals and the ability to manage in changing economic conditions.
The private hospital sector has a lot of potential of which untapped potential is still growing. PAPH private hospitals declare the possibility of admitting up to 20% more patients, and their specialist equipment is used at an average level of 70%. A modern base and specialist medical equipment are the advantages of PAPH private hospital sector. The flexibility of operation and speed of reaction to the changing conditions of hospital operations should be added to their advantages.
Hospital Da Luz Lisboa, the first private university hospital in Portugal
Students' visit to the simulation centre at Hospital da Luz
The first private medical course has begun in Portugal and the 50 students of the Faculty of Medicine of the Portuguese Catholic University (FM-UCP) made this month their first visit to Hospital da Luz Lisboa, the first private university hospital in Portugal, where their practical and clinical training will take place.
"Today, in partnership with the UCP, Hospital da Luz begins a new cycle of development and actively takes part in projecting the future where lies the most important of all investments: the investment in the next generations of health professionals, enabling them to distinctively face the magnificent health challenges of the 21st century and the digital age. And above all, as citizens, to be an active part of an admirable new world", said Isabel Vaz, CEO of Luz Saúde, at the inaugural ceremony of the new medical course, on 14 September.
"Students will have at their disposal an academic and clinical monitoring of high quality and proximity, in an international environment and following the best practices of medical education in a smart building, fully equipped and with a known hospital partner", said Isabel Capeloa Gil, Rector of the Catholic University of Portugal, to the newspaper Público.
In a course entirely taught in English and that seeks to harmonise Medicine and Technology, "students will have access to the most advanced medical simulation centre in the country", assured the Rector.
“Portugal was one of the only countries in Europe where, by law, there were only public medical schools, making this a historic moment”, highlighted Oscar Gaspar, President of the Portuguese Association of Private Hospitals (APHP).
Inaugural ceremony
Hospital da Luz Lisboa
Inaugurated in 2007, Hospital da Luz Lisboa, which has a staff of 300 full-time doctors, has already cared for more than 1.6 million patients, carried out close to 6 million general and emergency consultations, more than 170 000 surgeries, more than 30 000 deliveries and around 30 million diagnosis exams. It has been accredited by JCI since 2018, with an overall conformity of over 98% in relation to the highest hospital standards defined by this international organisation.
Integrated in a health campus, which represented an investment of 300 million euros and favours the integration of care, Hospital da Luz in Lisboa combines a highly differentiated hospital, a continued and palliative care unit, a general and family medicine centre, a residential condominium for the older population, and a Medical Simulation and Training Centre, which is one of the largest in Europe. In an area of 1 300 m2, it has more than 10 advanced simulation rooms, more than 100 simulators, around 30 cameras and sound and audio-visual systems and real clinical equipment.
"Hospital da Luz Lisboa is already a platform for innovation, research and entrepreneurship, which allies technology with the science of medical education and intends to be a hub for the development of new training models for health professionals," said Isabel Vaz.
Get to know the Simulation Centre here and watch the video here.
15 October - Brussels
UEHP Council meeting

26 October - Brussels
UEHP/SHAM workshop "What have we learnt from the health crisis to reinforce our resilience?"