We observe strong trends towards reinforcing the cooperation between European Member States after the COVID-19 crisis. We know that the European Commission is clearly involved in sharing experiences, and new forces are engaged. The budget dedicated to Health was significantly increased by recent decisions. HERA and EMA are certainly the best examples.

UEHP also shared experiences during our recent Workshop What have we learnt from the health crisis to reinforce our resilience? organized in collaboration with our Partner SHAM– European Insurance and Risk Management. The goal was to maintain a positive but necessary pressure for “the day after”. Although private hospitals seek to continuously provide high quality and safety standards, they still have to face the major challenge of aligning goals and incentives in hospital financial support by European national authorities. The crisis, and it became very clear during our workshop, freed initiatives and reinforced caregiver motivation. Our European expert network concluded that Value Based Medicine is key, and private hospitals will strive to maintain efficiency during this recovery period.

“The Visionen Award has established itself as an integral part of our VPKA Congress. We are pleased that we are bringing the most exciting, future-oriented projects of our member companies in Austria the upright attention, which in turn can serve as inspiration for others,” says Mag. Christina Hattinger, Managing Director of the Association of Private Hospitals in Austria (VPKA). The award winners were determined by an independent jury made up of the Secretary General of the European Private Hospitals Association UEHP, Ilaria Giannico, FH-Prof. Mag.a Dr.in Roswitha Engel (Department Head Applied Nursing Science FH Campus Wien), and Susanne Nestler (Director Human Resources at voestalpine Metal Forming GmbH).

The three winning projects of the Visionen Award 2021 of the Association of Private Hospitals in Austria are as diverse as the submissions. The main prize went to the PremiaQaMed private clinics for “Employer Branding – Shape.Health.Together”, with which the change in the labor market was addressed and the attractiveness as an employer was strengthened. The burning issues of shortage of skilled workers, cultural change, generational issues and the attractiveness as an employer were analyzed with a focus on the professional groups of doctors, nurses, IT specialists and administrative employees in Vienna, Graz and Salzburg. In addition, their fundamental values and topics were researched and measures for “Shape.Health.Together” were anchored in accordance with various methods.

The unanimous opinion of the jury gave the winning project “a role model also outside of Austria to counteract the shortage of skilled workers in the health sector” as well as the initiation of a “culture change process” and “an effect aimed at the well-being and appreciation of the employees, which serves the entire industry”.

The ExerG project of the Münster Rehabilitation Center borrowed from the gaming industry. The aim of this international project was to develop an innovative digital solution for elderly people at risk of falling, with or without physical disabilities. Using a platform for whole-body video games, so-called exergames, body movements or exercises can be controlled and a simultaneous training of the person's physical and cognitive abilities can be achieved through the combination of game and exercise. The therapeutic effect of the exergames has been proven in numerous studies and is equally suitable for patients who have had a stroke, those with Parkinson's disease or multimorbid geriatric patients. The jury particularly emphasized the "use of digitization, which enables a new approach in the field of treatment and rehabilitation".

Third place in the Visionen Award also went to Tyrol. Interpersonal skills training for nurses (IC care) is the name of the project that was developed by the Kettenbrücke Sanatorium of the Barmherzige Schwestern in Innsbruck together with the Clinic Ludwigshafen in Germany and Lufthansa Aviation Training GmbH. The result was a sustainable training concept that serves to create a safety and error culture. Findings from the aviation training were transferred to clinically relevant situations in the form of a one-day training course and specifically geared to the diverse requirements of nursing staff that the jury particularly liked about this project was the “strengthening of the human factor” and “that the know-how of a completely different branch has been used in the care sector”.

At the end of September, the French Federation of Private Hospitalisation (FHP) adopted a new signature, placed under its logo: "Hospitals and clinics with missions". Why this approach, and what values and convictions are behind it? In reality, the term "mission" calls into question in more than one way the private hospitalisation sector. It refers, of course, to the French law "Hospital Patient Health Territory" (HPTS) which in 2009 created fourteen public service missions, accessible to health establishments of all statuses.

However, "Missions" in the service of the common good are what make up the daily life of private hospitals and clinics, because of their very purpose: health and care. Welcoming all patients without distinction, accessibility and continuity of care, emergencies, prevention and public health... are the fundamentals of public service. The sustainability of any healthcare structure is conditioned by this duty: to provide a service.

"Mission" is also a reference to the company with a mission, the company seen as an "object of collective interest", as was the title of the 2018 report by Nicole Notat and Jean-Dominique Sénard aimed at redefining the role of the company and its social purpose. Over the years, society's view has evolved, with citizens increasingly considering that companies should be a place for creating and sharing value, beyond economic performance. This report prepared the Pact law carried in 2019 by the Minister of Economy and Finance, Bruno le Maire, which introduced the status of "company with a mission", allowing a company to declare its raison d'être through social and environmental objectives. There are currently around 200 "companies with a mission" in France. The first in the private health sector is the Vivalto Group.

This new signature reflects the identity of our sector, which strives to reconcile the economic efficiency necessary for its long-term survival with the quality of service provided to patients, a condition for "maintaining a dynamic of invention, innovation and collective creation". In a context of health workers shortage, it is also a question of finding motivational levers for professionals, who are anxious to give ever greater meaning to their work. We also strive to promote transparency and evaluation, through the quality of our acts and practices, and our certification results. Finally, hospitals and clinics must be at the heart of the city and in touch with societal issues. One example, among many others, is the recent partnership between FHP and the Women Safe and Children Institute, to meet the care needs of women and children who are victims of domestic violence.

Recently, the action taken by the private healthcare sector in the fight against the virus, and today in vaccination, has reduced the compartmentalised vision of health provision and consolidated recognition of the role of hospitals and clinics with missions. These achievements of the crisis deserve to be perpetuated, not only for our profession, but also for the benefit of the entire health system.

Reflection and communication are the aims of this book. Just some ideas to share as a contribution for the essential debate about health policies, given that taking a public position is a way to be heard and recognized even by those who do not align themselves with the new healthcare challenges. I had the honour of having the forewords of my book written by Professor Augusto Mateus (former Minister of Economy) and Professor Germano de Sousa (former President of the Portuguese Medical Council), whose thoughts and work strive for the improvement of the health system.

While I am solely responsible for these texts, they are part of the discussion of a new paradigm of Health sustainability in Portugal, in which the private hospital sector is an important pillar. Citizens truly deserve a healthier future.

Oscar Gaspar

The same picture can be seen in the crisis, as the study shows: many cantons compensate for the shortfalls in hospitals in 2020 under the title of Covid 19 aid: the roughly 830 million francs again flow for the very most part to inpatient service providers that are owned by the public sector. For seven years now, the Discrimination Monitor has been showing the extent of cantonal cross-subsidisation amounting to an average of 2.3 billion Swiss francs annually, with an upward trend. Around 16.5 billion Swiss francs, or over 7,500 Swiss francs of taxpayers' money per family of four, have been used by the cantons during this time to maintain structures instead of using this efficiency potential.

Unfortunately, Switzerland is still a developing country in quality assessment and measurement. The previous joint effort under the name ANQ does not go far enough here. We observe with interest how patient-oriented outcomes are measured and evaluated in other countries. We are convinced that our members need not fear such transparency, on the contrary: the data available so far and the numerous certifications of our members show that many private hospitals are very well positioned in the quality competition.

The association has a total of 130 members. These are mainly inpatient service providers, hospitals and hospital groups - but also outpatient surgery centers, medical chains, etc. Ospita members are employers for around 32,000 professionals and around 7,000 affiliated doctors. In 2019, the total turnover of the members was 6.375 billion Swiss francs. Slightly more than 20% of all nursing days in Switzerland are provided by Ospita members.

The future potential of the sector can be considered good, were it not for overregulation and market distortion, which make further development considerably more difficult. The general overregulation makes it difficult to provide necessary medical services.