We are being severely hit by a second crisis of major proportions that is shaking up the whole world and is taking place on Europe's doorstep. After a viral pandemic which is still active and for which European private hospitals are fulfilling their role at every stage of prevention, care and follow-up, particularly for " long " forms of COVID-19, the current war in Ukraine is challenging our existing balance.

Two key points deserve our attention. The first is the importance of our interdependencies. Globalisation, which is the result of the liberalisation of trade and initiatives, requires us to have mutual trust through a mechanism of shared balance. We see that we must strengthen our resilience through diversified partnerships. The second is, inversely, the immense effect of solidarity that emerges in response to the major challenge that is the human respect in the face of violent conflicts. Any unbalance, whatever its cause, has global consequences.

Our European society is reacting with dignity to protect the refugees who are fleeing the conflicts and their horror. We would like to bear witness to the involvement of our friends in private hospitals in Poland, Romania, and Moldavia in caring for these fragile populations, without any expectation of support. Out of simple humanity, out of simple generosity. We are only their voice as they are so discreet but so effective on the ground. The merit is theirs. As for UEHP, it has interceded with all the professionals concerned at the European Commission to offer its services in full cooperation with the Member States.

Our social Europe, a beacon of shared democracy, must enable us to explore all possible diplomatic avenues while seeking, to the best of our ability as actors of civil society, to welcome those we can protect.

Moldova, a country of 4 million people bordering Ukraine, has seen a large influx of refugees since the conflict began. This is a difficult time for our small country and we have major security concerns.

The private clinic Medpark, which I run, launched a humanitarian initiative on 25 February offering free 24/7 medical services for all refugees, including acute and outpatient care. Doctors have volunteered to participate in this project and Medpark is covering all costs related to treatments. I am very proud of my teams and the excellent work they do on a voluntary basis.

We did not expect to have such a high number of admissions to the emergency room. Our average patient flow almost doubled with the refugees in early March. It is now tending to stabilise. We have had 300 admissions in the last month, 15 to 20 a day. We have delivered 3 babies and performed 5 emergency surgeries. We will of course continue to offer our services, but we hope that the flow will not increase even more because our own resources are not infinite.

Other private institutions have also joined the initiative, but the heaviest burden falls on Medpark, as we operate 24/7.

It's a real war. One night we admitted the first war wounded to the emergency room, two Euronews journalists who were injured in an explosion near Kiev on 25 February, both Danish citizens. The refugees who arrive are traumatised, the children seem to be very affected by the events, they have children's eyes with adult looks, it is very difficult to see, very emotional. We pray and hope that the war will end soon.

5 private health establishments in Cambo-les-Bains in the south west of France (Basque Country) have sent more than 3.5 tons of medicines, emergency equipment and medical devices to Ukraine. In conjunction with the Ukrainian Embassy in France and its operational arm, the establishments first listed the immediate needs of the hospitals, clinics and emergency resources on site before gathering 3.5 tons of medicines (analgesics, anaesthetics, morphine, etc.) and equipment (defibrillators, electrocardiograms, oxygen masks, first aid kits, emergency kits, dressings, etc.). This chain of solidarity is the result of a collaboration and a sharing of experience between five establishments in the private sector of Cambo-les-Bains, the clinics Landouzy, Toki Eder, Annie-Enia, Korian Marienia and Les Terrasses. A second shipment is already scheduled in a fortnight.

Nicolas Bridoux (Director of the Landouzy Clinic, coordinator of the operation): "We are health professionals and we want to help our colleagues present in the field in Ukraine, as close as possible to the civilian population. We are in contact with the Ukrainian Embassy in France, which sent us a list of needs 10 days ago: we contacted our suppliers and the laboratories with which we work on a daily basis in our respective fields of activity, and very quickly, thanks to the mobilisation of our teams, our pharmacists and our technical staff, we were able to set up this operation. Four full pallets left thanks to a local carrier who, in the current context, enabled us to transport them immediately and at a lower cost. This material has been sent to Ukraine, as the needs there are urgent. A second shipment is already scheduled. The Basque Country is a land of welcome but also a land where solidarity, mutual aid and sharing are real values that we fully share on this occasion.

Dmytro Atamanyuk (Pharmacist and President of the France-Ukraine Medical Charity Association): "From a medical point of view, the emergency on site is absolute. Supplies have been disrupted and healthcare teams are short of everything. We are dealing with war medicine, and we need everything that can help us build first aid kits and evacuate the wounded. I would like to thank the establishments in Cambo-Les-Bains for having mobilised so quickly. The material has been sent immediately to the border between Ukraine and Poland, and then Ukrainian transporters, some of them risking their lives, supplied the health establishments.”

Article released by FHP (French Federation of Private Hospitals)

For several weeks now, the war raging in Ukraine, on Europe's doorstep, has been hitting the population very hard. The Ramsay Health group and its employees are mobilising.

The Ramsay Health group and its employees are responding to the appeal of humanitarian associations to support the population.

Many of our establishments have spontaneously mobilised in several French regions but also in Sweden where we are present. The collections are multiplying (medicines, hygiene products, equipment, donations for associations...). Based on the needs communicated by the humanitarian associations, our Pharmacy and Purchasing departments, in direct contact with the establishments, have identified the necessary products and equipment. The products are delivered via the Regional Health Agencies of the regions in which our hospitals and clinics are located, so that they can meet a real need, be used quickly, and not be a burden on the recipient countries. At the same time, the Group's head office organises the shipment of 14 pallets of equipment (medical devices and protective equipment). They are made available to the Operational Centre for Regulation and Response to Health and Social Emergencies - CORRUSS (managed by the Ministry of Health).

Ukrainian refugees and French nationals repatriated from Ukraine or Russia benefit from free health care in our establishments through the universal health protection scheme (PMU) and supplementary health insurance, which are granted to them immediately upon their arrival in France.

More and more associations working with the population remaining in Ukraine or with refugees are directing donations towards financial support. In addition to the material aid that we provide and to accompany this approach, our Capio subsidiary in Sweden is donating one million kronor (96.500 euros) to the Médecins Sans Frontières association, of which it has been a partner for many years.

To support the medical care of the population in Ukraine, the AMEOS Group is providing an aid package worth 500.000 euros.

The aid package contains, among other things, medical equipment, surgical instruments, medicines, bandages and a variety of medical supplies that will be delivered directly to Ukrainian hospitals to support the care of the people in the war zone.

"The war in Ukraine, the suffering of the people and the destruction of the country shake us deeply. As a large healthcare provider in the German-speaking region, it is natural for us to support the medical care of the people in the crisis area and to send a signal of solidarity. This includes not only the relief supplies, but also the availability of treatment capacities for the medical care of war victims in our hospitals," comments Dr Axel Paeger, CEO and Chairman of the Board of the AMEOS Group.

The urgently needed relief supplies were put together in cooperation with various aid organisations according to the needs reports from Ukrainian hospitals. The aid packages reached the border to Ukraine within 48 hours.

In addition, the AMEOS Group has reported available treatment capacities for war wounded in the regions to the responsible state ministries and is holding these capacities in readiness.

The board of the Association of Private Hospitals in Bavaria e.V. (VPKA) has informed its approximately 170 acute and rehabilitation hospitals in Bavaria about the possibilities for providing rapid humanitarian aid to Ukraine. The association is helping to coordinate offers of help.

"Our member facilities, whether acute or rehabilitation clinics, can provide very effective help to the affected people through their expertise and by donating medical supplies," Stefan Scharl, 2nd Chairman of the VPKA Bavaria, is convinced. "Some of the hospitals have already initiated help, and there is definitely great interest among many others. For us as an association, it is important in this situation to inform our members specifically about their possibilities for quick, efficient support for those suffering in this war."

For this reason, the association has now sent its members a list of Ukraine-specific internet addresses of the German and Bavarian Hospital Associations and the Bavarian Ministry of the Interior. The respective websites provide information on concrete aid possibilities and contact points.

"Especially medical donations in kind such as medicines, bandage materials or medical and technical equipment for Ukrainian hospitals or for refugee facilities in the neighbouring states are now of central importance for the people in the affected areas," says Dr Ann-Kristin Stenger.

The VPKA e. V. itself is now accepting offers of assistance from its member institutions, such as the provision of living space for Ukrainian refugees or their medical care. The VPKA office collects and coordinates the offers and requests and establishes contact with the Bavarian State Ministry of Health and Care and/or, if necessary, the Bavarian Ministry of the Interior.

Austria's most renowned private hospital combines the highest medical standards with the most modern architecture and building technology. Built between 1882 and 1905, the Rudolfinerhaus private hospital has been extended and converted several times in its long history.

In order to make the Rudolfinerhaus the most modern private hospital in Austria, the "Rudolfinerhaus 2020" project was launched: a green building behind a historic façade.

With an amount in the double-digit millions and without public funding, the project consisting of several extensive stages was completed in 2020. In 2016, the first stage of construction was the completion of an underground car park with over 200 spaces on three levels, 7 electric charging stations and barrier-free access to the main building.

As of November 2017, the general renovation of the buildings was carried out with a switch to exclusively renewable energy sources. This resulted in a state-of-the-art "Green Building" 100% independent from fossil fuels. The central element was the construction of five new care units by adding 2 storeys to the central building, the new construction of the Wilczek pavilion and the nursing campus as well as the construction of a spacious and barrier-free main entrance area. One of the decisive objectives was to carry out the extensive construction work between 2018 and 2020 without interrupting hospital operations. This goal was largely achieved.

The ambitious timetable and the high complexity of the overall project required extensive coordination between the various interfaces of the sub-projects and the departments of the private hospital, in order to keep the impact on hospital operations as low as possible. For example, the structural reinforcement of the surgery unit was completed within an intense 14-day period. By increasing the number of patient beds in the Billroth pavilion during the Wilczek construction phase, we maintained maximum bed capacity for the entire duration of the project. Both the transport of patients and the prescribed passable escape routes could be secured by alternating operation of the lift systems. Additionally, a provisional escape stairway was erected as a stair tower in the park during some phases of construction.

After relocating all patients and reinforcing the structure of the existing building by means of jet grouting and injections in the masonry, two storeys were added to the Billroth ward, using the modular construction method. The modules with a high degree of prefabrication were assembled with the help of a mobile heavy-duty crane.

The cooling supply of the Rudolfinerhaus was converted from a system with decentralised chillers and heat exchangers to a modern, efficient and climate-friendly district cooling supply provided by the City of Vienna. The entire conversion of the area was carried out in such a way that the cooling of the most important medical facilities (MR unit, angiography, surgery units) could be maintained during the entire conversion phase. This required the adaptation of all provisional building services systems during the various construction phases. By these innovative and wide-ranging measures, Rudolfinerhaus today is independent from fossil fuels and received various sustainability awards.

The Wilczek pavilion was demolished up to the central wall on the park side and rebuilt in conventional construction with two additional floors. The new building of the Rudolfinerhaus campus is located in the attic of the Wilczek pavilion. The renowned educational institution for health and nursing training is equipped with modern study rooms, its own skills lab and a daylight-flooded library for nursing and care.

The upgrading of the forecourt enabled the creation of a generous and barrier-free access to the private hospital. The access to the underground car park was equipped with a wide-span canopy and the entrance area and foyer were modernised.

In October 2020, following the expansion and modernization of the Billroth and Wilczek pavilions, five new wards with a total of 80 modern and well-designed single-bed rooms for patients with high standards were put into operation. The patient-friendly rooms have barrier-free bathrooms, individually adjustable air conditioning and enhanced sound insulation. Rooms facing south have park-side loggias or sunny terraces.

In the interior design, great importance was attached to building biology criteria: nutwood furniture, soothing colours and modern, functional design create a cosy atmosphere.

The redesign into one of the most modern and beautiful private clinics in Austria was carried out in the historic building while it was still in operation and required the highest standards of safety and functionality.

Paolo Silvano, Senior Advisor, ELSAN group

The workload of healthcare workers is extremely variable and uneven. On a daily basis, and this is even more true since the Covid crisis, they have to constantly adapt their working hours, or even work more. We need increasingly responsible and flexible staff, even though the rate of absenteeism in hospitals is increasing. To achieve this, it is essential that all staff, especially those who are closest to the patients, feel fully valued, motivated and enthusiastic about the work they do every day. This is the management challenge we face today.

The best way to achieve this is to work on team leadership, in each department, each operating theatre, etc. Managers need to be attentive, empathetic and able to bring the teams they are responsible for on board. Elsan has set up a training programme for a thousand team managers, which consists of a precise analysis of their strong and weak points. Personalised work on soft skills is then carried out, so that these managers can motivate, guide a team, create cohesion and harmony, and interface with each other... This learning process is not part of the typical curriculum of a nurse. Elsan wants its local managers to be the human and empathetic face of the company with regard to caregivers and the people who ultimately make the hospital work.

The second issue is professional training because the care professions are changing: digitalisation, ambulatory care, etc. This implies different types of care and work organisation. And obviously, there is a need to teach our employees, our staff, not only new techniques, but also polyvalence, because each employee, especially the carers, must be able to deal with more and more different pathologies in the course of their day.

Olivier Toma, advocacy Officer at C2DS (Committee for sustainable development in healthcare) and Founder of Primum Non Nocere

From the point of view of the attractiveness of health care institutions, under the perspective of CSR, what are the major challenges to be addressed at European level? And which stakeholders should be involved as a priority?

Three priority objectives affect all European institutions. The first is the decarbonisation of our health system. Today, we have a system that is 90% based on fossil fuel consumption, with very significant direct and indirect impacts. So, the first objective is to reduce the carbon footprint of our services. Many establishments are succeeding, those that started 10 years ago have already reached the 2030 objectives. Those who have not started will have to reduce their impact by 40% by 2030.

Second element: De-pollution of the health sector and the health system, particularly through our purchases. We produce a lot of environmental impacts that have consequences for human health, the environment and for biodiversity. Today, thanks to a responsible purchasing policy, we know how to reduce or even eliminate this pollution. We know how to reduce the exposure to endocrine disruptors, nanoparticles, electromagnetic fields and chemical risks. We need a national, or even European, campaign and major support from the ministries on these subjects, so that we can spread good practices and disseminate them widely.

The third objective is to reduce imported deforestation, because the result is the destruction of ecosystems of animals carrying more than 5,000 viruses, i.e. zoonoses and pandemics. Today we are talking about the One Health concept, which combines human and veterinary medicine.

There are four priority targets, all of which are important: hospital managers, employees (including doctors and anaesthetists), patients, suppliers, subcontractors and manufacturers.

Many hospital managers have not taken the measure of these challenges and have not yet understood that CSR is a lever for profitability, sustainability, efficiency and attractiveness. Attractiveness in terms of recruiting staff, as the new generations will only want to work in committed establishments, and attractiveness for patients, particularly in maternity wards. Doctors and anaesthetists are committed to reducing waste and implementing decarbonisation strategies, particularly with regard to anaesthetic gases. Finally, committed suppliers who innovate and reduce their impact on the environment and biodiversity are the ones who will win market share.

Cécile Lambert, assistant to the director of the Directorate-General for Healthcare (DGOS)

The health crisis and the discussions under the French Presidency of the European Union have given rise to the idea of a new cooperation instrument, which could take the form of a European hospital label.

The idea of this label was born out of the experience of the health crisis, a human context and an enormous challenge in terms of prevention and care, solidarity between European countries, sharing of knowledge of the emerging disease and feedback. The pooling of resources of health professionals and equipment was a factor of resistance and response to the crisis. We believe that this operation can and should be strengthened and that the creation of long-term partnerships between institutions involved in a European network will strengthen the response of EU countries in the event of a health crisis.

We are in discussion with all the ministries to define the contours of this label.