UEHP - European Union of Private Hospitals

Dear Health Policy Forum,

First of all, UEHP would like to thank you for having the opportunity to send its comments as a member of the Forum. We would also like to thank the Commission for dealing with ageing.
By listening to Ms Iglesia Gomez's statement, UEHP has been pleased to hear the wish to intervene on a research and innovation base. We've also been satisfied that themes related to economic costs and consequences of health expenses on GDP were also faced. These two issues are too rarely dealt with. Regarding ageing, we remember the resolution adopted by the EP in 2002 (Rapporteur MEP Mantovani - “The future of health care and care for the elderly: guaranteeing accessibility, quality and financial sustainability”). The three pillars mentioned above are extremely important.
Citizens must have free access to health cares. This access has actually been defined by several EU policies. For instance, the directive on the cross-borders patients has underlined that no discrimination to health cares access should exist. Patients have got the right to choose the best structure even if such a structure is in another Member State.
Regarding the second pillar of the EP resolution – quality – we have understood the wish from the European Commission to find a solution. Several projects and policies have dealt with patient safety and quality of healthcare. The project related to e- health has also contributed to develop solutions to this issue.
For the third pillar - financial sustainability - the question has never been developed (the issue being under national competence, the EC has therefore very few ways to intervene).
Thus, UEHP welcomes the project and Ms Iglesia Gomez statement regarding "Improving the sustainability and efficiency of social and healthcare systems". Health has always lead to major costs of the GDP (some countries spend more than 10% of their GDP for health). Nowadays, considerations are given to the economic crisis and to its consequences in the health field. However, health expenses have always been important, even before the recent economic crisis.

Often, UEHP pointed out the important deficit of national health systems expenses (with consequences on the taxes paid by citizens). UEHP has been interested in this issue for several years and thinks that a further collaboration with the private sector for a better management of health systems would be necessary. The mission of public interest must stay; health represents a good for everybody; but tools to realise this mission have to be based on the open competition principle as it is the case in all the other economic sectors.

The Spanish case should be taken as a model: The region of Madrid has opened the management to the private sector and has opened patients' care to private providers. Health expenses have obviously decreased.

Commissioner Dalli has recently stated that, with the crisis, it is better to talk about a better use of sanitary expenses rather than a decrease.

UEHP hopes that health funds will be orientated towards research and innovation, quality of health cares and towards an improvement of systems involving different service providers. UEHP thinks that the ageing issue would be better dealt with by focusing on medical research, added to prevention. Prevention is of course important but how does the European Commission intend to set up a prevention policy in Member States? There are very important costs with very few results. A policy aiming at improving technology is key and has to be integrated in all prevention policies. What to think about Alzheimer, which is specific to elderly and where no prevention is possible? Health cares of quality, together with a prevention policy, can save lives. By going into details in the AHAIP project, UEHP would like to underline an issue regarding the Work Area 2: The solution does not only consist in home medical cares. Medical devices and cares can not be the same than the ones provided in the framework of a sanitary structure. In addition, home medical cares can insure the same security level only in some very particular cases. UEHP therefore proposes to better equip health structures treating elderly with innovative and adequate measures.
Home medical cares are necessary but, unfortunately, can not be extended to everybody (i.e.: a single elderly) since they are also linked to territorial and social specificities. The solution can not only consist in home medical cares.

In conclusion, UEHP supports partnership for innovation in the ageing field and considers that health care access, health care quality and financial sustainability of our health care and social systems represent the first steps towards a European market for innovative products and services.

Yours faithfully,

European Union of Private Hospitals