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OPINION MATTERS
Major international
concerns for 2005
GÉRARD VINCENT
DIRECTOR GENERAL, FRENCH HOSPITAL FEDERATION, PRESIDENT OF HOPE (EUROPEAN FEDERATION OF
HOSPITALS AND HEALTH CARE) AND PRESIDENT DESIGNATE, INTERNATIONAL HOSPITAL FEDERATION
The year 2004 ended on quite a sad note. The UNICEF
report on child health reminded us of the toll still paid
by children today. At the same time, AIDS is following
its upward trend along with other major communicable
diseases. And wars and violence are still in the picture. On
the other side of the coin, hospitals and their professionals
are deeply involved in giving care and hope more than ever
before. The next International Hospital Federation Congress
‘Hospitals and their Challenges’ (20–22 September 2005 in
Nice, France) will keep this paradox at its very core.
In fact, there is no time for pessimism in our ever active
wards and we know that listing out the difficulties we are
facing is already a start in solving them. Two recent
developments among others are showing strong signs at
international level. Patient safety is one of them. An
estimated one in ten patients worldwide becomes sick, is
injured or even dies as a result of the healthcare they receive,
although many of these adverse events in healthcare delivery,
including medical errors, are preventable. To combat this
problem and improve patient safety, global health leaders
and the World Health Organization (WHO) have launched
the World Alliance for Patient Safety in October 2004. This
is the first time that a coalition of partners has joined efforts
to act globally to improve patient safety.
The second one concerns the migration of health
professionals. Employers and recruitment agencies in several
wealthy countries are actively recruiting doctors and nurses
from other parts of the world. But there is now a real
concern about the ‘brain drain’ in the health sector and
its consequences for population health. Charters,
recommendations and rules are beginning to flourish aimed
at promoting good recruitment practice and also to say that
Employers and recruitment
agencies in several wealthy
countries are actively
recruiting doctors and
nurses from other parts of
the world.
“
”
attention should be focused on retaining nurses rather than
recruiting nurses from abroad.
At the European level, hospitals are increasingly
influenced by the European Union decisions. Mutual
recognition of diplomas, public procurement regulations,
EU drug policy and safety regulations, have among other
things made a strong impact. Health was already present in
“
An expanding agenda of cooperation
and cross-border
contacts in the healthcare
field is also increasing with
European integration.
”
the EU treaties because a high level of human health
protection has to be ensured in the definition and
implementation of all Union policies and actions. But now
Europe will have a Constitution in which for the first time
ever health care will be clearly included.
An expanding agenda of co-operation and cross-border
contacts in the health care field is also increasing with
European integration. As health systems become more and
more interdependent, the process of adaptation needed by
health issues cannot take place solely at national level. The
enlargement of the Union from 380 million to 450 million
citizens is opening new perspectives. It takes place at a time
when all European countries will have to adapt to numerous
challenges, whereas candidate countries will look to the
Community for advice and help in rebuilding their health
systems, many of which are struggling to survive.
In this context, France is now concluding, what is
nowadays a recurring event for all systems, a series of major
healthcare reforms. For hospitals, the progressive change of
financing from a global envelop system to DRG-based
financing is the most innovative element. More generally,
confronting the lack of doctors and nurses, France has
revised the number of medical students but is also looking
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