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Representing public and private hospitals

Pascal Garel
Chief Executive,
HOPE, the European Hospital and
Healthcare Federation
HOPE is actively involved in projects to exchange good practices and share information, as well as contributing to the work of the European Union
This has been another challenging year for the health services in Europe, not least because of the news coming back to us. From an annual average growth rate of 4.6% between 2000 and 2009, health spending per person fell to –0.6% in 2010. This is the first time that health spending has fallen in Europe since 1975. As a result of the slowdown or negative growth in health spending per capita in 2010, the percentage of the gross domestic product devoted to health stabilised or declined slightly in many EU Member States.
All countries are under different degrees of financial pressure, with some at crisis level. Several have already experienced financial cutbacks but all face an increased demand. This reinforces more than ever the role of HOPE, the European Hospital and Healthcare Federation, an international non-profit organisation created in 1966 for fostering efficiency, effectiveness and humanity in hospitals and healthcare.
HOPE is now a gathering of 34 national organisations from 29 different states; 27 of them belong to the EU. A majority of HOPE members are national hospital federations. Where there is no national hospital federation, members are national federations of local and regional authorities, as owners of hospitals, or representatives of national health systems. HOPE covers approximately 80% of the hospital sector in Europe.
Further information can be obtained on:
Membership and structure 
HOPE is organised around a Board of Governors (see Box 1), a President’s Committee, Liaison Officers, a network of National Coordinators for the exchange programme and a Central office. The Board of Governors (BoG) consists of the President and of Governors, one from each Member State, and is the forum for all major policy decisions. Georg Baum (Germany) is President and Sara Pupato Ferrari (Spain) is Vice President. The President’s Committee (PsC) consists of the President, the Vice-President and three Governors: from Estonia, Hungary and Denmark. Two Governors, from Malta and Poland, have been co-opted. The PsC oversees the implementation and the execution of the BoG’s decisions, co-ordinates the work, acts for HOPE and authorises legal representation. The work of HOPE is organised around a network of Liaison Officers, one for each member organisation. The Liaison Officers meet three times a year. The network of National coordinators of HOPE Exchange programme meets twice a year to prepare the HOPE exchange programme under the authority of the Chief Executive. The Central office is based in Brussels (Belgium). It is organised and directed by the Chief Executive, Pascal Garel, assisted by Colberte de Wulf, with EU Policy assistant Silvia Bottaro and Isabella Notarangelo, Health Economist. 
Representation and influence 
In the broader context of increasing influence of EU policies on hospitals and healthcare, in 2012 HOPE had to handle several EU issues and was asked to intervene in major European meetings, seminars and conferences that matter. HOPE contributed to the design of several conference and seminars of the Spanish and the Belgian presidencies and continued its work with the High Level Group on health services and medical care. This Group, created in 2004, brings together experts from Member States and selected stakeholders. HOPE participates with the successors of the High Level Group working groups on Patient Safety and Quality and on European health workforce. 
HOPE is working principally with Directorate General Health and Consumer (DG SANCO), the remit of which broadened to pharmaceuticals and medical devices in 2010. The official entry point with DG SANCO is the EU Health Policy Forum (EUHPF). In parallel, HOPE commenced participation in the new process initiated by the Directorate General Enterprise (DG ENTR) on some aspects of the pharmaceutical policy. With the Directorate General Information Society (DG INFSO), the activities of HOPE in the field of eHealth were developed further. HOPE actively participated in the meetings of the eHealth Stakeholders’ User Group and represented the view of hospitals in several discussions devoted to eHealth. 
Contact with Members of the European Parliament has been more systematic in 2012. HOPE presented its activities, shared its positions and answered requests, and particularly focused its attention on work on the proposals for directives. 
HOPE worked on many diverse issues in 2012; some were rather political, some were more technical. The main one was, of course, the debate around the transposition of the directive on cross-border healthcare. But five other significant initiatives of the Commission were on the agenda: the implementation of the recommendation on patient safety; the directive on energy efficiency; the regulation on medical devices; the regulation on data protection; and the consultation on clinical trials.
Exchange of good practices
HOPE is fostering the exchange of good practices with different channels. The major ongoing project was the joint action on patient safety and quality that followed the EUNetPaS project. Its main goal was to establish an umbrella network to improve cooperation among Member States in the field of patient safety. It started in 2008 and was completed in 2010 by the implementation of goods practices in the field of medication safety. Following the involvement of HOPE in the MARQuiS project that ended in 2007, HOPE decided to join a consortium on a new project proposal – DUQuE (deepening our understanding of quality improvement in Europe) – that was accepted for funding in 2009 and successfully achieved by a final conference in Berlin in December 2012. HOPE was also working in MANAGED OUTCOME, completed also in 2012. These both are financed within the 7th Research Framework Programme. EURHOBOP is also a project in which HOPE is a partner, financed by the public health programme.
Knowledge on hospitals is sparse and spread in different sources. HOPE transferred and updated its work, Hospitals in the EU 27, on its website, giving comparable information for each of the EU Member States. Finally, in 2012, HOPE organised, for the 31st time, its Exchange Programme, with a central topic of ageing. The event was co-organised by the German hospital federation with HOSPAGE, “Ageing workforce, ageing patients: multiple challenges” being the final event that took place in Berlin from 11–13 June 2012.