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European Hospital and Healthcare Federation

HOPE

HOPE represents national hospital associations to promote healthcare improvements and high standards of care.

Lobbying Activity

European healthcare federation demands concrete cybersecurity targets in digital policy

5 Jan 2026
Topic — The European Commission is reviewing the Digital Decade Policy Programme for 2030 targets.
Message — HOPE calls for concrete cybersecurity targets for critical sectors and monitoring of technological sovereignty. They also urge for structured stakeholder engagement to share expertise.12
Why — Clearer cybersecurity standards would better protect hospitals from increasingly frequent and large-scale cyber-attacks.3
Impact — Individuals may face weaker privacy protections if digital regulation simplification measures are enacted.4
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Meeting with Flora Giorgio (Head of Unit Health and Food Safety) and Biomedical Alliance in Europe

28 Nov 2025 · Exchange of views on the state of play and next steps for the medical devices sector.

European Hospital Federation urges EU to focus on preventive care

8 Sept 2025
Topic — The initiative aims to develop a comprehensive plan to improve EU cardiovascular health.
Message — HOPE supports an EU framework focusing on prevention, early detection, and structured care. They call for systematic health checks and digital tools to enable earlier intervention. The plan must promote healthier lifestyles and integrate acute, chronic, and rehabilitative care.123
Why — Preventive models would reduce avoidable hospital admissions and ease sustained pressure on budgets.4
Impact — Small hospitals may face deeper inequalities if digital tools are not governed responsibly.56
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Response to European Research Area (ERA) Act

8 Sept 2025

The European Hospital and Healthcare Federation (HOPE), representing national hospital associations and healthcare providers across Europe, welcomes the European Commissions initiative to prepare a legislative proposal for an ERA Act. Hospitals, as key actors in Europes research and innovation ecosystem, are directly concerned by this process.. Hospitals face a number of structural challenges in advancing research within the ERA. The first is fragmentation. Research efforts remain siloed across Member States, regions, and even between hospitals, resulting in duplication, inefficiencies, and missed opportunities for collaboration. This fragmentation is compounded by uneven levels of investment in research and innovation, which creates disparities between hospitals in different parts of Europe. A second major challenge is the difficulty in mobilising and retaining talent. Hospitals depend on the contributions of clinicians, researchers, and allied professionals who face obstacles in mobility, recognition of qualifications, and career progression. Precarious contracts and inconsistent working conditions undermine the attractiveness of research careers in hospitals, especially for young professionals. Thirdly, hospitals struggle with limited access to research infrastructures and data. While they generate vast amounts of clinical data, the absence of harmonised frameworks for data sharing and reuse hampers their ability to contribute fully to open science. Equally, hospital-based researchers often face administrative burdens and legal uncertainties that limit their ability to participate in cross-border projects. Hospitals believe that the ERA Act must offer robust legislative solutions to these challenges if the ERA is to fulfil its promise in the health sector. The ERA Act should create legal instruments that facilitate the free circulation of researchers and scientific knowledge. For hospitals, this means streamlined procedures for recognising clinical and academic qualifications, improved frameworks for researcher mobility, and harmonised employment standards that make hospital research careers more attractive and sustainable. Another priority is the development of a coherent European framework for health data and research infrastructures. Hospitals call for legislative provisions that guarantee secure, ethical, and interoperable access to clinical and research data, aligned with the European Health Data Space. Such a framework would allow hospital-generated evidence to contribute meaningfully to cross-border studies and innovation projects, while ensuring patient trust and data protection. Finally, hospitals believe the ERA Act must enshrine the principles of scientific freedom, integrity, and equality in research. This includes explicit safeguards that protect hospital-based researchers from undue political or commercial pressures, as well as measures that promote gender equality and inclusiveness in all research programmes. If these solutions are embedded in the ERA Act, hospitals anticipate significant positive impacts. Research within hospitals will become more integrated and collaborative, reducing fragmentation and ensuring more efficient use of resources. Hospitals will be better positioned to attract and retain research talent, creating a virtuous cycle of innovation and clinical excellence. Patients will benefit from faster translation of research into practice, as hospitals will be equipped to lead and participate in cutting-edge projects across Europe. More broadly, a legislative framework that supports hospital research will strengthen the EUs strategic autonomy, improve competitiveness in medical innovation, and enhance Europes resilience in the face of health crises. By aligning hospital research with broader EU objectives, the ERA Act will help make Europe a global leader in health science and technology, while reinforcing hospitals as engines of knowledge, care, and societal well-being.
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European Hospital Federation urges balanced, people-centred data strategy

10 Jul 2025
Topic — The consultation explores streamlining EU data rules to improve data sharing and infrastructure.
Message — HOPE recommends defining realistic and people-centred goals while ensuring that data access is not unlimited. They emphasize that strong safeguards like anonymisation are essential, especially for personal data. They also call for investments in training and cultural adaptation for the healthcare sector.123
Why — This would protect healthcare providers from cyber threats and reduce their reliance on foreign technology.45
Impact — Non-EU technology companies could lose their market dominance as the strategy prioritizes European sovereignty.67
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Response to Critical Medicines Act

30 Jun 2025

Overall, HOPE welcomes the ambition to strengthen the resilience of the pharmaceutical supply and is positive about the direction of the proposal Critical Medicines Act submitted to consultation. HOPE considers however that: - The proposed regulation needs a strong impact assessment. - The proposed regulation needs legal clarity. - The proposed regulation should stick to a manageable list of critical medicines. - Procurement criteria should be indicative and not mandatory. - Participation in joint procurement should be voluntary. - The support of public money to industry must be conditional on requirements such as safe deliveries.
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Hospital federation demands more funding for EU cybersecurity mandate

19 Jun 2025
Topic — The consultation addresses revising the EU Cybersecurity Act and ENISA’s institutional mandate.
Message — The federation demands clarification on ENISA's role and calls for increased financial support. They want streamlined regulations that avoid administrative duplication while protecting sensitive healthcare data.123
Why — Securing more funding would help hospitals strengthen their defenses against evolving cyber-threats.4
Impact — Technology providers may see their market competitiveness deprioritized in favor of patient safety.5
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European hospital federation urges human-centric AI in healthcare

4 Jun 2025
Topic — The European Commission's strategy to accelerate AI adoption across strategic industrial sectors.
Message — HOPE advocates for human-centric innovation meeting actual needs rather than what is merely technologically conceivable. They request that healthcare representatives be included in the AI Advisory Forum.12
Why — Specific stakeholder inclusion ensures AI adoption supports healthcare professionals instead of disrupting hospital workflows.3
Impact — Commercial AI developers face delays as the federation warns against impulsive adoption.4
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Response to Implementing regulation for electronic instructions for use for medical devices

21 Mar 2025

In a pure and perfect world, electronic product information provides easier and quicker information. However, situations like backouts, in particular with cyberattacks, needs paper instructions to be kept. The burden would be then passed to hospitals to print in advance the electronic product information. The electronic product information should never replace the paper version to medical devices intended for patients but remain complementary. Personal data could be collected or stored for the simple fact of consulting the electronic leaflet. Electronic versions are easily linked to advertisement. Electronic instructions for use imply a mobile phone or a computer is based on the assumption of perfect internet connection. HOPE, the European Hospital and Healthcare Federation, is a European non-profit organisation, created in 1966 representing national public and private hospital and healthcare associations and hospital, health and social care services owners. With 36 organisations from the 27 Member States of the European Union, the United-Kingdom, Switzerland and the Republic of Serbia, HOPE covers almost 80% of hospital care and is also active in the healthcare and social fields.
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Response to EU rules on medical devices and in vitro diagnostics - targeted evaluation

21 Mar 2025

HOPE, the European Hospital and Healthcare Federation, is a European non-profit organisation, created in 1966 representing national public and private hospital and healthcare associations and hospital, health and social care services owners. With 36 organisations from the 27 Member States of the European Union, the United-Kingdom, Switzerland and the Republic of Serbia, HOPE covers almost 80% of hospital care and is also active in the healthcare and social fields. As expressed in various fora, hospital and healthcare are extremely worried that products which are significant for providing adequate state-of-the-art healthcare disappear from the market and consequently jeopardise patient care in the EU. Although the extension of transitional periods is a practical measure, it did not solve the problems. It essentially postponed them. The main issue hospitals are facing is the availability of medical devices and in-vitro diagnostics. Under the new regulations only medical devices and in-vitro diagnostics which obey the new, stringent requirements of these regulations are allowed on the market. This holds for new as well as for long-established existing products. For all products a long and expensive (re)certification process is needed to remain legally on the market and the lack of notified bodies adds to the problems. As a result, the product portfolios of manufacturers are shrinking. This is particularly virulent for products that serve a relatively small group of patients: niche products and orphan devices. These products are indispensable for the care of these patients. The withdrawal of these products leads to sub-optimal treatments or even no treatment options. The two new regulations were initiated with the welcome aim of improving patient safety. Unfortunately, their implementation give rise to serious issues, which endanger patient care. This is true in particular for orphan and niche products, as supply issues for these products have directly a very negative impact for the treatment of patients all over Europe. Since it is often mentioned that there are currently few notifications in the EU that products have disappeared from the market, this corresponds to usual conclusions, since the transition periods for existing products have been extended and the sales periods for medical devices have been cancelled. The clear shortage of supply will only become apparent at a later point in time and thus at a time when it will be too late to react at short notice by amending the regulations. Manufacturers do not disclose changes in their product portfolio, especially when the changes are a result of the time consuming and expensive processes that are needed under the new regulations. But hospitals already see the effects of the above-mentioned issue. It is expected that in the coming years and till the end of the transition periods of the two regulations these effects will become more and more visible. Added to that the legal uncertainty around in-house worsen the situation. Within the present legal framework solutions can be found only for very specific situations. Further measures must therefore be taken as a matter of urgency. They must be sustainable and anchored directly in the two regulations.
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European hospitals urge healthcare expertise in AI scientific panel

15 Nov 2024
Topic — Rules for establishing a scientific panel of independent experts under the EU AI Act.
Message — HOPE urges the inclusion of experts with deep knowledge of real-world healthcare needs and challenges. They want the panel to prioritize fundamental rights and the perspectives of underrepresented populations. Selection should bridge technical knowledge with a focus on equity and ethics.123
Why — Healthcare institutions would receive AI solutions that are more dependable and secure for patients.4
Impact — Commercial technology suppliers could lose the ability to prioritize profit over patient health outcomes.5
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HOPE urges EU to prioritize prevention-oriented mental health policies

13 Feb 2023
Topic — The initiative proposes a comprehensive EU approach to mental health and well-being.
Message — HOPE recommends integrating mental health into all EU policies and prioritizing prevention. They advocate for early intervention and transition to high-quality care.123
Why — Standardized EU frameworks would improve operational efficiency for hospitals and frontline health workers.4
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HOPE urges continued payment flexibility for public healthcare providers

7 Feb 2023
Topic — The initiative aims to reduce late payment delays that currently affect European businesses.
Message — HOPE recommends allowing public healthcare entities to extend payment periods to sixty days. The organization strongly advises maintaining current rules to ensure necessary financial flexibility.12
Why — Hospitals would better manage cash flow while balancing patient needs with available resources.34
Impact — Small businesses would continue to face financial strain from delayed payments for services.5
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European Hospital Federation backs Cyber Resilience Act to secure healthcare

10 Jan 2023
Topic — The consultation seeks feedback on cybersecurity requirements for digital products and services.
Message — HOPE requests clarification on how the Act interacts with other laws to avoid procedural duplication. They seek to ensure hospitals can still develop and use in-house software solutions. The group also asks for involvement in stakeholder dialogues to share practical healthcare experiences.123
Why — The Act would provide hospitals with more secure products and better transparency regarding cybersecurity.4
Impact — Manufacturers face more stringent and comprehensive obligations for products during their entire life cycle.5
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Response to State aid – revision of rules on exemptions for small compensations to services of general economic interest

29 Dec 2022

HOPE welcomes the revision of the SGEI de minimis ceiling as the current one is too low. There were as well a number of inconsistencies with the general de minimis Regulation, relating to the concepts of undertaking, undertakings in difficulty, and mergers and acquisitions. The introduction of a mandatory register that is mentioned should be truly aimed at reducing the administrative burden.
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European hospital federation urges stakeholder-led health data space governance

19 Jul 2022
Topic — Establishing a European Health Data Space for clinical care and research purposes.
Message — Prioritize specific health data categories instead of an unrealistic broad vision. Ensure governance remains with healthcare stakeholders rather than the technology industry. Support the transition with EU funding to manage significant infrastructure costs.123
Why — Aligning digital tools with clinical needs avoids unnecessary economic pressure on hospitals.45
Impact — The IT industry would lose influence over the system's design and management.6
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Response to Brain drain communication

21 Jun 2022

The European legislation of mutual recognition of diplomas in the healthcare field has been designed in the late sixties originally with rather homogenous healthcare systems of six countries. What looked like a nice idea in a pure and perfect market has, and still is, in reality facilitated the brain drain between EU member states on many occasions, notably following the 2000s enlargement. The only policies that have been somehow able to counteract this brain drain were those that trained more healthcare professionals. Despite several EU funded research in this field, the lack of accurate data makes in any case difficult to provide evidence on the efficiency of policies. The brain drain within countries is also important in the healthcare field for the same reason as for the other sectors of the economy. But this brain drain in the healthcare sector might certainly contribute significantly to migration from rural zones to cities. Several policies are in place in European countries and regions to find solutions. EU funded currently running projects on medical deserts might give soon a good overview of those existing policies and maybe some evidence that could help countries and regions to find solutions.
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European hospital federation urges adding Colistin to reserved antimicrobial list

16 May 2022
Topic — EU initiative designating specific antimicrobials to be reserved exclusively for human medical treatment.
Message — HOPE calls for adding Colistin to the list of reserved medicines. They also want a transparent procedure for periodic re-evaluation of the list.12
Why — Reserved status protects "last resort" drugs from becoming ineffective against resistant hospital infections.34
Impact — Intensive livestock producers lose access to antimicrobials used to sustain current farming practices.5
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Response to Recommendation for strengthened actions against antimicrobial resistance

24 Mar 2022

HOPE welcomes the opportunity to comment on the European Commission’s call for evidence on antimicrobial resistance (AMR) aiming at the creation of a proposal for a Council Recommendation. Please find attached our detailed response. HOPE, the European Hospital and Healthcare Federation, is a European non-profit organisation, created in 1966. HOPE represents national public and private hospitals associations and hospitals owners either federations of local and regional authorities or national health services. Today, HOPE is made up of 36 organisations coming from the 27 Member States of the European Union, as well as from the United Kingdom, Switzerland and Serbia as observer members. HOPE mission is to promote improvements in the health of citizens throughout Europe, high standard of hospital care and to foster efficiency with humanity in the organisation and operation of hospital and healthcare services. HOPE is actively involved in the fight against AMR for many years and would like to express its interest to be involved in the consultation activities that are being planned in relation to this call for evidence.
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Response to Proposal for a Council Recommendation on long-term care

23 Mar 2022

All countries face dramatic increases in the incidence of chronic illnesses, many of which occur later in life. Significant advances in science and technology have helped to alleviate the pain and suffering, although cures for cancer, diabetes, heart disease and respiratory conditions remain a distant goal. These innovations translate into higher health expenditures as an ever-increasing number of people require surgery, or access to medical devices, or are required to take medicines for the rest of their lives. The prognosis is difficult to deny. Demographic shifts over the next few decades could lead to unprecedented financial issues in society where populations are ageing and succumb more frequently to chronic diseases. The healthcare sector, including in particular long-term care, is aware of this shift and has prepared adaptation. A key issue at European level is however the clear need for coherence and articulation between the hospital and healthcare sector, including in particular long-term care and the social sector. HOPE believes that there is a particular significance to put this debate at EU level since different initiatives of the Commission are leading to fragmented approaches: hospital and healthcare, including long term care on one side and social care on the other. There are serious contradictions in the design of some policies; particularly visible in the debates around mental health, around cross-border care, as well as around services of general interest and in particular social services of general interest. HOPE urges the EU decision makers to avoid handling those issues separately when the population is ageing and will need better coordination between all social and health activities would be a mistake. It makes no sense to have complex system if they do not answer to the basic needs.
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Response to Requirements for Artificial Intelligence

12 Jul 2021

Artificial Intelligence (AI) is a complex phenomenon interfering with the way medical research is conducted, the biomedical data is used, and the healthcare professions and organisations are regulated. AI use in healthcare would then also requires a specific regulatory approach, in addition to a strong horizontal cross-sector regulation of AI. HOPE key recommendations to ensure that the application of AI in healthcare benefit patients and consumers are: - We need to agree at European level on a definition of AI for healthcare as a basis for further discussion from an ethical or legal perspective or to be used to determine requirements for the quality of AI. - We need to build action on AI on clear citizens’ rights (and not only when they are patients): transparency, explanation and objection; accountability and control; fairness; non-discrimination; safety and security; access to justice; reliability and robustness. The well-being and autonomy of the AI user should have priority. AI should support the user but not restrict the user’s autonomy. The effects of AI on social and environmental aspects should also be examined. It is important not only to adopt individual perspectives but also to take society as a whole into consideration. It appears useful to establish clarity as to the conditions under which AI processes can be used, especially in view of the Medical Devices and In-Vitro Diagnostic Regulations (MDR/IVDR). - We need professionals ready for AI The EU and the Member States (MS) should conduct regulatory assessments of the medical professions frameworks to determine whether they are fit for the use of patient/consumer-centred AI in health. The EU and MS should put in place mechanisms to ensure professional and educational assistance to both patients and the healthcare professionals to better understand and assess AI decision-making. - We need good quality AI The EU should facilitate the identification and should promote good practices ensuring robustness of AI systems in the health sector both at the stages of development and actual use to reduce potential biases and errors of AI-based decision-making. Mechanisms should be in place to make sure developers of AI systems are competent to do so in healthcare sector. - We need adapted legislation Ethics are a fundamental component for healthcare research and professions. However, an AI ethical code is not sufficient. AI needs that the existing regulatory frameworks are adapted and that a comprehensive AI legislation is created. The EU should update the EU safety and liability legislation that is relevant to the healthcare sector to ensure that it is still accurate and that citizens are well protected with regards to the use of AI. The EU and the MS should ensure that the MDR/IVDR are implemented with a view to include artificial intelligence: guidelines and specifications or the evaluation of safety and effectiveness of software, AI and deep learning powered devices throughout the entire usage cycle. The EU and MS must ensure that AI in healthcare is applied in full respect of EU data protection rules, while observing the balance between the interests of advancements in medical research and citizen protection. This must be achieved through diligent implementation of the GDPR principles and adequate use of provisions and exemptions on health research. During the evaluation and review report of the EU data protection legislation, the European Commission should specifically evaluate the need to establish rules on: anonymization techniques of health data; data access and control when it comes to use of data coming from multiply sources; and quality and safety standards for all information systems where health data is processed. The EU should establish a legal framework for AI integrating the specifics of healthcare. Finally, financing such innovation and in particular adapting the hospital financing to its development will have to be considered carefully by MS.
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Response to A European Health Data Space

2 Feb 2021

HOPE welcomes this Roadmap as an opportunity to further clarify certain elements in particular as the Commission mentions its priority to reduce inequalities, which are particular important in terms of digital access and digital literacy. Specificities should be recognized instead of being ignored with a one-fits-all approach. Health and care authorities across Europe face common challenges, which can certainly be best addressed jointly. But the diversity is sometimes more important and would require specific analysis instead of a unique approach. If the uptake of digital solutions for health and care remains slow and varies greatly across Member States and regions, this needs to be seriously analysed and taken into consideration. Further action at EU level would miss the point by not doing it. The evaluations that should bring evidence will need to be carefully handled. The responsibilities of hospital and healthcare services are to provide high-quality care and cure, not to help setting up a digital market and to build economies of scale in a that particular industry. Digital solutions for health and care can (and already do so) contribute to increase the well-being of millions of citizens but not only by themselves alone. Yes, they certainly could radically change the way health and care services are delivered to patients but this change should mean for good. HOPE agrees that to better advance health promotion, prevent disease and deliver integrated services based on people's needs, new technologies and products could help. But digital solutions, such as wearables and mHealth apps, by which citizens can actively engage in health promotion and self-management of chronic conditions should be carefully handled. So far, such new care models have typically been deployed on a small scale, then initial evidence is limited their benefits for both patients and health and care systems. Therefore, full-scale deployment of new care models needs more evidence. Digital technologies should be seen as an integral part of health and care and geared towards the wider objectives of health systems. It is not yet clear how the actions put forward in this Communication will be able to significantly support the Member States’ strategies on reforming health systems. HOPE is the acronym of the European Hospital and Healthcare Federation, an international non-profit organisation, created in 1966. HOPE, the European Hospital and Healthcare Federation, is made up of national organisations representing public and/or private hospitals and healthcare services and even social services in some countries.
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Response to Revision of the Union legislation on blood, tissues and cells

14 Dec 2020

The legislation on blood and all blood components should stay within the public health framework irrespective of the end use of the project. Blood is not a commodity. We were surprised to read in the roadmap that blood establishments and competent authorities did not know or anticipate the supply and demand in blood an blood products during the Covid-19 crisis. We do not find evidence of this.
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Response to Green Paper on Ageing

27 Nov 2020

In the context of demographic change and particularly of ageing, public health, i.e. health promotion and prevention, is a key goal set out in the European treaties. For the past twenty years, the European Health Strategy has been important in defining clear objectives at the European level within this framework. HOPE believes that there is a genuine added value to pursue this cooperation at EU level. Given the size of the public health challenges European societies are facing, it is crucial for EU action to be focused on those area and on initiatives which add real value. Public health activities should then remain the core activity at EU level as a lot of work still needs to be done: mental health, environmental health, cancer prevention, antimicrobial resistance, etc. The temptation to enlarge EU action beyond the public health agenda for focus on healthcare issues is a wrong approach, as there is a risk of dispersing efforts and reducing impact where EU action would be most beneficial. Good achievements have been made in this field by hospitals and healthcare services, in particular in their educational and monitoring role. HOPE has already produced evidence with studies and projects on the field. Through different networks at the European, national, regional and local levels, hospitals and healthcare services, aware of the fact that curative care is not the only way to health, are engaged in activities crossing boundaries for a better integration of care. Considering the diversity of healthcare systems, cooperation activities are the best tools, as show the European reference networks and the various joint actions: eHealth, cancer, antimicrobial resistance, etc. At the same time, the coherence of EU policies impacting health and social care is to be increased. All countries face dramatic increases in the incidence of chronic illnesses, many of which occur later in life. Significant advances in science and technology have helped to alleviate the pain and suffering, although cures for cancer, diabetes, heart disease and respiratory conditions remain a distant goal. These innovations translate into higher health expenditures as an ever-increasing number of people require surgery, or access to medical devices, or are required to take medicines for the rest of their lives. The prognosis is difficult to deny. Demographic shifts over the next few decades could lead to unprecedented financial issues in society where populations are ageing and succumb more frequently to chronic diseases. The healthcare sector is aware of this shift and has prepared adaptation. A key issue at European level is however the clear need for coherence and articulation between the hospital and healthcare sector and the social sector. HOPE believes that there is a particular significance to put this debate at EU level since different initiatives of the Commission are leading to fragmented approaches: hospital and healthcare on one side and social care on the other. There are serious contradictions in the design of some policies; particularly visible in the debates around mental health, around cross-border care, as well as around services of general interest and in particular social services of general interest. HOPE urges the EU decision makers to avoid handling those issues separately when the population is ageing and will need better coordination between all social and health activities would be a mistake. It makes no sense to have complex system if they do not answer to the basic needs. The European Hospital and Healthcare Federation (HOPE) is the voice of the hospital and healthcare sector in Europe. It gathers 36 national associations of public and private hospitals and owners of hospitals in 28 Member States of the European Union and two other European countries. It represents around 80% of hospital care in the EU
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Response to European Child Guarantee

6 Oct 2020

The development of a Child Guarantee by the EU is a necessary first step to fight child poverty and ensure children in the most vulnerable situations have access to key social rights, like healthcare. The Roadmap identifies that “the main drivers preventing access are unaffordable costs, lack of availability, or lack or poor quality of services”. This is particularly true for health care service. Indeed, the lack of affordable, available and accessible health structures and staff can be an important cause of a difficult access to healthcare for children, especially in isolated areas. Nevertheless, when the access to healthcare facilities is possible, other obstacles prevent vulnerable families to treat their children: administrative barriers (language issues, complexity, absence of social insurance or permanent address etc), health literacy, social and racial discriminations. The Child Guarantee should integrate provisions to address these causes as well. One striving example is vaccination: children remain vulnerable to potentially life-threatening diseases when they do not receive a basic set of vaccinations usually delivered in infancy. Important gaps remain in that areas in between children from different EU regions and different social backgrounds. Equitable access to safe and cost-effective vaccines is vital to protect the general child population, and children from disadvantaged backgrounds in particular. This includes migrants, ethnic minorities, those with low socio-economic status, and from rural communities and underserved urban areas. A study conducted in 2009 by FSG (Fundación Secretariado Gitano) in seven EU countries found out that on average over one fourth of Roma children (28.4%) do not fully adhere to the national immunisation schedules in those countries, i.e. approximately 300,000 children. Specific measures to prevent such gaps can be implemented: in Ireland and The Netherlands for example, vaccination schemes specifically adapted to migrant children and adolescents’ (in addition to those applied to the general population) are adopted. The Child Guarantee should also tackle the root causes of transmission of inequality between generations. A first step would be to ensure that accessible, affordable and high-quality services are available to women and girls, in particular providing health and social care in pregnancy and childbirth and knowledge for effective parenting of young children. HOPE participated in the project IPPOCA (2013-2015) funded under the EU Daphne III programme. It is a good example of an initiative aiming to improve vulnerable children care by enhancing the skills of health professionals working in paediatric hospitals and dealing with child abuse. The project shed light on the importance of training staff dealing with vulnerable children. A specific training can support health professionals to identify abuse in the form of neglect, which can relate to health, education, emotional development, nutrition, shelter and safe living conditions, and provide a clear process to help the child. The exchange of good practices in this area should be pursued and the Child Guarantee should integrate provisions on healthcare professional training. Moreover, vulnerable children are disproportionately affected by mental disorders. Adverse conditions in childhood and adolescence can have a long-lasting impact on children’s health as the effects of these conditions may persist into adulthood. Child mental health is a key element to consider in the case of vulnerable population and should receive a special focus in the strategy developed by the European Union. HOPE, the European Hospital and Healthcare Federation, is a European non-profit organisation, created in 1966. HOPE represents national public and private hospitals associations and hospitals owners either federations of local and regional authorities or national health services.
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Response to Pharmaceutical Strategy - Timely patient access to affordable medicines

2 Jul 2020

A pharmaceutical strategy should be first of all part of an overall health strategy. Pharmaceuticals should not be perceived as aims in themselves or limited to their production. All aspects should be covered: from prescription to use. This « holistic » approach would then facilitate putting in perspective the different logics at stakes, in particular the industrial one. What should be expected is certainly more than the « synergies » mentioned in the roadmap. The European Union needs real health-oriented policies. The « European pharmaceutical industry » is mentioned several times in the roadmap. But what does “European” mean in the context of globalized corporations? The affordability part does not mention the differences in wealth between EU countries as well as the different choices made concerning social protection in European countries. Concerning accessibility, a serious and accurate survey on shortages is really needed and the Covid-19 impact carefully analysed before jumping into conclusions or basing policies on perceptions or fragmented information. Then, it is not only “greater” access and availability to any product but better access and availability to accurate and adapted pharmaceuticals that is needed. The roadmap does not mention much the patient safety issues related to pharmaceuticals. Those issues are not limited to safe use of antibiotics, mentioned in the last challenge. Patient safety starts with the prescription and even before that with the training of healthcare professionals. The quality of prescription should be also mentioned together with medicine reconciliation. Patient safety means also looking at dispensation. Finally, compliance is also not mentioned in the document nor the issue of waste, which is broader than disposal mentioned as the last challenge.
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Meeting with Virginijus Sinkevičius (Commissioner) and

4 May 2020 · The environmental policy of the EU and its implications on the hospital healthcare sector

Meeting with Alina-Stefania Ujupan (Cabinet of Executive Vice-President Margrethe Vestager)

11 Mar 2020 · eHealth, digitalisation of health services, Covid-19

Response to Evaluation of State aid rules for health and social services of general economic interest and SGEI De Minimis

12 Jul 2019

The members of the European Hospital and Healthcare Federation consider that the results of the implementation of the rules concerning state subsidy for health and social services of general economic interest are very positive as far as the exemption of notification for hospitals is concerned. The only suggestion based on practice would be to raise the de minimis level at 600 000 euros instead of 500 000 euros today. In any case the European Hospital and Healthcare Federation will follow closely the roadmap presented by the Commission.
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Meeting with Vytenis Andriukaitis (Commissioner) and

3 May 2018 · HTA

Meeting with Vytenis Andriukaitis (Commissioner) and

25 Jan 2018 · State of Health in the EU; European Reference Networks; falsified medicines