1. Gérard Vincent/FHF1 INTERNATIONAL HOSPITAL FEDERATION 32nd Congress HONG KONG 15 – 18 May 2001

2. Gérard Vincent/FHF2 The Role of Hospitals in the New Century Gérard VINCENT Director General - French Hospital Federation Vice-President of the Standing Committee of the Hospitals of the European Union Member of the IHF Governing Council www.fhf.fr

3. Gérard Vincent/FHF3 OUTLINES I – WHAT CAN WE LEARN FROM LAST CENTURY ? I – WHAT CAN WE LEARN FROM LAST CENTURY ? II – WHERE ARE WE NOW ? II – WHERE ARE WE NOW ? III – WHAT GENERAL TRENDS CAN WE FORESEEN? III – WHAT GENERAL TRENDS CAN WE FORESEEN? IV – WHAT ABOUT THE FUTURE OF HOSPITALS ? IV – WHAT ABOUT THE FUTURE OF HOSPITALS ?

4. Gérard Vincent/FHF4 I – WHAT CAN WE LEARN FROM LAST CENTURY ? From a place poor in technology and in efficiency…and for the poor... From a place poor in technology and in efficiency…and for the poor... … to an efficient high tech organisation for all, … to an efficient high tech organisation for all, Hospitals of the XXth century were a key added value for life expectancy... Hospitals of the XXth century were a key added value for life expectancy... in a context of growing inequalities between and within countries in a context of growing inequalities between and within countries

5. Gérard Vincent/FHF5 II – WHERE ARE WE NOW ? In wealthy countries health care tends to be the first sector of the economy In wealthy countries health care tends to be the first sector of the economy In emerging countries health care and hospitals are developing, but with remaining inequalities In emerging countries health care and hospitals are developing, but with remaining inequalities For the less advanced countries lack of funds is the rule but health care is the choice to make For the less advanced countries lack of funds is the rule but health care is the choice to make

6. Gérard Vincent/FHF6 Health care expenses : % of GDP

7. Gérard Vincent/FHF7 III – WHAT GENERAL TRENDS CAN WE FORESEEN Health care and hospitals will have to meet new needs (an age ing population for example) Health care and hospitals will have to meet new needs (an age ing population for example) New requirements coming from the patients : New requirements coming from the patients : –more information, –lobbying of patient associations, –patient empowerment.

8. Gérard Vincent/FHF8 III – WHAT GENERAL TRENDS CAN WE FORESEEN Medical progress : molecular biology, genetics... Medical progress : molecular biology, genetics... Technical innovations, information technologies... Technical innovations, information technologies... Organisational change : more decision making at the regional and local level; networks Organisational change : more decision making at the regional and local level; networks In a world still unequal but hopefully with a more efficient international aid In a world still unequal but hopefully with a more efficient international aid

9. Gérard Vincent/FHF9 IV – WHAT ABOUT THE FUTURE OF HOSPITALS ? Hospitals will not be bureaucratic institutions any longer, but management focused Hospitals will not be bureaucratic institutions any longer, but management focused A well balanced public private mix will provide a fruitful emulation A well balanced public private mix will provide a fruitful emulation Hospitals will not do everything Hospitals will not do everything Hospital as a real part of a global health system Hospital as a real part of a global health system

10. Gérard Vincent/FHF10 IV – WHAT ABOUT THE FUTURE OF HOSPITALS ? Still an indispensable place for professional training Still an indispensable place for professional training What about research ? What about research ? Hospitals will remain a key social actor Hospitals will remain a key social actor But they will cost more and more But they will cost more and more And finally their economic importance will, without any doubt, increase And finally their economic importance will, without any doubt, increase