fundamental transformation under way in our societies continues apace. While
change impinges on all aspects of life, its impact is particularly acute in the
area of healthcare.
The causes and characteristics of these changes are multidimensional. On the one hand, the range of medical services is expanding in response to demographics, advances in medicine and rising consumer expectations, while on the other, the capacity of governments and health insurance systems is constrained by limited resources and the growing problem of manpower shortages.
Safeguarding the future of healthcare in the context of these competing forces is a major challenge for all economies and, as such, for Europe in general.
If we are to prevent rationing and guarantee universal access to health services, we must attain high levels of effectiveness and efficiency while maintaining high quality structures, processes and outcomes.
The privatisation of hospitals is regarded in some quarters as a panacea. The argument goes that shareholder expectations of a return on investment increase pressure to reduce costs and maximise profits – this must, therefore, improve effectiveness and efficiency.
This argument is assessed in this issue of HOSPITAL, which also highlights the uni - que nature of the healthcare market as well as the factors which distinguish it from other markets for goods and services.
We also examine the proposition that mechanisms other than the profit motive can deliver increases in efficiency and effectiveness. Good examples of such mechanisms can be found in both voluntary and public hospitals. The EAHM will devote greater attention to this issue in the coming months.
The aforementioned areas of conflict give rise to complex ethical questions which have implications for both the individual citizen and society as a whole. These questions are becoming increasingly relevant for hospital managers who must continually strive to strike a balance between ethical principles and economic needs.
Although these two sets of priorities are often regarded as mutually exclusive, this is not necessarily the case. The economy must be treated not as an end in itself but as a means by which to realise an objective (quantity and quality) using the minimum amount of resources (without waste!).
This and many other questions will be discussed at this year’s EAHM Congress in Graz. These are vital issues to be addressed in managing our hospitals and securing efficient, effective and high quality patient care. We look forward to Graz!
Heinz Kölking ,