Interview Claude Evin

What are the strengths, competencies and target regions of the FHF and the French hospitals in the area of international cooperation?

Like the institution of the hospital itself, hospital cooperation has a long history and many different facets. Too often equated with emergency intervention, it covers in reality a large number of technical assistance assignments with a long-term focus.
Hospital partnerships are another key aspect of hospital cooperation. These broaden the scope of cooperation and prevent a more fragmented approach confined to individual hospital services.
By recognising the capacity of public health institutions to enter into international agreements, the 1991 Hospital Act both legitimised and strengthened the cooperation process.
Six years ago, the FHF set up an international arm to provide information to hospitals engaged in international programmes, and to help them prepare projects and publicise achievements. It has also played an active role in developing hospital federations in other countries.
Most of the activities of French hospitals and the FHF focus on the French-speaking countries and the wider Francophone community. But partnerships have also been established in the Spanish and Portuguese-speaking countries aided by the many hospital professionals who speak those languages. Partnerships are also developing in English-speaking countries like South Africa. Other regions are targeted due to their ties with the hospital unions of the Caribbean, the Indian Ocean and more recently the Pacific. And major cooperation initiatives are going on in non French-speaking Asian countries like China.
The know-how offered by French hospitals is tailored to the level of development of the country concerned. In some cases this will mean addressing the underlying organisation of the health care system (assistance in implementing hospital reforms for example)... in other cases it will involve developing hospital management tools or leveraging medical and paramedical know-how.

Can you give some examples of major cooperation initiatives that have been either implemented or coordinated by FHF?

The main focus of public health care institutions in recent years has been their work with GIP ESTHER. To strengthen the capacity of developing countries in treating HIV patients, GIP Esther supports partnerships which help to provide care on a sustainable basis through hospitals and support networks. French hospital action allows care to be improved through better ancillary services and the supply of hospital equipment. Further assistance is provided in the form of training of health professionals and partners to enable them to establish a genuine support network around HIV patients.
For the FHF the two main areas of activity are its work with the International Hospital Federation (the IHF Congress of September 2005 was held in Nice), and its efforts to mobilise and raise awareness among the decentralised cooperation agencies, which have included the publication of a handbook on international cooperation.

What are your expectations of GIP SPSI?

The FHF expects the GIP to support the international action of public hospitals. The uncertainty arising from the tariff reform and the recent provisions concerning the international activity of public hospitals means that there is a need to stress the importance of the international role of the public hospital. As an interface between public-sector players, GIP SPSI should be able to stimulate debate on this issue.
The FHF also expects GIP to be fully informed about French activities and priorities. As well as facilitating access to information on visiting delegations and explaining the policy goals of the different public players, it should make constructive use of the feedback obtained from the last hospitals questionnaire.
One of the functions of the GIP is to secure a better knowledge of the multilateral environment. This requires targeted intelligence activities, including those already undertaken. The aim will be to identify the priorities of the main multilateral institutions and relay this information back to GIP members.
Lastly, the creation of the GIP should result in coordinated action with public and private organisations responding to multilateral calls for tenders, to enable them to incorporate French expertise in their proposals.