We’ve recently been looking at university hospitals in Europe. And it has been fascinating.
You can see our report on the state of play in Europe here. Basically, in Europe each university hospital is an unlinked twin to a research institute (normally a university). They are unlinked because the funding is siloed: the uni hospital is funded from healthcare payors whilst the research is funded by departments of science or business. Together, the two organisations are there to deliver complex care, further scientific research and to train the next generation of doctors. With a siloed payor set up like that, what could possibly go wrong? (Many things – see the report).
These highly complex organisations are almost impossible to manage. But, curiously, the direction of travel is very clear. Everywhere they are merging to form ever bigger constellations. Paris now has an aggregate revenue of over €7bn and Kings Health Partners in London has over £4bn. Both are titchy put alongside Boston and East Coast centres that bring together MIT, Harvard and Mass General Brigham.
Bigger, because only by being bigger, can they develop the data sets that will serve scientists best. And only by being bigger can they build integrated care so that they can treat and track patients from the hospital to outpatient to their home.
Accountability in all this is hard to pin down. How do you measure any of these outputs in a clear and meaningful way? It is certainly enlightening talking to these organisations. In England the NHS is very secretive. At MIT, the profs call you back in minutes.We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.