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Editorial Editorial ERIC DE ROODENBEKE CHIEF EXECUTIVE OFFICER, INTERNATIONAL HOSPITAL FEDERATION ALEXANDER S PREKER CHAIR, EXTERNAL ADVISORY BOARD, INTERNATIONAL HOSPITAL FEDERATION The year 2011 was certainly not among the best for good memories. Instead of looking backwards, we in <strong>International</strong> <strong>Hospital</strong> <strong>Federation</strong> (IHF) believe that the future is always full of opportunities. In the Chinese Calendar, 2012 is the Year of the Water Dragon. In China, the Dragon is a legendary animal. It is the symbol of both imperial power and the unexpected. Looking back, 2012 marks the centenary anniversary of important events such as the establishment of the Republic of China (January 1, 1912); the creation of the African National Congress (January 8, 1912); the discovery of the South Pole by explorer Robert F Scott, although Ronald Amundsen had got there before him (January 18, 2012), the sinking of the Titanic (April 15, 1912) and the declaration of war on Turkey by Montenegro, beginning the First Balkan War. In health care, the legendary British National Health Insurance Act came into effect (July 15, 1912). In the same spirit, 2012 is already shaping up to be equally action filled and unpredictable. Despite some guarded optimism about Europe’s latest attempts to stem the euro zone crisis, the mood is sombre, with many concerns about what lies ahead in 2012. The growing inequality between the planet’s haves and have-nots has reemerged as a central issue, thanks largely to the Arab Spring uprisings, the Occupy movement and other protests around the globe. When gazing into the 2012 “crystal ball” what do we see as some of the main opportunities and challenges for the health sector? ✚ Although globalization of care is still at an early stage, major IHF is well placed to help its members address many of these challenges and to provide global leadership in the hospital and health sector more broadly changes are to come in the next decade but their pace and evolution are uncertain. Some large groups are developing a real international strategy, but most service provision is still national. E-Health presents an opportunity for accelerating globalization. This evolution needs to be closely monitored. Increasingly there is a need for effective global governance of the health care industry. ✚ At the same time, complexity and diversity in health care are on the increase. All countries face challenges of providing effective, quality, and efficient care within the limited budget envelope provided by governments and by households’ willingness to pay. Although many countries pay increasing attention to patient safety and quality of care, both must continue to improve at a faster pace to meet the expectations of better-informed and more-empowered patients. Health care organizations and health professionals need to accelerate their changes to best respond to these trends. ✚ There is increasing recognition of the limitations of both the public and the private sectors in providing for all the needs in the health sector. Increasingly a new public-private mix is evolving with strong role for both in health care. In emerging markets where the public sector is not yet well established, the private sector is stepping into the gap between patients’ expectations and the public sector’s ability to deliver quality care. Slowly, long entrenched historical barriers are eroding, and a new more open public-private mix is emerging in response to market pressures. ✚ There has been an interesting shift in attention to operational issues. Topics that were traditionally considered of secondary importance, like procurement or supply chain management, are suddenly becoming the central strategic focus of efforts to transform, modernize, and improve the performance of health services. General procurement organizations (GPOs), long considered instruments for securing value for money in terms of price of goods and services, are now also becoming major players in shaping the very essence of service delivery. ✚ Finally, university hospitals are coming back into focus as centers of excellence, providers of essential care, and trainers of a future cadre of health care workers, instead of being seen as esoteric ivory towers, black holes in the health budget. World <strong>Hospital</strong>s and Health Services Vol. 47 No. 4 03
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