Welcome to the third edition of The Healthcare Law Review. The Review now provides an introduction to healthcare economies and their legal frameworks in 17 jurisdictions, with new contributions from Russia and South Africa in this edition. Our expert authors have also reviewed and updated their chapters to reflect the ever evolving situation in the jurisdictions covered in earlier editions. While a hugely diverse area of practice, it is possible to discern common challenges and similar approaches in very different countries.

Increasingly it appears that some aspects of healthcare are being delivered in ways that transcend usual requirements of co-location of the patient and provider, and traditional national boundaries. Regulators and legislative frameworks have struggled to keep pace and to reflect this new reality. In Germany, France and Russia we have seen recent new telehealth laws as countries seek to find a balance between, on the one hand, opening up new provision and meeting patient expectation and, on the other hand, commitments to ensure safety and quality and domestically appropriate regulation.

Every country wants a health system to care for the sick and promote the well-being of its people. Every nation wants to raise the bar to keep up with improving living standards and expectations. However, every economy requires this to be done at an affordable price. Managing the costs of healthcare and workforce shortages, and ensuring a sustainable model of delivery, seem to be key drivers in each of the countries covered in this publication. Integration between health and wider social care continues to be a key area, alongside a recognition of public health and wellness and a desire to relieve pressures by seeking to keep large ageing populations well for longer. Another rapidly developing area is personalised medicine and as countries gather more genomic data, and speed and costs of profiling reduce, payers look to the rapid identification of diseases, their causes and individualised cost-effective treatments. The ways different countries are meeting the demands of healthcare vary enormously and, for the healthcare lawyer or the healthcare provider, alternative destinations provide unique challenges, risks and opportunities. This publication identifies the broad characteristics of healthcare to be found in each jurisdiction. It considers: the role of insurance or public payers; models of commissioning; the interplay (or lack of it) between primary, secondary and social care; and the regulatory and licensing arrangements for healthcare providers and professionals.

These continue to be exciting times for the delivery of healthcare and I anticipate that the year ahead will witness far greater levels of comfort with digital and online involvement in diagnosis and treatment, continued debates about the democratisation or elitism of new technology and a recognition of the impact of data in the sector. Each chapter describes a country's healthcare ecosystems. I would like to thank the many leading experts for the time and attention they have given to this project, and also the wider team at Law Business Research for their support and organisation.

Sarah Ellson
Fieldfisher LLP
Manchester
August 2019