The Healthcare Law Review: Editor's Preface

Welcome to the fifth edition of The Healthcare Law Review. In 2020, we made reference to the covid-19 pandemic and paid tribute to the commitment shown by all working in the sector: the healthcare professionals, the organisational leaders, all staff working in health and social care environments, and the scientists and public health officials seeking to navigate nations through this crisis. Little did we know how this would continue to dominate our lives throughout 2021 and what ingenuity and resilience it would ask of these professionals. This review provides an introduction to healthcare economies and their legal frameworks in 13 jurisdictions, with chapters including Cambodia, Malta and Vietnam. Every country will have been touched by the pandemic and, of course, each has responded in a different way. Some leading healthcare systems have been overwhelmed at times, many have been revealed as vulnerable and limited, and internationally governments and the private sector have shown their ability to innovate, expand capacity and ask more of their systems and professionals than was ever thought possible. The speed with which the vaccines have been developed has defied all previous expectations, and as the world works towards global vaccination we have a new vocabulary and a realisation that we will be expected to live with this new virus.

Our expert authors have reviewed and updated their chapters to reflect the ever-evolving situation in the jurisdictions covered in earlier editions. At the time of writing, many countries were still subject to emergency legislation and altered priorities. The legal position is subject to constant review as countries move through positions in relation to the scale and spread of the coronavirus and the roll-out of vaccination programmes. This review does not seek to navigate the rapidly changing pandemic-based positions, but this year's chapters reveal how underlying systems have changed and may be expected to adapt as a result. As previously, the book reveals both diverse areas of practice and the common challenges and similar approaches in very different countries.

Previous editions considered the rapid expansion of telehealth and telemedicine but few could have foreseen the 3,000 per cent increase in online consultations reported in a number of jurisdictions as we went into lockdown. Regulations, laws and reimbursement had to be revised or rewritten overnight. We will undoubtedly emerge with a newfound confidence about what care can and should be delivered remotely, where the risks that need to be regulated are, and where to prioritise face-to-face interactions between patients and healthcare professionals.

Scopes of practice have been revisited with professionals fulfilling roles outside their usual remit and the recently retired being brought back into practice, often in non-frontline roles, allowing current practitioners to step forward.

Every country wants a health system that cares for the sick and promotes 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, have been seen as key drivers in each of the countries covered in this publication. Countries around the world realise that excess deaths and heightened morbidity during the pandemic are not just from coronavirus. Many patients have not attended healthcare facilities for other illnesses or ongoing treatment, and getting care back on track at a time of economic recession with depleted resources and an exhausted workforce will be tough. The virus has asked huge questions of our healthcare systems, and populations will be re-evaluating expectations in the months and years ahead.

Integration between health and wider social care continues to be a key topic, and in countries where care-home mortality has been devastating, further questions are being raised about how social care is expected to operate in conjunction with existing hospital and hospice settings.

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 have been unprecedented times for the delivery of healthcare and have laid down challenges and opened opportunities. 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
August 2021

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