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Switzerland: Health System Challenges

Switzerland: Health System Future Challenges

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“There are two important fields in which legislative activity is currently ongoing: one is the area of quality improvement and HTA [Health Technology Assessment], where a draft Federal Law on the Centre for Quality in MHI [Mandatory Health Insurance] was recently abandoned in favour of the idea of a Network for Quality in Health Care. The other is the area of e-health, where a proposed Federal Law on Electronic Health Records (EPDG/LDElP) was adopted by Parliament on 15 June 2015.

“In fact, improving quality management and HTA has already been on the political agenda for quite some time. In 2009, the FOPH published a National Quality Strategy for the Health System (FOPH, 2009) and measures to implement the strategy were proposed in 2011 (FOPH, 2011b). In the area of HTA, two associations have been founded since 2008 (the Swiss Medical Board and SwissHTA), which aim to promote the use of HTA for decision-making on health care coverage (see section 2.7.1), and consensus seems to be emerging that a stronger process for systematic HTA is needed. A draft Federal Law on the Centre for Quality in MHI was proposed in 2014 with the aim of creating a national centre for quality as a public institution under the Federal Council (Federal Council, 2014). This new structure would have strengthened activities of the federal government in the areas of quality management, patient safety and HTA.

“However, during a preliminary parliamentary consultation process, it became evident that considerable opposition existed against the creation of a new institute. In particular, concerns were raised by many actors concerning the relationship between the new institute and existing structures, such as the ANQ [National Association for Quality Improvement in Hospitals and Clinics], the Foundation Patient Safety Switzerland and the Swiss Medical Board.

“Opposition was strongest at the level of the corporatist actors, such as MHI companies, hospitals, physicians and the existing institutions. Together, these actors lobbied for strengthening existing multi-stakeholder structures instead of creating a new institute under the Federal Council. As a result, the Federal Council is now proposing to set up a Network for Quality in Health Care and the FOPH [Federal Office of Public Health] is currently drafting a new proposal for an amendment to KVG/LAMal [Federal Health Insurance Law] (FOPH, 2015a). The idea is to strengthen existing institutions, programmes and projects by securing sufficient financial resources for quality management, patient safety and HTA.”

Source: De Pietro C, Camenzind P, Sturny I, Crivelli L, Edwards-Garavoglia S, Spranger A, Wittenbecher F, Quentin W. Switzerland: Health system review. Health Systems in Transition, 2015; 17(4):1–288.


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Page last updated March 22, 2021 by Doug McVay, Editor.

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