In 2004, Health Consumer Powerhouse (HCP) introduced an index comparing Swedish county council responses to the care consumer (Vårdkonsumentindex - VKI, www.vardkonsumentindex.se, also available in English). The success of the VKI has recently inspired/ forced the public Swedish authorities to develop their own set of indicators for comparison, significantly improving transparency in the healthcare system.

The HCP transferred the concept to a pan-European level in 2005 with its first Euro Health Consumer Index (EHCI) and; one year later, with the "Act Now" campaign linked to the EHCI 2006, we started our work on offering countries recommendations for improvement and consumers tools for empowerment. Indexes of performance in specific healthcare needs (diagnoses, illness groups, care needs) represent a new step in the process of strengthening the position of the healthcare consumer.