The Ministry of Health approved this Tuesday in the Council of Ministers a draft bill that will replace the 1997 regulation, implemented during the Government of José María Aznar, and which opened the door to health privatization. The new law seeks to put a stop to health privatization by placing extra requirements to outsource the management of public hospitals and establishing additional control mechanisms.
The Draft Law on Public Management and Integrity of the National Health System (SNS), advanced by Cadena Ser, includes the obligation that autonomous communities that want to outsource the management of a hospital must submit that project to a prior evaluation, and must justify with a report the need for this privatization. This proposal will pass the examination of a committee of experts and technicians.
With the new standard, healthcare outsourcing can only be launched when direct provision is not possible, as long as financial sustainability is guaranteed and when the requirements for quality, continuity, accessibility and affordability of the service are met. The report of the autonomous communities that includes these points will have to be public.
In addition, the rule includes prioritizing concerts with non-profit entities, instead of with companies seeking to do business. In practice, the law seeks to limit the model of groups such as Quirón or Ribera Salud, specializing in the private management of public hospitals.
There is another key point in the preliminary project, which has allowed the construction and privatization of a multitude of hospitals, especially in Madrid and Valencia: until now, the companies closed a global agreement with the administrations by which they built the hospital center and kept the management, in exchange for an armored contract that guaranteed an annual fee from the autonomous community. The new rule will prevent this: contracts cannot be made that include the part of the hospital work and then its management.
“We are going to protect healthcare from the clutches of profiteers”
The Minister of Health, Mónica García, pointed out in the press conference after the Council of Ministers that in recent years “we have been listening to and have witnessed absolutely obscene cases that should not be part of the daily life of our public health system” and has described the law as a response to a motto: “Healthcare is not for sale, health care is defended.”
To exemplify this, García has recalled several statements from businessmen in the private health sector in recent years: “You all know that the elasticity of the income statement to the waiting list is direct.” CEO of Ribera Salud. “Surely you are capable of identifying processes that are not contributory, that is, that are not profitable. I am talking about the capita.” CEO of Ribera Salud. “It will probably surprise you, but the income from the public side is more profitable than that of the private side’. CEO of Fresenius, as soon as he bought the Quirón group with a capital gain of 2,600 million, which he defined as the goldmine being in the contracts and concessions that the Community of Madrid specifically had. “This is what we have come to put a stop to today,” he said.
The person in charge of Health has said that “internal audios” have been known in which business leaders spoke “openly” about inflating waiting lists to have greater profitability, “how appointments are made at four in the morning to carry out diagnostic tests, to make money off of waiting lists” or “reusing material in order to reduce costs, putting the safety and quality of healthcare at risk.”
Mónica García has also recalled the case of Quirón and how “it has multiplied by six” the number of patients it receives from public health in the Community of Madrid “and has also multiplied its income by six” or how “in some territories this outsourcing of some of the tests or some of the procedures such as breast cancer screening has put prevention at risk and has put control at risk precisely in one of the essential functions of our health”, in reference to the case of breast cancer screening. Andalusia.
“These are some examples. I could be here all day and all morning. And what these examples demonstrate is that they are not isolated cases, that it is a structural problem that is based on a regulatory framework that allows, for too long it has allowed, that the management of public health can have an orientation towards economic benefit, instead of an orientation towards the care of our health,” the minister concluded.
The minister also wanted to respond to the president of the Community of Madrid, Isabel Díaz Ayuso, who after hearing the news of the arrival of the rule to the Council of Ministers and before it was even presented at a press conference, has already attacked the Executive, accusing it of wanting to “end” healthcare in Madrid. “What do we have to do? End the Jiménez Díaz Foundation. Tell patients that they are wrong when they choose these types of hospitals. We have to incite fear, block what works,” Ayuso said.
“Mrs. Ayuso has already come out to say that what we want is to destroy the Health Service. No, madam, we want to destroy your beach bar, your business,” responded Mónica García, who recalled that in recent years the Quirón Group “has been given 5,000 million euros, which is half of the entire Health budget for one year” and has questioned that the Community of Madrid used 1,300 million to settle debts with it. business group after the transfer of 3,000 million from the central government for health and residential spending during the COVID-19 pandemic.
Spending on this type of centers has increased by 84.6%
In the last decade, the number of private hospitals that end up integrated into the public network has increased by 36.8%, which implies that 30.7% of the hospitals in the National Health System now have “private functional dependence.” Or what is the same: one in three public health hospitals is managed by a private company. Furthermore, spending on this type of centers has increased by 84.6% between 2011 and 2023.
A report prepared by the Ministry in December indicates that the National Health System has gone from having 106 integrated private hospitals in 2011 to 145 in 2023. “The proportion of operating beds that belong to private centers within the SNS has gone from 13.7% in 2011 to 17.8% in 2023 and the proportion of operating rooms that belong to these centers has grown from 8% to 10.7%”, points out the document.
In addition to the fact that there are private companies managing public hospitals, in many territories a good part of the tests and treatments are referred to private centers. In 2023, 34.6% of hospital stays and 17.6% of discharges registered in privately managed centers that are not part of the public system were financed with public funds.
Source: www.eldiario.es
