The Community of Madrid chaired by Isabel Díaz Ayuso is paying recent and old invoices to suppliers with an exceptional system, the so-called “expenditure validations”, at a level not known in other autonomies. Between 2020 and 2023, Ayuso paid at least 2,004 million euros under this formula, much of it to private healthcare companies that provide public services through hospitals and contracted services. Only the General State Administration reaches total figures similar to those of Madrid, but on a much larger budget. The central government manages accounts of 347,486 million euros, which is 12 times more than those of the Community of Madrid, which manages 27,558 million.
The validation of an expense always covers a more or less serious irregularity, either because services have been provided without a contract being involved, or because the contract has been void, voidable or has ended without being extended or tendered again. . They may also be due to verbal orders from the administration to a company or to specific invoices that arise due to errors.
In any case, according to all the sources of the intervention consulted – the auditors are the officials who supervise the public accounts –, it is an admission that something has not been processed well but for a service that has been provided. Something “totally abnormal”, according to the sources consulted. It is used exceptionally so that the supplier is not left unpaid and must go through the approval of the Governing Council.
According to the minutes of the Madrid executive, which are public, in the Díaz Ayuso government it has become a recurring method – 1,769 payments approved in four years. When this system reached its maximum it was in 2021, the second year of the pandemic, with 774 million paid with this exceptional mechanism. Of them, 574 million went to health providers, of which the Quirón Group – the main payer of Alberto González Amador, Ayuso’s partner and whose relationship was made official that same year – is the maximum beneficiary, since it manages four hospitals. .
2021 was also the record year for the validation of expenses for the Fundación Jiménez Díaz de Quirón hospital, with 415 million paid in recurring payments for the same amount. As can be seen in the minutes of the regional Executive, more than 22 million were approved at once for “payment on account” in a council in March, April or June, and it reached 68 million in September, without specifying more about the service. borrowed.
Health companies are not the only ones that Madrid pays through this system – in 2021 you can find “expense validations” of more than one million to a security company or 1.2 million in payments to another company for washing sheets and hospital towels – but they are the ones that take the cake. Between 2020 and 2022 alone, Ayuso validated 1,273 million in invoices to private healthcare without contract support (out of a total of 1,700), and more than half went to Quirón’s flagship hospital, the Jiménez Díaz Foundation. The trend is repeated: of everything validated in 2020, 89% of the money went to concerted healthcare providers, in 2021 it was 74% and in 2022, 64%.
Sources from the Ministry of Health, in fact, admitted last Tuesday in an informal meeting to which they called the press that this payment system should be avoided and that they are considering the objective of “zero validations”, but they insist that it is of a legal formula. “Sometimes there were great difficulties in the agreement between both parties that ended in these types of procedures having to be carried out,” they point out. These sources also acknowledge having resorted to this tool “when a contract ends and there has been no time for the next one to be formalized.”
The payment figures with this system are very far from the usual ones, according to municipal and regional auditors consulted by this newspaper.
The Más Madrid parliamentary group denounced this payment system before the Court of Auditors, the body that supervises parties and the actions of different public administrations. In his complaint he made reference to the “abuse” of this formula, after obtaining the global data in a one-by-one analysis of the agreements of the Government councils, to which this medium has had access. In fact, the Community of Madrid does not provide this data and has suggested elDiario.es request it through the Transparency Portal, as well as the global money owed to private health companies.
Eduardo Gutiérrez, deputy of Más Madrid in the Assembly and who presented the complaint to the court – the prosecutor ordered it to be investigated but it was finally filed – says that they have also gone to the National Markets and Competition Commission and have given it all the documentation: “There are operations that are recurring, in health but also in social policies, such as payments for dining room service or to private security companies.” He also analyzes the consequences of there being no legal procedure or oversight after these payments approved by the Madrid executive: “Madridians are not guaranteed services in free competition, there are surely surcharges and conditions that could be better. “It is a breeding ground for the worst practices, such as clientelist networks or the appearance of commission agents.”
Payments years late and the unknown of the debt with Quirón
Surprisingly, many of these invoices are not even from the year in which the payment is approved, but instead involve debts from the past with up to five years of delay, something that is totally out of the norm. “They must be formalized the same year,” says an expert from the Intervention. For example, in 2023 Jiménez Díaz was paid three million for dispensing medications in 2018. And why was it not paid that year? “If an invoice is not in compliance, it is returned after thirty days, it is not paid years late,” the same sources point out. This is where the succinct explanation of the Ministry of Health comes in: there are discrepancies between the company and the Community of Madrid, the invoices are not paid, but at the same time they end up being paid by validation of expenses and with late payment interest.
The big question to be resolved is how much money is owed to the Quirón Group (which has three privately managed hospitals plus Jiménez Díaz under the umbrella of a “singular agreement”) and why the maximum disbursement was made in 2021. Health sources once again refer to the Transparency Portal, although in the briefing with journalists they insisted that it is not possible to know because the concessionaire and administration fight over invoices to the last euro, “colonoscopy for colonoscopy.” This should not prevent there from being an approximate calculation, but Health does not reveal it. “Until they are resolved” these procedures will not be published and, if necessary, they will be referred to in the Government agreements that authorize them. The Ministry points out that some of these “live” processes with amounts to be determined still date back to 2016, under the Government of Cristina Cifuentes.
Although there is no global picture of the debt and the payments that remain to be faced, the 2022 report of the Chamber of Accounts – an external auditing body – gives a clue: the public health service made provisions in the long-term budget for more than 1,000 million for payments to private healthcare, calculating that it would have to pay 248 “for responsibilities for judicial procedures” (double than in 2021) and more than 700 million “for the forecast of pending settlements from previous years of the agreements and concerts with hospitals managed indirectly.
These are the same millions that the same court calculated to be owed four years earlier, in its 2018 report, a debt that the Quirón Group calculated in 2021 to be more than 1,200 million. Mired in several judicial processes in which discrepancies over services are resolved (for example, a court has forced Madrid to pay an extra nine million to the Majadahonda hospital), the validations of expenditure for old services continue without the Community revealing what exactly they owe and why the amount owed to the healthcare concessionaires is not decreasing.
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