In two and a half years, the Deputy Minister of Health of the Government of Andalusia until three months ago, Miguel Ángel Guzmán, awarded contracts worth 43.6 million euros to 11 private hospitals and clinics of the Asisa Group in Andalusia, a company for which he has just signed as medical director in this community.
The emergency awards to clean up the waiting lists by sending patients to the private sector – without advertising or competitive competition or prior inspection – were made between January 2021 and June 2023, with the declared purpose of alleviating the “overload on the own network derived from of the covid-19 pandemic”, according to the title of the files. The initial emergency file bears the signature of Guzmán, then manager of the Andalusian Health Service (SAS). The last extension of expenditure expired seven months before his dismissal as number two in the ministry (on December 27) and ten before signing for Asisa.
Between January 2021 and June 2023, the Ministry of Health of the Andalusian Government awarded 242.7 million euros to private clinics to refer patients, operations and diagnostic tests, taking advantage of the emergency contracting procedure enabled by the central Government to expedite the health response to the pandemic. In total, the insurer that just signed Guzmán accounted for 17.9% of that amount, and was the first or second entity that received the most funds in five of the eight Andalusian provinces compared to other successful bidders.
The origin of these emergency contracts, which were signed with a total of 79 private hospitals and clinics in Andalusia, is in File 110/2021, an Emergency Agreement of January 20, 2021 signed by the then managing director of the SAS ( and then vice-counselor), Miguel Ángel Guzmán. These contracts at the hands of the SAS were extended until the summer of last year under a Royal Decree Law repealed two years earlier, and the Government of Juan Manuel Moreno announced their suspension in March 2023, 24 hours after elDiario.es revealed it. In Andalucia.
The initial budget of that file for contract hiring was 70 million euros, but it was expanded over two and a half years with extensions and spending addenda until reaching 242.7 million, of which 43.67 million went to 11 private hospitals and clinical centers owned by the HLA Asisa Group, of which Guzmán is currently a member as medical director responsible for all of Andalusia.
Asisa, first and second winner of emergency contracts in five provinces
The breakdown of awards, as it appears in the profile of the contractor of the Andalusian Government, is as follows: the Santa Isabel de Seville hospital, from the Asisa group, was the first beneficiary of 17 companies awarded in the province: it received from the SAS more than eight million euros of the 42.7 million distributed by hand in this province between January 2021 and May 2023; the HLA El Ángel Hospital, in Malaga, obtained 8.8 million of the 50.6 million that were distributed among companies in the sector (it was the second most benefited of 19); Also in Malaga, the Doctor Mario Gallegos center received 142,000 euros.
In Huelva, the Los Naranjos Clinic obtained 10.7 million, of the 23 million distributed in this province (the one that earned the most out of five companies); Sanatorio Cristo Rey, in Jaén, was awarded 5.75 million of the 10.7 million for private clinics in the province (the first to benefit from two successful bidders); The HLA Inmaculada hospital, in Granada, achieved 1.15 million euros of the 21.5 million for the private sector in the province (the fourth of eight companies).
The Mediterranean Hospital, in Almería, received 4.2 million by hand, of the 14.8 million awarded; the Policlínica del Poniente SL obtained 20,000 euros, and the Policlínica del Levante, another 20,000 euros. Asisa was the second beneficiary of four companies. In the province of Cádiz, the Jerez Puerta del Sur Hospital, from the HLA group in Jerez de la Frontera, received three million of the 48.3 million distributed in the province, and the South Health Platforms, from the La Salud hospital, in Cádiz , 1.7 million. Together they are the third company by award volume.
Guzmán’s incorporation into the Asisa insurance company is scheduled for the coming days, although it is not yet effective, according to company sources, who explain to elDiario.es that they have valued his “professional career in the health sector, with extensive experience in public and private entities.” According to a spokeswoman, Guzmán had already started the procedures provided for by the Incompatibilities Law. “We trust that there will not be any problem,” they emphasize, clarifying that the contracts with the regional administration are with the health branch of the group: “As a hospital group, logically we have had contracts with the Junta de Andalucía and other administrations.”
Incompatibility by law
His jump from the top of Andalusian public health management to one of the largest private insurers in Spain – with a dozen hospitals and clinical centers in Andalusia – has raised a storm of criticism from the opposition, which accuses Guzmán of breaking the law. of Incompatibilities for having ignored the minimum period of two years required by the norm to be able to enter a company in the sector in which they have had direct powers.
Guzmán denies that his move from the senior management of the Andalusian public health system to a private insurer, in just three months, incurs any case of incompatibility or revolving doors because Asisa does not currently have any contractual relationship with the Andalusian Government.
The aforementioned law, of 2005, prohibits “the performance by itself or by a person appointed of positions of any kind, management or representation functions, as well as advice and mediation of companies or concessionaire companies, real estate companies, construction contractors, services or supplies, or with participation or aid from the public sector, whatever their legal configuration.”
Almost 24 hours after the news broke, the spokesperson for the Andalusian Government, Ramón Fernández Pacheco, explained to journalists’ questions that he was not aware of “the new performance of the former Deputy Minister of Health”, beyond “what appeared in the press.” , although Guzmán himself has confirmed his hiring as a director of Asisa.
“We are not aware that any rules have been broken. We are going to collect everything related to this situation and analyze it to adopt the measures that should be adopted. Totally against any type of revolving doors, of course, but also against the fact that going through politics ends up harming those people who decide to make the leap to the private sector,” stressed the spokesperson for the Board.
The Ministry of Justice and Public Administration is competent to resolve whether there is legal incompatibility in the jump from the public to the private sector of the second person responsible for health management in Andalusia. Until this Tuesday morning, this department had not received a consultation from Guzmán about whether his new position in Asisa represents a possible conflict of interest, they say from Justice. The department headed by José Antonio Nieto will study the case and if it finally detects an infraction, it will issue an unfavorable ruling.
Three extensions and triple the budget
The initial emergency contracts that Guzmán signed as manager of the SAS, with an execution period from February to December 2021, were extended three times: the first in December 2021 up to 125.7 million euros; the second on June 21, 2022, adjusting “the new real spending need” to 226.7 million; and the third in December 2022, expanding the overspending to 242.7 million. This last extension did not appear in the contractor’s profile until eldiario.es published the first information about these contracts, in March 2023. Finally, the Board ended up easily tripling the initial budget for hand-picked awards to private clinics: from an initial 70 million at 243.
The extensions were in parallel to successive addendums with a budget extension until June 2023, expanding the benefits of almost all private clinics that signed the initial contract. All of the Asisa Group benefited from some extension and budget expansion, and its hospitals earned almost 44 million euros for caring for patients referred from public health.
The period in which addenda and extensions are authorized coincides with the second state of alarm of the pandemic. The initial contracting agreement allowed Health to sign the 79 contracts with health companies, but the estimated budget was shown to be “insufficient” a few months after being approved. Between June 2021 and December 2022, the SAS signed 124 addendums (98 throughout 2021 and 26 more in 2022) that modified the contracts with the awarded companies, raising the global amount for that same period to 109.7 million of euros (39 million more than the price established in the contracting resolution: 56.7% more than initially planned), as stated in the list of contracts and addendums published on the Board’s Transparency Portal.
From the private sector to the Rajoy Government
Miguel Ángel Guzmán is a specialist in Occupational Medicine and Family Medicine, but he only practiced as a family doctor in the SAS for four years, from 1988 to 1992. In reality, his career developed mainly in private medicine, to the point of who became a member of the Board of Directors of the Confederation of Businessmen of Andalusia (CEA) and a member of its Health, Prevention and Labor Relations Commissions.
He has been medical director of the Vithas Parque San Antonio Hospital in Málaga, medical director and deputy manager of the Private Comprehensive Hospital Complex – Chip Hospital in Málaga and director of Market Intelligence and Innovation at Mutua Universal, a company in which he held different positions of responsibility.
He parked his career in private healthcare to hold various public positions for the Andalusian Government of Juan Manuel Moreno. Thus, counselor Jesús Aguirre appointed him manager of the Bajo Guadalquivir Public Health Business Agency in April 2019, and seven months later he promoted him to managing director of the SAS. In the second Moreno Government he was appointed Vice Minister of Health. Previously, he had been a member of the Advisory Council of the Ministry of Health, Social Services and Equality from September 2012 to February 2018, coinciding with the Government of Mariano Rajoy.
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