The privatization of health care opens a new gap between PSOE and Podemos

The Minister of Health, Carolina Darias, has assured that the Executive is committed to repeal in an “explicit and express” manner the law 15/97 of the José María Aznar executive that opened the door to the privatization of public health and that has generated a new chapter of differences in the coalition government for an issue that can be considered tangential: the new Law of Equity, Universality and Cohesion of the National Health System (SNS).

The purple formation was opposed to this norm, which the minister has taken to the Council of Ministers this Monday, in first reading, because it considers that it does not end with the privatizations, enshrined in Law 15/97 of the Executive of Aznar. The minister, for her part, has insisted over and over again that the regulations block the introduction of new health copayments and places public health management as “preferred”.

In the press conference after the Council of Ministers, the Minister of Health has indicated that it is “an important day” because the Government has examined, in the first round, the law that modifies various rules to consolidate equity, cohesion and universality. He explained that for this, Laws 14/86, 16/2003 and Royal Decree 16/2012 have been modified and the aforementioned Law 15/1997 on enabling new forms of management of the National Health System has been repealed. In this way, said the minister, the provision of health and social health services will preferably have direct and public management.

An “all government” law

Thus, in reference to law 15/97, the minister spoke of a repeal “explicit and express”. Darias assured that “it is a law of all the government“And it has had the support of” all the ministries. “In this way, he said,” it consolidates and shields that situations from the past cannot be repeated. “The rule, said the minister, seeks to strengthen the SNS and expand and improve rights of citizens “establishing as preferential management formulas the provision and management of health and social health services those that are of a direct public nature”.

The minister denied any conflict with her partner and that she complies with the agreement between the PSOE and United We Can since she advances “in the direct management of public health” and also defended that, although the strategy has been developed by her department, they have added the contributions of other ministerial portfolios.

The misgivings of United We Can

United We can, explain sources from the Executive, considers that “it cannot support this bill because it defends public health and that a process of deprivatization is addressed as is happening in the Valencian Community”, in reference to the reversal of the hospital concessions to private companies carried out by the Government of Ximo Puig in the case of hospitals in Alzira and Torrevieja. The same sources maintain that it is to maintain the legislation that has allowed the president of Madrid, Isabel Díaz Ayuso, to privatize several centers in the Community of Madrid “is not a minor issue.”

In addition, they assure, it supposes to breach the agreement of the coalition Government that in the point on the commitment of “shielding” of the public health, sustained in a “direct public management”. In this sense, the Government pact alluded directly to “the revision of Law 15/1997 of the PP to enable new forms of management of the National Health System and the set of regulatory mechanisms that open the door to privatization of the system.”

Government sources indicate that the alert on this matter arose when they verified in the meeting of the commission of secretaries and undersecretaries, prior to the Council of Ministers, that the draft Darias it did not modify that legislation. An aspect on which the Government has not yet ruled. On Saturday the minister took advantage of her presence in the congress of the Andalusian PSOE to announce that the Government would approve the draft in first reading on Monday. According to sources from United We can, this first filter has passed without changes in this regard. That is, without any allusion to nullifying the sanitary privatizations.

Repeal the Aznar law

“We are not saying that the law does not have positive points. The problem is that the fundamental point is not addressed, which is privatization and that is the real problem of public health & rdquor; points to THE PERIODIC OF SPAIN Rosa Medel, health spokesperson for United We Can in Congress. “We have proposed alternatives throughout the development procedure for the processing of the law, we will provide the amendments and we hope that the PSOE will take it into account because, as the text is, we do not support it & rdquor ;, Medel indicates.

United We can support “clearly & rdquor; the direct public management model, the same as the Executive says it defends. “A law was made, 15/97, and it was not a consequence of any EU directive, it was our law and we believe that it is necessary to repeal it, not to make small changes to the text that keep the law of José María Aznar & rdquor; , Medel says.

The health spokeswoman insists that her party wants “in the public services, specifically in healthcare, which is a public service, private management is not allowed because it implies a clear decrease in efficiency and a very large diversion of public money is produced for private companies to do business & rdquor ;.

Alzira model

This is what the public expects, Medel stresses and it was one of the conclusions of the Reconstruction Commission of the year 2020, he recalls. “This is our amendment. Fundamentally that because precisely repealing law 15/97 and betting exclusively on direct management is the most important thing in the entire text & rdquor ;, he adds.

The United We can proposal is to facilitate de-privatization when the administrative concession contracts are fulfilled. The purple formation, explains Rosa Medel, chooses the model of the PSOE of the Valencian Community, the one imposed by the former minister Carmen Montón (the so-called ‘Alzira model’) that “seems to us the model to follow & rdquor ;.

New health copayments

On October 20 the Ministry of Health The draft law on measures for equity, universality and cohesion of the National Health System (SNS) was put out for public consultation. A regulation that, according to the department directed by Carolina Darias, introduces the health approach in all public policy.

According to Health, this measure effectively materializes the approach to health in all policies, in such a way that, in the definition of public policies, in all sectors and systematically, it will be necessary to take into account the health implications of the decisions that are made, with the aim of avoiding negative impacts on health and improving the health of the population and health equity.

The standard also seeks to avoid the incorporation of new health copayments, as is already the case with those established for medicines, in benefits that to date are not imposed, such as non-urgent medical transport or ortho-prosthetic products. These would increase the financial burdens of families and increase social inequalities in health, especially affecting the population at risk of poverty, which has also been severely affected by the covid-19 pandemic, according to Health.

Likewise, the text introduces a modification of the Assistance Guarantee Fund with the aim of making its regulatory development viable, in order to cover through this extra-budgetary fund the movements of persons entitled to health protection between autonomous communities and the cities of Ceuta and Melilla, guaranteeing cohesion and equity in the SNS.

Attack on the private healthcare of Podemos

Precisely, the initial rejection of the United We Can parliamentary group of the bill has provoked criticism from the employers’ association of the Private sanity. From the Spanish Private Health Alliance (ASPE) they have shown “their concern at the irresponsible attempt at confrontation that, once again from certain political groups, disqualify the model of public-private complementarity in health matters”.

For the bosses, the UP veto to the regulation, considering that it allows the “privatization” of public health, requires an “objective analysis that denies this type of unjustified attacks that only destabilize the National Health System.” According to ASPE, based on data from the Ministry of Health itself, only 11.2% of public health spending is allocated to the budget for concerts. Therefore, only slightly more than 1 in 10 euros dedicated to public health in Spain are used for concerts, which reduces waiting lists for hospitalization, diagnostic imaging, respiratory therapy and dialysis, among many other areas that comprise comprehensive health care.

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In relation to the allusion of United We Can to the Valencian Community, in the case of the non-renewal of concessions of the Torrevieja and Alzira hospitals, the employers put on the table the extra cost of 76 million euros generated only by the latter center after his return to public management

“There is no extra cost. The problem is that when it was governed by administrative concessions, the ratios of health personnel were so low that they put themselves at risk the health of patients. In fact, when the Alzira hospital returned to public management they had to hire 400 health workers to be able to carry it out “, responds the spokeswoman for United We Can Health.