Amidst such controversy and debate on healthcare in Spain, in this article (published in Medical Economics) I defend partnership and union between public and private management as the sum of both is essential to overcome the crisis with a renewed model.
“We ought not to play public management off against private management. Each has had a different origin and holds its own set of ground rules, obligations and even contradictions. However, under an original model in the context of a fresh scenario for a different society of a new century, we all have to show flexibility in our positions to bring them closer as well as make reforms while focusing on tomorrow’s needs rather than old habits.
Here is my article. Greetings,
In the fifth year of the economic crisis we do not yet see the light at the end of the tunnel. Worse still, several authors claim we still have a long journey ahead of us across the darkness while, according to others, effort, work and hope have reached an all-time low.
Is all this due to misdiagnosis or to using tools from the past to solve today’s problems?
I believe it is time to ask ourselves if traditional paradigms work in a complex international economic model with multiple inter-related variables. This is a permanently changing social environment, faster than ever before and where phenomena like internet or social networking have given easier and better access to information.
It is also time to reflect on other issues that directly touch the healthcare sector. I strongly believe that public administration management has to change. Thus, greater autonomy must be awarded to our healthcare managers, higher salaries in exchange for greater supervision, transparency, accountability and results. Public sector governance has to change towards non-political executive positions, short- and medium-term team training and bureaucracy-free decision making. In short: greater responsibility and professionalism of public managers and increased transparency and supervision.
We have attacked public management and continue to do so today, instead of claiming a truly public property while leaving behind its current political or bureaucratic character. In a changing world we have to support modern public management with flexible tools and trained executives with the capacity to use them. I support modern public management for the 21st century.
As the world is changing and evolving at increasing speed, I believe the private sector is undeniably also being called upon to play a role in managing public services. Besides, in order to gain broader visibility it has to develop a new relationship model with the administration and to invest in long-term loyal partnership and to share values, principles and procedures. In addition, corporate social responsibility and a new model of relations have to be placed above a market-oriented vision in the management environment of healthcare, a cornerstone of the welfare system.
We ought not to play public management off against private management. Each has had a different origin and holds its own set of ground rules, obligations and even contradictions. However, under an original model in the context of a fresh scenario for a different society of a new century, we all have to show flexibility in our positions to bring them closer as well as make reforms while focusing on tomorrow’s needs rather than old habits. We have to make an ethical commitment with society and learn from mistakes made during this crisis, lack of values and scruples or inherent inertia not to change or risk anything.
We have to assume that for the first time in history, and unless nothing is done to prevent it, our generation is going to leave the next one conditions inferior to those received from previous generations and all due to an excess of complacency and short-termism.
From the perspective that 14 years of the concession model of public private partnership bring, I consider we have proved that public healthcare can be managed while keeping the system’s values – gratuity, universality, equity, etc. – and with greater efficiency and flexibility as well as higher capacity to innovate and adapt itself to a progressing society. The over 10,000 professionals working at hospital and primary care centers under the Alzira Model ought to feel proud to have created a path that is widening both in Spain and abroad. Thus, it illustrates that the best of public healthcare and private initiative can be added to build a sustainable model of excellence.
Consequently, we are at a turning point for Spanish healthcare. Public administration will face the challenge of educating and developing the necessary mechanisms to control the private sector, starting by the appropriate selection of partners with whom to work in the long term. The private sector will also have the challenge to help out educating, supporting transparency and to create once and for all a business model with a vision and a profile for public private partnership that is different from the traditional profile of private provision.
Great challenges, great tests, great opportunities and great dilemmas. At the end, today’s big decisions will reduce tomorrow’s problems. Although economy, society, values and understanding that date prior to the crisis will not provide a way out. Cultural change, comprehension and complete assumption of the crisis in which we find ourselves are a must. We ought not to fear change.
Utopia? May be, though I firmly believe that we can only emerge rejuvenated and renewed from the crisis by overcoming paradigms and stereotypes from the past and adding everybody’s efforts, a great deal of generosity, consensus and greatness.
I am betting on it.
Link to the article on Medical Economics