Whenever I have occasion in my talks with the media, in conversations with industry peers, in forums and debates in which I participate, I say there needs to be more transparency in the data we provide to the public, both from the public and private sectors. To do so it is vitally important to create an independent external observatory to analyse and compare healthcare performance, quality of care, waiting lists, and generate public information available to the whole population. This information should contribute with new approaches to sustainability and improvement in the quality of healthcare.
It’s a recurring theme that was recently the subject of two very interesting conferences in which I was invited to participate. On the one hand, I applaud Ignacio Para and the Bamberg Foundation’s initiative to convoke, with the intriguing title ‘The Renaissance of Healthcare’, a group of experts to calmly debate the issue and offer suggestions for improvement. On the other hand, I congratulate ESADE (renowned business school at the Ramon Llull University), Foro PPP (Public-Private Partnership Forum) and Kreab Gavin Anderson for the excellent conference entitled ‘The benefits to society of public-private partnerships: pro a new relational framework’.
At both events I wanted to make it clear that no one questions our excellent healthcare system; however, it is necessary to discuss areas of improvement in the way they run because right now, both in Spain and in surrounding countries that we should look to for inspiration, private enterprises contribute in innovation and take part in pioneering projects that are available to the Administration and are put into practice successfully.
Here is a summary of my talk at the Ateneo de Madrid on 22nd September. I hope you like it.
“I think it is necessary to talk about the renaissance of healthcare. For indeed, if we divide the situation into pre-crisis, crisis and post-crisis periods, this scenario exists: in the pre-crisis period there was a tremendous boom in the construction of infrastructure and a significant increase in the number of professionals, who were probably needed. In addition there was increased spending, well above the increase in gross domestic product.
If we analyse the first data available in the crisis period, which I understand to be from 2010 with one government and a different government as of 2012, primarily cost containment measures were focussed on two areas pharmaceutical spending and investment, the areas with the most significant cuts applied during these important years. And this has resulted in a deterioration in the general condition of the health system, both for the public in terms of waiting lists, and professionals in terms of working conditions. It would appear that now the crisis is coming to an end, and it should be said that we are doing so in worse conditions than when it started.
I think an atmosphere of disaffection is being produced, both amongst the public and healthcare professionals. This is evidenced in the last survey carried out by CIS (Spanish Centre for Sociological Investigation). Because we have a system that is entering into a state of de-capitalisation as a consequence of the enormous reduction in investment throughout the long crisis. Nevertheless, we should have a commitment to society to improve services and to adapt them to the real needs the citizens of today have. We must not squander this opportunity to introduce reforms because, like it or not, the costs will increase further.
Furthermore, we have to fulfil our commitments as a country. Because the only constitutional amendment that has occurred in Spain has been a commitment to our European partners to comply with deficit requirements. I think that on this issue there really has been a union between the parties at such a sensitive moment for the country, and we must fulfil our commitments to our European partners. To all the political parties represented here and to all the dignitaries from our sector I say now is a time to reflect, now is a time to come to agreement.
I think that is what we, as citizens of Spain, want. For there to be reflection and agreement. And for there to be no restrictions to the intellectual debate which is what is happening in this country at the moment. It is not about who can come up with the easiest most saleable solution. It is about behaving like adults with the citizens. The Abril Report was a good example and I think it is high time we recovered that initiative. And, of course, we have to rethink, and all reflection should centre on, the fact that the public want a system that works well. And, of course, the public wants all politicians and service managers to be up to the task of providing what they deserve”.
