From professional to political management

On 14th, January, 2017, the then commisioner of the Ribera Salud Department, José Sanfeliu, recently named the Deputy Director of staff costs and financial control of the Ministry of Finance, had already predicted: «A La Ribera job pool will be created, which will include our family and friends«. It has been barely a month and a half since the reversion and I have been left astounded after reading an article in the press about the development of healthcare in Alzira: «Healthcare breaches working conditions and strings are pulled for relatives in La Ribera«.

History is repeating itself, unfortunately, both here and outside the Valencian Community, as was clearly reflected in the report that was broadcast on Cuatro: Pulling strings in public healthcare, in which, I recall, the appointment of 200 coordinators and healthcare officials in the different health departments in the Valencian Community were opposed. And for some of them, it had been decades since they had practised their profession. Therefore, in this article I would like to reflect on the need to appoint less people based on ideology and to have more professional contracts in public healthcare. It isn’t a new issue. It is a subject which, for a long time now, has been debated by professional circles and associations, such as SEDISA, with its well-known professionalism report.

Despite not being a legal requirement, the appointment and termination of health professionals should be regulated by objective criteria and an independent and apolitical evaluation. In recent years, milestones have been reached in terms of autonomous initiatives, but a leap forward is needed to professionalise the selection system.

Human resources’ management is one of the National Health System’s pending issues. It’s inconceivable that even today there aren’t schemes in place in the public system to award those who do the best, those whose added value is supporting the system. Treating everyone the same regardless is demotivating for any professional.

It is paramount for both the public health system and society to count on professionals, who achieve their position through the evaluation of their training, which should be accredited and with proven experience. In addition, they should be hired and evaluated based on achieving previously established objectives and have professional career development. In this respect, the public private management model developed by Ribera Salud has also had a milestone in people management.

One of the tools that allows private initiatives for the modern management of people is the introduction of an incentive scheme that awards those who work more and better, because it is the best way of aligning the main asset of a health organisation, its professionals, with the fundamental objective of achieving the best health results.

It is for this reason that is saddens me to see how a project (Alzira) that was created to place value on professional health management is giving way to political management. Our management model could have been created amongst any political backdrop but for us, whose main focus is the patient, it is of utmost importance to hire the best. In fact, the public private collaborative model was designed from the April report, supported by all political parties, and promoted by the socialist minister, Julián García Vargas, to whom we awarded the ‘Health Advocate” award. In the Valencian Community, this model was carried out with the PP (Popular Party) government but, as we know, there are public private collaboration experiences in all autonomous regions, from Catalonia to Andalucia, of different political groups.

The first steps are being taken towards Alzira not contracting professionals based on their CVs, worth and experience. Their ideological position is examined instead. We have always had professionals occupying different positions of responsibility (service chiefs, supervisors, etc.) without asking if they belong to a union or political party. This is something that is very difficult to imagine with the current management model in Hospital Universitario de La Ribera, as well as in the rest of the public hospitals within the Valencian Community. And, to demonstrate this, you need look no further than the statement issued by CC.OO (a trade union), shown on the bulletin board in the centres of La Ribera, demanding the termination of professionals “from the previous management”.

In essence, more professionalism and less politicalisation in health management. Will we manage to see this in Spanish and Valencian healthcare?

Photo: <a href=””>Foto de Tecnología creado por jannoon028</a

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