A year since La Ribera reversal (Chapter 1)

In just one year we have seen that the most controversial decision of the Valencian Regional Government, the return to public management of La Ribera Healthcare Department, is not bearing the fruits anticipated by the major advocates of 100% public health.

The truth is that after 365 days, La Ribera Healthcare Department (Alzira) neither works the same nor better than before; rather the opposite holds true, it is in decline. I am very sorry for all those who predicted that Alzira would be a victim of its own success once it rid itself of private management.

Several months before the end of the contract, different players sought to enter the dangerous political game of manipulation by announcing that from 1 April 2018, Alzira would launch unparalleled public and, of course, ‘not for profit ‘ management that would evidence the specific interests of the company. I am not really sure which ‘interests’ were being and continue to be referred to because we at Ribera Salud no longer know how to explain more clearly and more loudly how our management model works, yet we will continue doing so as often as necessary.

In this regard I question whether, in addition to giving all the relevant explanations, it has really helped to publish all the contracts and healthcare information in the transparency portals because I begin to doubt the analytical capability of those humans who turn a deaf ear to the data and reasoning, and have been dragged along by a campaign of discrediting (still active) towards public-private collaboration.

In Alzira our interest has only ever been to take care of our citizens and we did so during the 18 years we shared management with the Public Administration. Patients are the focal point of our management model, which is in constant transformation. We are a restless, young company with a spirit of ongoing improvement that seeks innovative solutions to address the global challenges faced by healthcare systems around the world.

Transforming solutions that we launched in La Ribera Healthcare Department. During the period of private management, Alzira headed the ranking of the Management Agreements established by the Conselleria de Sanitat Universal i Salut Pública (Ministry of Universal Health and Public Healthcare) for all Healthcare Departments that make up the health map of the Valencian Community. A comparison that measures approximately fifty indicators related to the care provided to the patient and the proper use of resources. Alzira always appeared in the top ten positions and won important national and international awards. In fact, it has the accreditation of the Joint Commission International although I predict that, due to the decline in which the department is immersed, it will forfeit that unique status in the next review.

However, it is now in retreat. It has been submerged in a process of regression that is affecting professionals, patients and, of course, also the public coffers. From the first day following the reversal there were problems with the orders, the maintenance of the facilities, the parking, the citations, the payrolls, the shifts and the substitutions. Complaints by patients have increased and, for the first time in 20 years, the healthcare professionals have taken a stand -those who have decided to remain in Alzira because many others have left- to protest about their working conditions, which include the incentives.

In addition, a car park has been expropriated which, in addition to costing Valencians more than 10 million euros, has made access to the hospital chaotic. All this, while material and medicines are purchased costing up to 70% more than prior to the reversal; unfair dismissals are being paid; A&E is busier than ever, and subhuman units are being created, where 26 patients and their relatives have to share a single bathroom.

The optimistic forecast of 100% public management has not been fulfilled and the decline worsens. All because the conclusions and recommendations of the reliable technical reports were ignored. I refer to the two audits conducted by the Sindicatura de Comptes de la Generalitat Valenciana (Audit Office of the Valencian Regional Government) on the concessions of Manises and Torrevieja, commissioned by the current Valencian Government, the last of which did not even include any arguments from the Ministry of Health. Both reports show that private management is capable of doing more things at a lower cost while maintaining quality processes of excellence.

I read in the press that the person responsible for completing this management disaster called ‘reversal’, the ‘public’ defender that has done the most to make it ‘private’, Isabel González, has retired. She has left just like other colleagues who either resigned or stepped down from their positions during this year due to the managerial and administrative instability. All of them were appointed by the former Minister for Health, Carmen Montón, and I ask myself: from whom do we have to claim responsibility for all this nonsense?

Now we learn that Isabel González has been replaced by Liliana Fuster, whom I congratulate on her appointment and to whom I would like to address the following reflection: “Liliana, you know that without the management model of Ribera Salud, the Health Department of La Ribera will continue its decline and worsen its service. So will you lead a politicised management guided by prejudice rather than evidence, or will you be able to propose changes and new healthcare models thinking of the citizen?”

Time will tell…

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