The newspaper “Salut i Força” published in January this article. I hope you like it, because it gathers my reflections on the new challenges for this year, as a nation, and as the health sector we represent.
It’s obvious that to face up to this difficult year, both words mentioned on the title will be required.
We’re facing, as a nation and as the healthcare sector we are, important challenges for this year. It’s time to take important decisions, sometimes difficult decisions, and sometimes not appreciated decisions. That means we all should assume our responsibility, Government and citizens. But it’s time to be courageous, because it’s time for management.
The most important risk for the healthcare sector sustainability and also for the Spanish economy is stagnation, the lack of decision-taking, and the sensation of “everything is ok”. We must accept we are in new and unexpected and not planned scene, and it’s necessary to act.
We all are required, we all can and must contribute to improve this situation, and we all must do our best to leave behind this crisis as soon as possible.
There is an urgent need for extensive reform. We need the implementation of a reform plan for the healthcare management model, in order to make it sustainable and to assure the survival of one of the most important treasures of our democratic society. Other sectors are going through different changes already, such as later retirement, labour market flexibility, centralization and capitalization of saving banks etc… but in healthcare sector we miss these changes.
This reform plan should be based on clear objectives and strategies: flexibility in organizational models, to improve system efficiency, XXI century tools to face XXI century challenges, to use all the public and private system resources.
Today, some of the Spanish hospitals, even new hospitals, are ruled by old organizational models emerged 30 years ago, focused on financing the activity, and not the health. The capitation system is an alternative, which has obtained good results focusing on health results, instead of activity results. This model also obliges to reform the foundations of the healthcare integration, removing the barriers between the bureaucratized levels. The profile of our patient is a chronic patient who needs a comprehensive medical care. In this sense, and taking advantage of the new technologies, more services and processes should be shared between levels and hospitals, simplifying and making easier the non-medical administrative management, and approaching the multi-hospital model, for example, only a call center, HR Department, Accounts Department, Logistic service to be shared by all the hospitals. In summary, the reform plan must make the organization more flexible and simple to make it more efficient.
The HR is the unfinished business of our National Health System. In this area, new policies to improve the salary of the professional staff as they are the main figures in our NHS, should be promoted. But this salary should be also linked to productivity and objectives achievement. The professional must take on a new role, with greater autonomy, making less bureaucratic the organization, and more flexible recruitment processes, adjusted to the current needs of our citizens’ medical care.
But all these reforms make no sense if they not come together with XXI century tools and information technologies to help in clinical management, decision-taking, or illness prevention. Communication between professionals and different healthcare levels is a must, as well as facing up to the chronic patient management, improving all processes transparency by means of centers of assessment and best practices implementation. Another aspect to bear in mind is the implementation of an open organization model, and committed to our citizens.
Today, public-private partnership is the model which reflects this reforms policy. With more than 13 years of experience, the model was born in Hospital de la Ribera, in ALzira, and has been “exported” to other regions and countries. In this moment, we can find more than 20 administrative concessions in progress in Spain, and Europe believes more and more in public-private partnership. It’s a successful model considered as a precedent in healthcare management, because it fulfils our citizen and professionals expectations, as well as the Local Government requirements. Moreover, it’s an effective model that has proved to save 25% in healthcare expenses compared to the traditional hospital, and the Local Government, meanwhile, keeps control and planning.
All things considered, it’s time to undertake a reform program in healthcare sector, as it has been done in other productive sectors, in order to maintain a public, free and universal National Health Service, but also modern, flexible, and particularly sustainable. Healthcare is highly valued asset and it’s our responsibility to preserve it for the future.