Alberto de Rosa

While I was travelling to Kuwait last week, I was thinking about how, thanks to the public-private collaboration model that we started with our first hospital in 1999, we at the Ribera Healthcare Group have had the opportunity to meet very interesting and different people from almost every corner of the world. On some occasions we have been invited to their countries to explain our management model, which gives such good results to citizens and is a case study in universities such as Havard or Berkeley. On other occasions international delegations have visited our hospitals to learn about our model of integration of primary and hospital care, our technology and our innovative people policy and our social responsibility towards the community.

Working in an international company puts many stamps in your passport, forces you to spend many days away from your home and family, sometimes on special dates, but also allows you to get to know other cultures, customs and ways of managing services, such as health, working in multicultural environments, and with administrations and governments of all kinds.

Undoubtedly, all this diversity brings unparalleled value to the Ribera Group. Even more so when we have the opportunity to become actively involved in specific projects, with professionals from the surrounding area, and when we have first-hand knowledge of the real needs of the citizens of each region of the world. This was the first thing we detected in our first contact with Latin America and the hospitals in which we have a small participation in Peru. We experienced it more intensely in Central Europe, where we bought the high-tech company Pro Diagnostic Grup (PDG) in Slovakia and OBK Klinic, the bariatric and high-complexity clinic in the Czech Republic, and more recently when we took over the management of Cascais Hospital in Portugal. We have also developed technological projects with Futurs in the United Kingdom and Saudi Arabia.

In the specific case of Kuwait, the experience of our alliance with a corporation such as Dhaman Hospitals has been very satisfactory in both professional and human terms. Not only for the management team most involved in the project, but also for dozens of our professionals, who have travelled at different times to this Middle Eastern country, to collaborate in the implementation of two hospitals and several primary care centres. It is a very ambitious project, which is going to allow Kuwait to make a qualitative leap in the quality of healthcare for its citizens, and also for expatriate workers. And Ribera is already part of this legacy.

Let me tell you briefly. Kuwait has allowed us to get to know in a single project the public-private partnership that we advocate, at other levels and in a very different country, involving citizens and institutions in the renovation and improvement of their health infrastructures. Working with Dhaman on such an important health project for the region has been a magnificent experience, full of learning for both of us.

My first assessment of the project, which is still underway but which I would like to share in this blog, is that Ribera not only brings to Kuwait its know-how, based on 25 years of experience in healthcare management in a public-private partnership model. It also brings with it what I like to call «the genetics of internationalisation». Because this capacity for adaptation, immersion and creating multidisciplinary teams is in our DNA. And it is a characteristic that undoubtedly sets us apart from other healthcare and hospital groups.

In Kuwait we met very different people and realities, but with needs and challenges similar to ours. Once again, we have seen, as Covid has shown, that the challenges of healthcare are the same for everyone, and that it is only necessary to adapt global solutions to local realities.

My second reflection has to do with our people, the professionals of the Ribera Group. This project in Kuwait, like so many others, has been possible thanks to the genetics of internationalisation that many already have in the group. A genetics open to diversity, to cultural exchange, to equality, to flexibility and to the ability to organise and react. I am very proud that this characteristic is not only part of those of us who have been leading this type of project for many years. To see that the professionals who have joined our organisation have the same vision and are clearly committed to the internationalisation of our responsible healthcare model is something that fills me with pride. They defend with solvency and much success abroad that Ribera is called upon to collaborate with all types of governments and institutions for the sustainability of health systems. Wherever we are required, of course. In fact, on my last trip to Kuwait, I went to dinner with the entire team there and asked them if they would be willing to participate in other similar projects, and the answer was unanimous and resoundingly affirmative. Thank you for that.

Finally, with regard to this project, I would like to thank the Spanish Ambassador to Kuwait, Miguel Aguilar, for receiving us at his residence to share views and knowledge about the area, as well as for his kind treatment and encouraging words about the importance of a sincere, honest and loyal collaboration between administrations and companies and to contribute to a greater rapprochement between the two countries.

For this reason, I would like to thank both our official ambassador and the «Ribera ambassadors», our professionals, for their good work, commitment and hard work. Without a doubt, our representatives abroad are the best calling card for Spanish companies that are committed to internationalisation.

The year is coming to an end and it is time to take stock of these twelve months and our challenges for 2023. In general, 2022 will be remembered as the year of the war in Ukraine, the first in Europe for 30 years, following the Russian invasion. This conflict has brought back the worst images and memories of the horrors of war, an international tension of war that most of us have not experienced and important consequences for the West, the result of our globalised world: the rise in the price of many raw materials and energy, the threat posed by possible cuts in the gas pipeline in the area, problems in the distribution of corn or wheat and the mass exodus of refugees, among others. I would like to take this opportunity to publicly reiterate my solidarity with the Ukrainian people, to whose citizens we have provided health care from the hospitals of the Ribera Group. In fact, we had the good fortune to care for the first baby born in Spain to a Ukrainian refugee mother in our hospital in Denia. In addition, we have promoted and facilitated the recruitment of Ukrainian professionals in the group’s technology company, Futurs, and we have helped displaced families and also those who remain in the country, through campaigns and donations of health material, food, clothes and toys.

In this macro scenario, marked as I have mentioned by the war in Ukraine and its consequences, I would like to briefly review the trajectory of the Ribera healthcare group in 2022, a year that has undoubtedly meant a transformation, especially after having overcome challenges and also important changes. The most significant at the corporate level has been the exit of Centene Corporation and the entry of Vivalto Santé as a reference shareholder. I have already commented on this fact in another blog, so I will not expand on it, but I would like to highlight the naturalness and good work of all parties in the operation, which in no way affected the day-to-day running of our hospitals or our professionals, nor our roadmap for growth and consolidation in Europe and other regions of the world.

In fact, this has been a year in which we have added three new projects to the Ribera Group: the entry of the largest hospital group in Murcia, Virgen de la Caridad; the award of the Cascais Hospital (Portugal); and the collaboration project with Dhamam to start up the first two public-private hospitals in Kuwait. We are growing in Spain and Europe, with our entry into Portugal, and we are taking the first steps to contribute to the sustainability of the healthcare system in the Middle East as well.

These are three transformational projects, different from each other, which bring us experience, internationalisation and the value of new professionals who join the Ribera family. We will end 2022 with 13 hospitals (two of them university hospitals) on three continents (Europe, Asia and Latin America), 1,568 beds, 64 primary care centres and 35 polyclinics, 9,050 professionals and more than one million patients attended per year. And it is precisely these important figures that have made me realise that, regardless of the numbers, we have an important challenge ahead of us, to which I intend to dedicate a large part of my efforts in 2023: to maintain the values and essence that have always made the Ribera healthcare group different.

We must remain loyal to our roots, to a brand that professionals and patients value and support, to principles of closeness, humanism, trust, inclusion and respect for diversity that make us unique.

It is precisely these shared principles that make Ribera «great» in human terms: a diversity of projects, business models, culture and traditions that add up to much more than figures, that enriches us, creates ties and synergies between professionals and facilitates constant learning, to make us stronger and improve every day in the care of our patients and their families.

Today we are the only Spanish healthcare group with such an outstanding international presence, since before Portugal and the Middle East, projects from Latin America and Central Europe joined Ribera. Moreover, our vision is to create a brand that we build among professionals and managers to provide an excellent service to the citizens of our areas, and to take advantage of the accumulated knowledge of the entire organisation so that, with the best practices, we are in a position to offer a valuable medicine, aligned with our model of responsible health.

That is why I insist. It is important that we remain loyal to our roots and principles. Let us not lose our essence. Diversity is the strength that has always helped us to adapt and to manage change in an agile and efficient way, as we demonstrated in the toughest moments of the pandemic.

This was the central message that I shared with the teams of all the group’s hospitals a few days before Christmas, and it is the message that I would like to convey to each and every one of the professionals working in the Ribera Group. From this blog, I would also like to take this opportunity to wish you a happy new year and, above all, good health for you and your families.

The pandemic has been a global tragedy from which we should have learned. However, that is not the impression that the public has, given the current situation in hospitals and primary care centres. That is why it is more necessary than ever to take brave and efficient decisions, in order to guarantee the sustainability of healthcare in the medium to long term.

Before Covid, there was already pressure regarding the evolution of the costs due to the ageing of the population, the increase in chronicity and the incorporation of technology and scarcity of professionals. Now, as a result of the pandemic, we also have to add the challenge of facing the longest waiting lists in history, significant diagnostic delays, which are already putting the lives of many patients in danger, and primary healthcare that is completely overwhelmed by the lack of organisation and historical neglect, in spite of the fact that it is the key to the health and well-being of the public.

In my opinion, there are three keys to successfully dealing with the challenges of the healthcare sector in the medium to long term. Firstly, we have to invest more in human resources, and faced with a general lack of professionals in Spain, we need to better organise workforces for the future, starting with university places and Resident Medical Interns. In addition, we have to introduce flexibility and incentives, which allow for the implementation of a modern human resource policy.

Secondly, we must assume that technology is essential for both the present and future of healthcare, that telemedicine is here to stay, and that applications and devices that monitor patients remotely are of growing importance. The healthcare of the future requires us to take care of the citizen when they are healthy and heal them as soon as possible when they are sick.

Lastly, it is crucial to commit to improving the management of social healthcare systems, both public and private, and to strengthening the collaboration between both. This is because the public system needs the private. The role that healthcare organisations, such as the Ribera healthcare group, are playing with agreements with public administration and insurance providers, is key in order to make high quality and efficient healthcare available to public and private funders. The response to Covid would have been impossible without the collaboration of both,  even though some are still insisting on challenging views, as shown with the draft of the Law regarding Equity, Universality and Cohesion of the National Health System (NHS). There are those who do not want to see the elephant in the room.

It may seem surprising, but the truth is that this is the first blog that I have written in 2022. We have experienced very intense months at the Ribera healthcare group since practically the start of the year. Together with the challenges of the healthcare sector and the effects on the Covid pandemic, which are still being felt this year in our hospitals, we have also had the passing away of Michael Neidorff, the Chairman and CEO of Centene Corporation, the main Ribera shareholder, on 7^th April. A few months earlier, he had announced his retirement due to his poor health.

For that reason, during the months before and after this sad event, I preferred to be prudent, since Michael Neidorff has been and always will be part of Ribera, both emotionally and professionally, due to his humanity, charisma, strength, foresight and support in all of the projects and moments that we have shared. And, in my opinion, he saw the same values and spirit in Ribera that he always transmitted to his own company.

Michael Neidorff was not only the Chairman and CEO of Centene Corporation, but also the founder of the company, who started with a turnover of 40 million dollars and left the company with one of 130,000 million, positioning it as one of the 25 most important companies in the United States.

His social vision of healthcare, his work capacity and leadership, the social projects that he spearheaded and his personal involvement in the commitment to quality healthcare for all (Medicaid, Medicare) are an inspiration for those of us who dedicate our lives to health prevention and taking care of the population. He always sought balance between management, the unique nature of each aspect such as the healthcare of the population and the commitment and involvement of the professionals. He placed value on and prioritized the humanistic side that those who dedicate themselves to healthcare should have, our public service vocation, social commitment and passion for this sector.

Michael was a visionary who understood, visualized and knew how to convey the keys to the healthcare of the next decade better than anyone which, as I pointed out earlier, will always be a reference for me. I have felt the loss greatly and I would like to take advantage of this first blog entry of the year to send his wife and son a hug and a message: Michael Neidorf will always be with us, and his work and legend will live on as an example of healthcare, both within and outside the United States.

In the group’s central offices, all of the rooms have the name of important figures in medicine, from Ramón y Cajal to Marie Curie or Severo Ochoa, and we have decided to name the Ribera Board Meeting room with the name of this great man, Michael Neidorff, because we know that his philosophy and vision regarding healthcare, as well as his memory, will forever inspire us.

After these events and changes in Centene’s management, there was, as we all know, a re-definition of its strategy and projects. Today the Ribera group no longer belongs to Centene. We have grown and learned a lot together, but we are beginning a new stage. At the end of July the purchasing of the American insurer’s shares by Vivalto was made public.  They are the 3^rd leading private healthcare group in France with which we share our values, vision and mission, as well as the obvious close geographical location. We are starting a new journey, with a lot of experience and the knowledge of our more than 7,000 professionals in the group, as well as great excitement and a lot of projects in which the role of these professionals is going to be even more important in this post-pandemic era.

If you follow this blog, you will definitely have seen the importance that we always give to the role of the professionals in our organization. Clinical leadership has always been key in our responsible health model, but, without a doubt, it has also been one of the keys in terms of successsfully overcoming the hardest moments of this pandemic, together with foresight, flexibility in management and the ability to adapt quickly. Furthermore, if you know Ribera’s new shareholder, Vivalto Santé, you will know that part of his equity is in the hands of professionals connected to the project. That is the level of importance that our new shareholder gives to their role. This is the spirit. And with so many shared values, principles and priorities, I know that we are going to do great things together. 

And I’ll finish here. We are starting a new chapter to which are passionately looking ahead, involving significant challenges, both as a nation and a sector. In the next blog entries I will try to continue to present my analysis and vision regarding the trends and challenges that await us. I will just say that, with work, enthusiasm and commitment, I am sure that we will progress with the Ribera group’s great responsible health project.

In this blog I would like to share some words of thanks for the New Medical Economics award which I received on 15^th, November, in Madrid, for the work carried out during my career. 

Firstly, I would like to thank this renowned medium of digital communication, edited by Health Economics S.L. and managed by Doctor José María Martínez García, economist and Doctor of Medicine, for this acknowledgement of my experience in the health sector. However, in addition, I also want to dedicate it to all those people that in these 32 years have joined me in working for responsible, excellent, sustainable and transformative healthcare. I have learned from all of them and together we have shared challenges and proposals, worries and achievements. In my speech infront of a packed audience which gathered at the Jiménez Díaz Foundation, I wanted to give a special mention to the Communication, Marketing and Corporate Social Responsibility Manager, Angélica Alarcón, who has accompanied me for the majority of this journey.

I am passionate about the health sector. I have been working towards closer, more human, sustainable and innovative healthcare for 32 years and all of those adjectives are shared by those of us that met on Monday at the NME awards. This connection, invisible but real, is largely what motivates us to continue working, each of us from our own organization, on building the healthcare of tomorrow, today. 

And we need to think about the immediate future now. This is because we are going to face big challenges in the next few years and we should look for what unites us and that which allows us to give the response that the citizens deserve. Above all, in order to guarantee them an integrated, universal socio-healthcare, without waiting lists, which integrates the different levels of care – from Primary Healthcare to care homes for the elderly – and permanently establish this new digital culture, something which is a pending matter, so that our healthcare is a global benchmark due to its quality. 

At Ribera Group we have dedicated our work to helping to build a strong public system, from our innovative and sustainable model, with responsibility, institutional loyalty and the confidence that good health results and patient and professional satisfaction give us, after more than 20 years managing hospitals and health departments. 

I am sure that we will go from strength to strength on this path that we began  on many years ago and, between us, we will manage to secure the pillars of a single form of healthcare, one that is transformative and universal, without anyone taking ownership of it.

Thank you to those who have accompanied me in these 32 years of professional career and mutual learning. My hope is that life allows me to keep working and providing my knowledge and experience in the sector in order to continue transforming healthcare and preparing it for the immediate future.