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Alberto de Rosa, English

Together, a step ahead of the virus

13 marzo, 2020 • By

As a society, we are facing a global crisis caused by the COVID-19 coronavirus, a public health threat that originated China and spread across several countries to neighbouring Italy, France and Spain and is now a global pandemic. It is this century’s first crisis deserving of the name.

I’m not a doctor and cannot offer medical advice, but I can, as a healthcare manager at the head of a healthcare group, give my opinion on what is certainly an exceptional situation, one that is putting health organisations and professionals to the test.

While its essential to stay calm and not panic, it is equally important to take preventive measures and use common sense, even social isolation in certain circumstances, because some people are at higher risk of getting very sick from this illness, including older people and people with health problems. And because governments and local authorities are tasked with ensuring that public services continue to operate. And one of those priority services is health care.

The fear of decision-making in some countries has wasted precious time that could perhaps have prevented at least some of the consequences. Public convenience cannot put vulnerable populations, and above all the healthcare system as a whole, at risk. In Spain, the government’s position as of Sunday, 8 March, was centred on a “containment phase”. Everything suddenly changed on Monday, 9 March, and a series of decisions have been made since then, likely motivated by the growing number of cases in Spain.

The Spanish healthcare system is complex. Healthcare is a responsibility of the autonomous communities. But from my point of view, national public health transcends the regional sphere, because the level of movement and circulation in a country as developed as Spain is tremendous. And it is precisely at this point when a government must demonstrate that it can handle a crisis, set an example of responsibility and take the lead to determine, from the state level, the comprehensive policies and actions that are required nation-wide. For too many days now the public has been receiving contradictory messages—some football matches were played behind closed doors while others before a limited crowd, events with large crowds like bullfights were celebrated but only a certain number of fans were allowed to watch a basketball game—in a random, confusing and often contradictory set of measures from national health authorities. Not only is it important that the public listen to the authorities, but public health decisions must be coordinated as well.

Because it’s about prevention, not panic. And, above all, being a step ahead of the illness. And learning from the mistakes (and successes) of others. But we can’t be a step ahead of the virus if we suddenly take three steps sideways and two back. We must move forward in the fight against this crisis together, in the same direction.

An example of this type of decision is the cancellation of Valencia’s Fallas celebrations, which came late for some and for others was a decision not entirely justified by the number of cases in the region.

But I repeat: it’s better to prevent, to bolster support for healthcare professionals and help strengthen the healthcare system, than to regret in a few weeks’ time that we were not brave enough to do what needed to be done. It’s likely that we’ll never know what would have happened if other decisions had been made. But my personal position is clear; when it comes to health and safety, I prefer to be tough and make drastic decisions rather than regret inaction later.

I would like to ask the public for their patience and understanding. We are likely to be facing a tough few weeks ahead, but I’m confident that we’re going to win this battle. Let’s be cautious, follow the instructions from the authorities and shift our thinking from the individual to the risk you could pose by infecting your friends, family and colleagues with a potentially dangerous virus.

And I want to finish this blog post the way I should have started it, by expressing the deep pride I feel for the exceptional efforts of healthcare professionals who, once again, are examples to follow, people who serve as the public’s first line of defense in a crisis as severe as the one we are experiencing. And I would especially like to thank all the professionals at Ribera Salud for their commitment, professionalism and hard work. Everyone is demonstrating a commendable level of professionalism, dedication to service and solidarity among colleagues, and I am extremely proud to lead a team like the one Ribera Salud has in all hospitals.


Tripping twice (or a thousand times) on the same stone

26 febrero, 2020 • By

I have spoken several times on this blog about waiting lists, and this time I want to start with public recognition of the transparency exercise undertaken by the Generalitat. Even when the data isn’t good, there is no doubt that transparency is essential in a mature society that aspires to progress. Unlike many, I like to recognise and appreciate other people’s work when they do things right.

The publication of the waiting lists by department may have generated a certain level of controversy and debate, but these advances in transparency by the public institutions are fundamental in order to search for solutions to the problems: just like in Healthcare, when there is a clear diagnosis, the correct treatment can be applied. If you cheat at Solitaire, you’ll always be deceived.

The information made public by the Conselleria de Sanidad (Department of Health) has allowed us to learn that there are hospitals with an average waiting list of five months (154 and 140 days). And given that the average is almost half a year, that means that there are people who wait a year or more… something which is incomprehensible in the year 2020. The average waiting time in the Community of Valencia is 86 days, which is a slightly better figure in comparison to last year, which shows that, beyond the inefficient government policies, the professionals are always committed to offering good healthcare to the citizens. For them to have the necessary tools is another story. As the regional secretary stated at an appearance, “operations don’t take place in the offices, they take place in the operating theatres”. I couldn’t agree more.

However, beyond these general details, there are two points that I would like to highlight. The data provided by the Department of Health clearly reflects that the concession model significantly contributes towards the reduction of average waiting times, with tremendously favourable and positive data. I have read some comments that question these figures, coming from people that I have not seen in my day-to-day work in healthcare management during 30 years of experience in the sector, ladies and gentlemen that have never asked or learned about the reality of healthcare offered by the public-private collaboration model. In politics, as in almost all scopes of life, we must first learn the reality in order to later have a valid opinion and not just talk about what we’ve heard or follow scripts, which, by the way, are written by more people who have never seen the reality of what they are now discussing as though they are authorities on the subject.

These types of people are the ones who believe that the best way to hide the failure of their management is to question the success of others. Mediocracy is a way of life for some. What a shame.

Well, let me tell you that the Department of Health itself recognises, in this publication of waiting lists by health department, that the Ribera Salud hospitals are positioned among the top three in the Community of Valencia. That is to say, at our hospitals, citizens wait for half the amount of time than the average in hospitals in our region and up to four times less than the longest waiting lists. The numbers are stubborn.

There is another point of information that must be highlighted and that is interesting to analyse in this scope of Healthcare: the decreased quality of care at Hospital de la Ribera just 20 months after the Department of Health took over direct management. The waiting lists have moved from 57 to 78 days in less than two years, and those who wait for longer than 90 days have tripled in number, despite having hired almost 900 people. And this is only just getting started, despite the commendable work that I know the professionals at La Ribera are carrying out. The fact that something (or many things) are failing is evident.

I know that some people find it difficult to understand that it is important to have an open mind in order to seek new formulas that can help us, as a society, to improve the healthcare system and, above all, to make it sustainable over time. We must be flexible. And brave. To publish the waiting lists by department might be the first step, but bravery is necessary in order to make decisions.

If there are many indicators that clearly describe a situation, the problem is not the data but rather the underlying cause behind the data. I understand that I can get repetitive about these types of analyses, but it is necessary because sometimes we are forced to undertake positive pedagogy. When we talk about waiting lists, we’re not talking about numbers but about people.

This leads me to the appearance by the regional secretary of healthcare technology and efficiency, Concha Andrés, on February 10th, where the solution she suggested for current waiting lists was to send patients to hospitals with shorter waiting times. Given that she has not contacted either of the Ribera Salud hospitals, both positioned among the three hospitals with the shortest waiting times, I will take this opportunity to offer the healthcare clinics in our group to help them to improve the waiting times for patients in the Community of Valencia.

Cataracts, bunions, hernias and whatever is required in Traumatology, Ophthalmology, Otolaryngology or General Surgery. I’m sure that may of these ailments with the longest waiting lists are suffered by older patients, and we cannot allow political prejudice to have a negative impact on those who deserve our utmost respect for everything they have contributed, and continue to contribute, to our society.

For this reason and for the good of all of our citizens, I will never stop trying to be constructive and positive and trying to build bridges and collaborations with the public administration, always in favour of quality, efficient and sustainable healthcare.


We all create the future together

21 enero, 2020 • By

The future belongs to the brave. Ronald Reagan said this phrase, so frequently repeated by coaching experts, to the North Americans after the Challenger tragedy in 1986. His message was clear: We can never give up, we must always be looking forwards, work hard, get up after every fall, keep moving and never stay still. It is difficult, but of course, if you have help, it is easier.

This help is the great value contributed to society by Lanzadera and, if you allow me, the companies that form part of its Corporate program, in order to boost innovative projects in various sectors: from health to aerospace engineering, including nutrition and logistics. Ribera Salud has already started two work with two teams of young entrepreneurs who have been selected from among the Lanzadera experts and our technology subsidiary, Futurs, for their initiatives to revolutionise and improve healthcare for citizens. This is based on an app, Serenmind, to facilitate self-guided psychological treatment, with monitoring by a professional for all citizens; and a platform, HumanItCare, to gather, organise and analyse the information of people with chronic diseases in order to improve their quality of life and their health results.

When we were invited to participate in the Corporate program by Lanzadera, we immediately noticed that their philosophy perfectly fit in with the mission, vision and values of Ribera Salud. We have a responsibility to the society that we serve. The possibility of participating in the selection of innovative projects in the health sector and of helping the creators to develop them in our hospitals allows us, once again, to stay one step ahead of society’s needs, which are always changing and increasingly demanding.

At the same time, this has allowed us to directly interact with an eco-system around innovation and entrepreneurship that the businessman Juan Roig has highlighted, once again giving a first-hand example of the importance of bravery in the business world and in life. And we have found so many brave people throughout the difficult process of choosing between the dozens of projects presented, just in the health sector! From here, I would like to congratulate all of you and encourage you to keep working hard to meet your goals.

For Ribera Salud, without a doubt, this experience has been an incentive to grow better every day and to offer maximum quality healthcare. We are proud to participate alongside great companies such as Airbus, Mercadona and Facsa in a project for business support for young entrepreneurs that will help them to develop their projects here, in Spain. We are all firmly focused on boosting, attracting and retaining talent in our country in order to offer the best service for our citizens. With this support for innovative initiatives, we give back to society part of the trust that we have received from it. We are connected by one single goal: to help to build a better future for the society we serve.

The various public administrations ought to observe Lanzadera as an example to be followed, as well as the firm focus of Juan Roig to consolidate a genuine entrepreneurial “hub” in the city of Valencia, the province of Valencia and all over Spain, starting with the creation of the EDEM University, continuing with the Lanzadera projects and culminating with Angels Capital, the society used to invest in these entrepreneurial leaders. So, yes. The companies participating in the Corporate program by Lanzadera are also contributing our grain of sand so that new entrepreneurial initiatives can come to light and be successful, because they contribute towards improving our activity while always providing better results for our citizens.

At Ribera Salud, good health results alone are not enough, given that nowadays we are working with very high standards and models, always aiming to improve healthcare for our citizens. Professionalism, integrity, passion, innovation and responsible and sustainable health management are in our DNA, based on the 5 P’s that we apply to the medicine that we practice: preventive, predictive, personalised, participative and population-based.

The future is now and we are building it with hard work, effort and passion.


Condemned to wait?

2 enero, 2020 • By

The year is ending with the worst waiting lists in the recent history of Spain. The Ministry of Health has published this information by autonomous communities on September 30th and the balance is shocking. The average waiting time on a national scale has moved from 93 to 115 days in just one year. This is to say, patients have to wait almost a month longer to be operated than they did in 2018.

It is true that this is a situation we have been experiencing for many years in the public system. Too many years. It is a genuine curse, meaning that the Spanish health system is not effective and is causing serious harm to its citizens, who ought to be the focus of the system and yet feel like they are victims of it.

More than half a million Spaniards (671,494 in June) will spend this Christmas waiting for a surgical intervention that, on average, will be delayed by almost four months. Some people wait a year.

I worry that, if after a fifth of the 21st century we still have the worst waiting lists in history, all signs point to this being a structural problem rather than circumstantial.

But as Einstein said: “If you are looking for different results, don’t always do the same”. And that is exactly what our politicians are doing. It is incomprehensible to listen to them talking about solutions as ineffective as paying professionals to attend to patients on the waiting list outside of their usual working hours. Why? Because this measure is outdated, it goes against an efficient management model, it implies an obsolete personnel policy and has been proven to be completely ineffective. When I started to work in the health sector, in 1990, it was already being said that working overtime was not the solution, as the system itself promotes working extra hours, lack of family balance and excessive working hours, with the consequent reduction in safety at work for the professionals. Also, genuine bottlenecks are created because it is only applied to professionals in surgical specialties when others, such as GPs or paediatricians have the same problems with waiting lists.

Another of the measures proposed by the politicians time and time again, as if this were “Groundhog Day”, are the crash plans. There are governments that resist the establishment of stable and efficient overtime in the private sector and apply these types of temporary measures, thinking that this is a circumstantial problem, when that is not the case. The crash plans have also been shown to be inefficient in the long term, as they do not reduce the lists.

So what is the solution? We can’t perform magic, but we must all be brave: The governments, to apply new management formulae in the public system, such as the Ribera Salud model, or at least tools that have been proven efficient such as modern management of human resources; and the private initiative, to innovate and offer the best healthcare to citizens, with long term collaboration formulae with the public administration. Administrations and companies must always place the patient in the centre of the system and motivate and encourage professionals to reach their goals, including quality of care, delay, suitability of facilities, waiting lists, etc.

The waiting lists are a structural problem, and if we want to face the new challenges of the Healthcare Sector with determination, we must get to the bottom of the problem, to the active ingredient of the system, the professionals. We must give them the importance they deserve and rewards that are not only economical but also professional recognition, flexibility and family balance, training and research, as well as variable compensation. It is necessary to align the objectives of the professionals with those of the organisation, to open the services in the morning and in the afternoon and to do away with the rigidity of a public system that resists modernisation of its modus operandi. Also, it is important that we work together on our focus on technology as a tool to facilitate work for professionals and to improve the care and information for patients.

While we continue to apply the same responses to the same problems, the result will not change. The clearest evidence that things can be done differently is the Report by the Court of Auditors of the Generalitat Valenciana, where this advisory board for the Government of Valencia ensures that the waiting list at the Torrevieja hospital is three times shorter than the average in Valencian hospitals.

At Ribera Salud, we are brave. We aren’t perfect, but we always make an effort to improve and to offer the best healthcare. And that, in the end, is truly placing the citizen at the centre of the system and giving importance to the principal asset of the system, the professionals, so that they can lead the process of change.

Given the current time of year, I’d like to take this opportunity to wish a very merry Christmas to all the readers of this blog and a happy New Year.

English, Hospital Povisa

Welcome Povisa Ribera Salud focuses on local projects with global strategies

9 diciembre, 2019 • By

I haven’t written any entries for the blog since September because I wanted the first entry this year to be about the incorporation of Povisa to the Ribera Salud group. Finally, it is now a reality.


I have been personally following the project of this great Vigo hospital since 1990. It was probably one of the first hospital names that I heard when I joined the health sector almost 30 years ago. Historically, it has been a hospital with great professionals, cutting-edge with regards to the digitalisation of clinical records and with values and quality standards for patient care that for a long time supported it as a reference in Galician and Spanish healthcare.


It was also a pioneer when it attempted to create a public-private collaboration model with capitation financing, a project that was never undertaken but was known as Vigo 92. Therefore, the Povisa model has many similarities with the experience that Ribera Salud has developed in the Community of Valencia and the Community of Madrid in the last 20 years.


Thus, on both a personal and professional level, I believe that the integration of Povisa to the Ribera Salud group is a great opportunity to bring together premium experience, knowledge and teams of professionals, while facing the challenges of the Spanish health system with greater solidity and solvency. I want to clearly state that we have come to Vigo with the desire to join resources, and we are going to need the experience of the great human team that I have had the opportunity to get to know in recent months and that has worked very hard for this hospital. This is our main commitment.


Like I have always said on this blog, the future of Healthcare involves the configuration of large groups of healthcare professionals without losing the uniqueness and local basis of each of the projects: society, culture and habits are different in Vigo, Valencia, Alicante and Slovakia. Healthcare has a very important local component and to us, it is essential to maintain this local rooting.


At Ribera Salud, we focus on local projects with global strategies. The uniqueness of each project enriches our vision as a group and helps us to strongly face the challenges of Healthcare that we encounter as a society: The focus on technology, innovation and investigation, the creation of online assistance models, the application of predictive models and personalised and quality treatment are the future of Healthcare.


We cannot forget that we have the obligation to guarantee the sustainability of the health system, being efficient and effective, providing incentives for healthcare professionals, attracting and retaining talent and offering the best attention to citizens.


Ribera Salud is a company that is committed to society, that has been working for 22 years to improve the health and well-being of the citizens of the Community of Valencia, Madrid and Galicia, within Spain, but also with an international perspective, given our firm focus on Central Europe, among other regions. We have a responsible management model that contributes towards the stability of the healthcare system and guarantees quick and high quality care, supported by official organisations such as the Court of Auditors of the Community of Valencia.


I’m sure that we will all learn from each other. A new era is beginning at Ribera Salud. Welcome, Povisa.