Repercisión a nivel internacional ( publicación en inglés)

NEWS: BMJ

Largest healthcare privatisation plan in Spain is to go ahead, despite massive opposition

1. ser García Rada

Author Affiliations

More than 300 staff from half the 270 primary care centres in the Madrid region have tendered letters of resignation to their local health authorities in a protest against a plan to privatise six hospitals, 10% of primary care centres, and all auxiliary services in the region. The plan is expected to be implemented this summer.

The resignations will take effect once the regional government invites tenders for private companies to run the primary care centres, expected in the next two months.

Javier Fernández-Lasquetty, head of the regional health department, has dismissed the resignations. “We’ll replace them [staff],” he said.

The privatisation plan, announced on 31 October by Ignacio González, president of the regional government and member of the conservative People’s Party (PP), has been met with strong opposition.1 Medical societies, doctors’ colleges, unions, and university authorities have all declared their objections, and one million citizens have signed a petition demanding its withdrawal.

More than two months of protests have included 17 days of doctors’ strikes and four days of general healthcare strikes, which have led to the cancellation of 50 000 outpatient appointments and 6500 operations. Six large demonstrations—referred to as “white tides”—have taken place, and three healthcare workers have been on hunger strike since the end of December in protest at the plans.

The Socialist Workers’ Party (PSOE), the main regional opposition party, has said that if it wins regional elections in 2014 it will revert any privatised centres to public ownership.

Fernández-Lasquetty turned down proposals from regional unions and a group of health professionals that did not involve privatisation. He maintained that privatisation would save €200m (£165m; $270m), although so far he has not presented any evidence to support his estimate.

Despite the mass opposition, the plan moved forward when a law permitting the privatisation was passed on 27 December in the Madrid regional parliament, where the PP has a majority.

The new law also introduced a €1 charge for prescriptions from 1 January—similar to that established in Catalonia last June—which has been criticised by doctors and consumer associations and even by some members of the PP, such as Spain’s prime minister, Mariano Rajoy. He has appealed to the Constitutional Court that the €1 charge in Catalonia was unconstitutional and has announced a similar action against the proposal in Madrid.

Moves are also under way to privatise four regional hospitals in Castile-La Mancha and auxiliary services in Valencia. Both areas are governed by the PP.

Further strikes have been called, and the main doctors’ union calling for protests, AFEM (Asociación de Facultativos Especialistas de Madrid), is looking into a lawsuit against the plan. It intends to extend the protests to the whole of the country and aims to organise a national congress to debate the future of the Spanish health system in early February.

Notes

Cite this as: BMJ 2013;346:f236

References

1. ↵
   García Rada A. Privatisation in Spain provokes protests among doctors. BMJ 2012;345:e7655.

 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f236 (Published 14 January 2013)

Cite this as: BMJ 2013;346:f236