Spain seeks to block private firms from running hospitals


About a third of Spain’s public hospitals are run by private companies. — Reuters

MADRID: Spain’s Health Minister Mónica García has a plan to fix the country’s healthcare system: stop private companies from running public hospitals.

“I won’t tell anyone how to spend their own money,” Garcia said. “But public funds must be invested in healthcare – not in the profit margins of private companies,” she said in reference to an upcoming bill that seeks to ban private operators from managing public hospitals.

At the heart of the politically loaded government initiative is a growing trend of private investors running public hospitals in a country where the public health system has traditionally been a matter of national pride. 

About a third of Spain’s public hospitals are run by private companies, following a 37% increase over the past 15 years, according to Health Ministry data.

Although support for public healthcare is strong, satisfaction levels have fallen by about 20 percentage points since the pandemic, according to the national statistics agency. 

“Some hospitals are well run and others are not, regardless of whether a private company is in charge,” said García, a 52-year-old doctor who has spent most of her career working in public healthcare and is a member of the coalition government’s far-left junior partner Sumar.

Public hospitals shouldn’t need to worry about delivering financial returns to shareholders, as is the case with for-profit operators, she said. 

In Spain, health policy is primarily the responsibility of regional governments, most of which are currently controlled by the opposition People’s Party. The central administration has limited powers, a division García’s bill seeks to sidestep. 

The draft legislation would also require greater transparency from private operators that continue to partner with public authorities.

Scrutiny over the involvement of private corporations in public healthcare intensified in December after the newspaper El País published audio recordings from a meeting involving the chief executive officer of Ribera Salud, of the two main private managers of public hospitals.

According to the recordings, managers at one of its Madrid-run hospitals were urged to lengthen waiting lists or prioritise more profitable patients, and staff were also instructed to reuse single-use materials to cut costs.

If passed, the bill would not modify the existing contracts of companies such as Ribera Salud or Fresenius SE & Co, which is also a major operator. But it could potentially block them from renewing them or getting new ones.

Passing the new management framework is far from certain. The bill has gone through public consultation and must now be sent to parliament, where the minority government struggles to pass legislation.

Right-wing parties and private healthcare providers have criticised the proposal as ideological and anti-business. — Bloomberg

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