Where will the public health Balearic?

TOWARDS WHERE THE PUBLIC HEALTH BALEARIC?

After more than 20 years of the entry into force of the General Health Law (promoted with great success by the former Health Minister Ernest Lluch, during the first government of Felipe González) is very sad to see how certain aspects of the law have never entered into force, because they have never received enough interest from the various state and regional administrations. The interest of successive governments has been focused on the objective of providing input to the private sector and privatize the more profitable parts of the national health system and are now about to do so.

The strategy has been designed so that they could move forward without a major social rejection of public opinion, trade union or of the various left wing. Despite the deteriorating working conditions at the Public Health, the most representative trade unions have maintained a good relationship with successive governments.

Moreover in the last decade, the Centers and the Public Hospitals have not received the necessary budgets for a smooth operation and proper maintenance. Neither the staff has seen an increase in salaru the increased responsibility, dedication and work loads that they are imposed.

All this has meant a slow but progressive dismantling of certain areas and areas of public health, undermining the confidence of many people in the Public Service and its professionals, by threatening the quality of care and breaking the equity in access to services.

Whe the functioning of the new Hospital of Reference of the Public Health Balear Son Espases, we will no longer speak of a public hospital, as we know so far, not least because the administration of the new hospital will be leased to a company through a private concession. That means public health care will be provided in a hospital for profit.

The building of the Son Dureta Hospital, will likely be converted into a Center for Social and reformed and capital and private companies that may choose its system of exploitation and conditions similar to those of the new Hospital Son Espases.

 Mechanisms for the privatization of the Public Health

The entry of private capital and for-profit business within the Public Health Department, began long ago, and has been carried out so subtly and with different mechanisms:

Report Abril Martorell, recommendations for opening the sector to market. Separate funding for the provision of service. Its aim was to implant the foundations for the entry of private enterpreses. Introduced competition between public service providers at the expense of time and the necessary collaboration between them and the private. That is the law was introduced in the market within the health system.

Outsourcing agreement with private entities; To reduce the waiting lists, to perform cleaning services or maintenance of facilities and buildings.

Law 15/97 on New Forms of Management;

Provides that management and administration of centers, and health and social services, can be made, directly or indirectly by any entity or public nature admitted in law, Foundations, Government Partnerships, Public Companies and consortiums that have legal personality own and shall be governed by private law.

This means that the provision and management of health and social services may be in addition to means, arrangements, agreements or contracts with persons or public entities or private.

The aim of the new forms of management and delivery care, efficiency is not to win, but to circumvent the controls that provides administrative law in the interest of the citizenry, it is carried out with public money.

But it also allows the chapter to reduce staff because the employees of these companies are not regulated by the Statutes of Health or the Civil Service Law. In short, the less control of public funds, less staff and more precarious working conditions and flexible.

Regulation to govern the New Forms of Management;

(art.12). (RD 29/2000 of 14 January) provides for them the full ability to develop their own organizational structures, with full autonomy to manage their cash, their heritage, their economic and human resources (Art.12) . It also allows enables receive donations, gifts, bequests, pleadings and other public and private contributions.

With public money you can buy a private property and can be re-sold, thus opening a clear risk decapitalization progressive public health system. Concessions of Public Works with Private Finance Initiative, (known in English by the acronym PFI)

The formula used to fund the future of Hospital Son Espases, allows companies to private construction companies, banks and venture capital funds, making temporaru construction and operation of hospitals, which in our case (Hospital Son Espases) commitment reaches 30 years and, in agreement with the Balearic Government, the concession may be extended.

A very big leap in the privatization of the Public Service, since there will be profit-making companies and awarded the hospital will manage and operate for the duration of the concession.

All the risks are for public administration because, in case of bankruptcy or economic failure from the viewpoint of the effectiveness of , the IB-Salut will be forced to cover their debts and loans made by the concessionary companies within the which sould last 30 years the concession.

Recourse to this mode of finance (PFI), to give free land to construction companies, defended the Administration by the inability to say that goernments have to borrow if they meet the plans of budgetary stability. But as has been demonstrated in other cases that this method of construction of hospitals leaves much more expensive and leaves mortgaged future budgets.

 The health consequences of the Hospital Son Espases

The shortfall of hospital beds will be maintained.

Referrals can be made of certain complex diseases to other public hospitals. It may make some adverse selection of patients and target their services portfolio toward a curative services, depending on high technology and provide more economic benefits.

The funding will be obtained in large quantities by way of tax administration will contribute their budgets over the next 30 years. Some money on which the IB-Salut lose the power to manage and control.

An important part of the staff will report directly to the various concesionaires operating the new hospital will be governed by private law and their working conditions are more precarious than in Son Dureta.

 Health policy

Financial institutions and large construction companies that invest large amounts of money in building the Son Espases, they do so because they are very good business prospects. In record time, gain major economic and this very poorly with the objective of the Administration, to direct public health services based on the health needs of the population.

The new referral hospital of the Balearic Islands, shall be in the business logic to obtain the highest possible return for the maximum spread of benefits among different stakeholders.

This obviously affects the quality of care for all health services controlled by private companies.

The government does not have much information on the progress and development of health services, simply for lack of interest of the owner companies.

Health information overall, more importantly, can be significantly altered or used to benefit private companies that control.

The axis on which for many years has established the National Health System, promotion and prevention, can be displaced because it is more economically viable is preventive but curative medicine, but, a large consumer of technology and pharmaceuticals.

Guillem Ramis
June 12, 2009