The Spanish Government takes a step to limit health privatization

“Letting private health absorb the public one could be a disaster”, explains Josefa Ibáñez, a surgical nurse in the Hospital of Sant Pau in Barcelona. “There would indeed be differences between patients, since those who couldn’t afford private health would either mortgage themselves for life — as happens in the United States — or simply would not be treated at all,” she says.

Both she and her husband, Juan Manuel Luna, work as public healthcare workers and have witnessed the rise of privatization of public health in the country. Twenty years ago, Juan Manuel was almost fired due to privatization.

What’s happening in Spain is a process of outsourcing of the public health service. Some of the utilities offered by the public administration are externalized to private health companies, which sometimes don’t have the proper control or are not driven by population needs, but by economic interests.

A few months ago, the CEO of Ribera de Salud, manager of the Madrid Hospital of Torrejón, was caught giving instructions on prioritizing patients that could be “more profitable” rather than being driven by their health needs. The newly proposed bill tries to stop this kind of situation.

“The proposed law put forward by the government tries to establish a control system to ensure that outsourcing is carried out properly, that it is well structured,” says David Sancho Royo, an expert on public services and administration at the University of Pompeu Fabra.

“The Spanish healthcare system needs an increase in budgetary effort to guarantee transparency and ensure and maintain a standard of quality”, he states. 

Working conditions are also a struggle for the Spanish public healthcare system. According to OECD, doctors in the country are paid almost four times less than in Denmark.

In the last months, thousands of doctors have taken the streets of Spanish cities demanding a better life-work balance and salaries that meet their tough work conditions.

Josefa Ibáñez sees that as another reason why, in many cases, public doctors prefer working in the private sector or moving to better-paid countries. “Many colleagues leave, despite their preference to stay in Spain”, she says.