Beatriz Pérez Barcelona – Domingo, 01/12/2019 –
The general secretary of Metges de Catalunya (Catalonia Doctors) denounces that the Generalitat only invests 3.7% of GDP in health, while the Spanish average stands at 6.2%
The general secretary of the Metges de Catalunya (Doctors of Catalonia) (MC) union, Josep Maria Puig (Barcelona, 1954), analyzes for EL PERIÓDICO the situation of Catalan health and how it is still affected, nine years later, by the cuts of Convergència i Unió (CiU ). In addition, he is a nephrologist at the Hospital del Mar in Barcelona.
What has the Government done with health in the last year and a half?
The health situation, like that of all welfare state services, is of absolute paralysis. There are no short, medium or long term projects. The main problem is that we have no budgets – they have been extended for two years in a row – and we urgently need to update them because health financing, at this time, is well below what we would need. Much more than it has historically been.
How does this budget extension affect?
Repeat the same budget – when you are increasing expenses because you have more professionals working and more people to attend – it causes delays facing the citizen, as well as a very important decrease in technology. We are becoming increasingly technologically outdated and there is a lack of human resources – doctors, nurses – to serve the population that now needs health care.
Has the situation worsened in recent months?
To try to lighten the waiting lists, the ‘exconseller’ of Salut Toni Comin, in 2016, put money on the table and with this injection more operating rooms could be opened, especially in the afternoons, since in the mornings they have always worked to 100%. This extra activity, which could be paid thanks to the money that was placed on the table, decreased the waiting lists by 0.5%, very little, far from the target, yes, but it was something. From that moment the waiting lists have only increased, both surgical and visits to the specialist, complementary tests …
“The Generalitat has increased its budget 4.6% in nine years and the investment in health has fallen 10.1%”
How much should the health budget be increased?
What we have is a problem of political will. And this is easily demonstrated by seeing how the Generalitat, in the last nine years [from 2010 to 2019], has increased its budget by 4.6%, while in the same period the Government has decided to decrease the investment in health by 10, 1%. If we have more money and they give us less, the difference is 15%. How the cake is distributed is a political decision. I insist: although the budget of the Generalitat has increased, the political will has diminished an important part of the welfare state, which is health.
Missing one billion since 2010.
Yes. In 2010, Catalan health had 9,875 million, now with 8,876. Indeed, we still have a billion that have not been recovered. And another thing is the accumulated loss: we have one billion less than we had in 2010, but the accumulated loss is around 10,230 million. 10.230 million less than have reached health, when we all knew that it was an under-financed health, especially if we look at Europe.
There are politicians who say that this little investment in public services is because Catalonia is underfunded by the State.
Here is the trap. I do not talk about that cake that comes to Catalonia is large or small. You say it’s small, okay, I buy it. But I am telling you that you are responsible for how the cake is distributed once it is here.
And how is it distributed?
Well, there is a very significant fact: the percentage of gross domestic product (GDP) that each country uses for public health. Catalonia allocates 3.7% of its GDP. Spain – taking into account that Catalonia is in, which pulls down – 6.2%. In the EU, the average is 7.2%. And if we look at other countries, Germany is at 9.5%, and France, at 9.3%. The country in Europe that least invests in healthcare is Luxembourg, which is a very rich country, and allocates 4.5%.
Consequences of all this?
All this has had a clear counterpart: the increase in people who have signed up for mutuals – to private healthcare – because they look unassisted, with tremendous waiting lists in the public. This has been the result of this policy: to give life, year after year, to the private one and to reduce public assistance.