Country report Spain 2? 2012

 

C/ Conde de Peñalver, 60              28006 Madrid

Tf. 915 63 33 47 www.aspromel.org aspromel@aspromel.org

 

 

             E.A.N.A.  MEETING  PARIS , NOV 30-DEC 1 , 2012

 

                                       COUNTRY REPORT FROM SPAIN

                                                       BY ASPROMEL

 

 

 

 

POLITICAL EVOLUTION

 

Further cuts on expenditure and structural changes as well as strikes determine daily live in Spain. The country goes through a hangover following a state of drunkenness. People is in a state of disillusionment and distrust. Sobering up allows on the other hand reconnecting with reality. We can’t spend the money we don’t have. Urgent unpopular measures are needed and put into practice by the Government. The bank sector is confronted with certain abusive practices, such as eviction of people from their home if they cannot pay their mortgage, confiscating the house and forcing them to continue paying the mortgage.

 

 

HEALTH POLICY

 

Structural changes of the NHS are carried out such as increasing integration of health professionals into reform programs. Basic catalogue of services, maximization of technologies, abolishing standard salaries decided by the overall budget. Salaries must reflect the level of training, dedication and skills. Reinforcing the collaboration in the Interregional Council. Creation of a National Register of Health Professionals, promotion of e-health such as health card, electronic prescription, digitalized clinical history. National HTA – network. Centralized procurement platform for drugs, material  and technologies., outsourcing of administrative and logistic services.

 

 

MUTUALITIES AND PRIVATE SECTOR

 

MUFACE, the mutuality for administration officials, could become in the future THE Spanish model for public-private partnership.

 

The sector of collective private medical services is deteriorating work-conditions for physicians, private insurance companies  dismissing unilaterally physicians and blocking  adaptation of income scales for the doctors. The private hospitals in increasing financial difficulties, fusions and internationalisation of the big groups.  

 

 

 

The completely private sector of medicine without any contract with insurance companies is resizing downward.  

 

 

MEDICAL PROFESSION

 

The NHS needs an effective and new policy of human resources. 10’000 Spanish doctors already left the country. 12’000 non-EU doctors working in Spain without homologation. Homologations ” en bloc” by the former government, now a commission whose decisions are not transparent and probably not representing standards of the EU. Illegal practices by the NHS, admitting to work non-EU doctors before homologating their degrees. All protests since 2007 from Medical Profession are ignored. Too much medical faculties in the country, too much graduates for post-graduate training places, where 20% of places are reserved for foreign doctors. As far as the medical associations themselves a reorientation is needed. The Colleges of Medicine are not trade- unions, they are not political institutions. Membership probably won’t be any more compulsory.

 

 

 

 

 

Madrid, November 16, 2012                                    André Bolliger M.D.

                                                                              President of ASPROMEL