Hostilities have surfaced on the regional board after months of apparent calm, of loyalties duly calculated within the framework of a favorable scenario, that which has positioned the region as a benchmark for the management of the pandemic and, in turn, as a beacon of the left in decentralized Spain. Now, the storm has been unleashed by the discrepancies on how to manage a legacy of Zaplanismo, that of the health concession system. The formula proposed by the PSPV of create a public company that it assumes the services that will return to the portfolio of the Ministry of Health has been the trigger for the disagreements with Compromís and Unides Podem; differences and crosses of accusations that the opposition tries to make profitable to wear down the tripartite. The solution that is finally adopted could be momentous. It will be the roadmap that will set the course for the next reversals in the Community, largely concentrated in the province and the most imminent being that of the Torrevieja health department, scheduled for October 15. For now, the controversy can be summarized in ten keys.
A public company for any health reversal
The draft decree law signed by Ana Barceló to create the public health company establishes that the company will have a private legal personality. Its purpose is “the provision and direct management of public health services from other public or private entities that are incorporated by reversion to the health field of management of the Generalitat, as well as by transfer or succession of companies.” The document specifies that the staff to be subrogated will maintain their staff status and will not acquire the status of a public employee.
RESONANCES AND PHARMACY
Argument of the PSPV that generates distrust among its partners
The preamble to the decree law drafted in Health highlights the situation of two specific services. On the one hand, the provision of pharmaceuticals to users of the Community’s social and health centers. It is an assistance that was privatized through a contract that expired, but the Generalitat has not resolved the situation of assuming its direct management and subrogate the workforce. The scenario is identical in the MRI service, whose contract ended in 2018, but it is still provided by the company that was awarded it for a period of 10 years. The economic report of the decree estimates that the public health company will require a budget of 25 million euros and its operation will generate savings of more than 30 million. That is one of the PSPV’s lines of argument to press for the creation of this society, which would be born in principle to assume the management of these two services. However, the wording of the company’s object is so generic, so broad and indeterminate that Compromís and Unides Podem distrust the intentions of the socialists. They believe that they intend to lay the foundations to be able to use this firm to direct future reversals of the entire health departments, the first one in Torrevieja.
Torrevieja, Dénia and Vinalopó, in the final stretch of the concessions
The bulk of the health departments that provide their services through private companies in the Community is located in the province. In Torrevieja the contract expires in just over four months. The next ones on the calendar will be those of Dénia, Manises (Valencia) and Vinalopó. In total, more than half a million people from Alicante are assigned to health areas managed by private companies, mainly Ribera Salud, DKV and Sanitas.
Health marks its roadmap and triggers tension
Two months have passed since Health signed the initial resolution to promote the creation of this public health company and until Barceló has signed the final decree. Since the publication of the initial draft of the Ministry, both Unides Podem and Compromís presented allegations. Those of Pilar Lima requested a change of base. They proposed creating a public entity in the style of the Entitat Valenciana d’Habitatge i Sòl. With this, it would cease to be governed by Commercial Law and would do so by Public Law. The purple ones refuse to use an entity of these characteristics for the services of socio-sanitary pharmacy or resonances, and even less for health departments. They propose that it undertake maintenance services, sanitary transport, cleaning or restoration. The Valencianists, for their part, requested to modify the object and purposes of the society, limiting it to the socio-sanitary pharmacy and the resonances. With this, the door to managing health departments with that firm would be closed.
BREAK IN THE BOTANICAL
The management of the process confronts the left-wing partners
Those of Unides Podem were the first to demonstrate, to mark their own political profile. They warned that they would not support the PSPV project to create the controversial public company and launched an ordeal against Ximo Puig: they threatened to overturn the decree if the Alzira model was not followed, which they understood had been agreed at the Botànic. Compromís initially showed a certain lack of definition. He argued that workers and unions had to be listened to first, but eventually he ended up adding to that same thesis. The Valencianists do not close down to negotiate, but they consider that the reversal at the Alzira Hospital is the only one that has been carried out so far and, therefore, its lights and shadows are known. They bet on improving that formula to repeat it, for now, in Torrevieja.
The Health maneuver this week to raise the approval of its decree to the full Council has been the genesis of the three-way war due to lack of consensus. The PSPV pretended to move on without even resolving the allegations of his partners, who have ended up stopping him.
The Socialists underpin their strategy by appealing to the efficiency of the public company, as this week the President of the Generalitat stressed, and showing their opposition to bringing workers closer to the reversion to the condition of public employees. After the crossfire in the form of thick statements, the head of the Consell has been forced to stop the project. You will have to negotiate it and the round of meetings for it has already been started. His intention is to be able to bring this matter to full session in a few weeks, after being forced to remove it from the agenda last Friday. Puig claims to be willing to debate, to listen to alternatives, but he has increased the pressure against his partners, warning that decisions must be made.
The first botanist-driven process
In April 2018, the Ministry of Health assumed the reins of the health department of La Ribera, in the hands of Ribera Salud, thus liquidating the first private health concession in Valencian territory at the will of the Botànic. The workforce was integrated into Health under the formula of workforce to be extinguished and there are still frictions due to the differences between their working conditions and those enjoyed by statutory staff. A new collective agreement is currently being negotiated.
WINGS TO THE OPPOSITION
The confrontation unites the discourse of the right
The PPCV, Ciudadanos and Vox have been attacking the tripartite with all this for weeks. The opposition bench has taken advantage of the evident division in the left-wing coalition to charge against the public company project and defend public-private collaboration in health matters, positioning itself in favor of extending the Torrevieja contract. In this sense, the right wing has been especially belligerent about reversals.
All oppose the process and organize protests
All the unions that represent Valencian health have asked the Generalitat to reverse the creation of the public health company to take on outsourced services. Without exception. They advocate a “real integration” in the Ministry of privatized services through a formula that provides all possible legal guarantees and respects the rights of both the professionals subject to the reversal and the statutory ones. The Torrevieja works council, which represents a workforce of 1,400 employees, has been protesting for months and demanding dialogue with Barceló. They want to know what your future job will be. The Community Radiology Society also rejects the public company.
The company appeals and Barceló denounces that it hinders
The Minister of Health has openly accused the Torrevieja concession company, Ribera Salud, of “constantly hindering” the reversal process to incorporate this health area into public management. He assures that the company is paralyzing the pre-established process to execute the transfer and accuses him of not providing the necessary information to continue working with the workers on the path of this reversal. And it does not, always according to the councilor, despite the fact that the TSJCV has urged him to comply with the reversion rules. The company has appealed both the decision of the Consell not to extend the contract, as well as the reversion rules, a judicial war that also occurred in Alzira.
The left rules out the paralysis, but it is possible
Executing the pact to end the concessions is one of the initiatives with the greatest political significance of the tripartite in health matters, apart, of course, from the management of the pandemic. The three Botànic partners have always ruled out that their differences end up preventing the reversal in Torrevieja. It is a completely unlikely scenario, but sources from the regional government admit that it is not entirely impossible. If the public company is finally approved, the Valencian healthcare model will have three corners: the direct management service, the public commercial and the private concession.
Socialists believe that the public company to articulate the reversals in resonances and socio-sanitary pharmacy brings efficiency. They reject that the health personnel of Torrevieja go to integrate directly in the Conselleria.
Valencians look favorably on the public health company, but only for certain services. They defend that the only reversal model that has been contrasted is that of Alzira, so they bet on that option for Torrevieja.
The coalition that integrates Podemos and Esquerra Unida rejects the public company and wants all services and personnel to be managed directly from the Ministry of Health, following the Alzira pattern.
The popular ones take a position against creating a public sanitary company and defend maintaining the concession system. They argue that the only reason for the reversal in Torrevieja is ideological because the service works.
Supporters of the Consell renewing the contract with Ribera Salud in Torrevieja, want an audit to be made between direct management and the concessions model to compare data and not make decisions due to “sectarianism.”
The far right is committed to maintaining the concession system. He is against the reversal of the department of Torrevieja because “what works should not be touched”, and they believe that the public company is a “botched”.
Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.