Healthcare in crisis as regions' debt to suppliers reaches record

The accumulated debt the regions owe suppliers that furnish prescription drugs, medical technology and other products to public hospitals has now reached a record high, threatening the very survival of the system, industry insiders say. All the bills piling up in boxes throughout Spain's regions now add up to more than 10.56 billion euros - more than half of which relates to medicine while the rest is owed for everything from syringes to scanners.

It is an unbearable situation for the suppliers, who complain that they haven't seen any payment for more than 400 days in some regions. In Andalusia, Murcia and Valencia, the pay due period has passed 700 days.

Humberto Arnés, director general at Farmaindustria, says that it is the private companies which are sustaining Spain's public system and that this will not last much longer. "We cannot expect that they will keep supplying the regions indefinitely. This could put their companies at risk," he said. "But at the same time this also puts at risk patients with chronic diseases. Some firms might have to fold and this could cause problems in the way prescription drugs are dispensed."

Just over the past five months, public hospitals' debts have risen by 10 percent. "We are experiencing a historic situation when it comes to debt," explains Margarita Alfonsel, secretary general of the Spanish Federation of Medical Technology Companies (Fenin). Since 2007, Fenin says that the number of unpaid bills has soared by 270 percent.

Farmaindustria hasn't updated its breakdown of figures for the different regions. Nevertheless, Arnés says that the situation hasn't changed much since the last report released at the end of June. Five months ago, Madrid, Andalusia, Valencia and Castilla y León were the regions reported to have most medical debt. They were also the four regions that took the most time in reimbursing their suppliers, a situation that continues today. Of the four, Andalusia has the highest amount of unpaid bills - about 1.1 billion euros - followed by Valencia (886 million), Madrid (527 million) and Castilla y León (476 million).

Regional officials take approximately an average of 431 days to pay their medical suppliers - about eight times the time limit allowed by law. In Valencia, it can take as much as 765 days before a supplier sees his money.

"This is a generalized situation. Our priority is to pay our suppliers and we are working hard to pay off our debts. What we can do is stop purchasing things that we don't need," says a spokeswoman for the Valencia health department.

In some towns near a border of two regions, disputes over which government should pay for patients' treatment have emerged. La Rioja officials have closed off their public hospitals to residents of a finger of the Basque province of Álava, who now have to travel 90 kilometers to Vitoria to get treatment after using nearby Logroño's hospitals for years. "It doesn't matter who wins the elections, he has to fix this," says Obdulia Pintor, a cancer patient who now has to make the long journey to Vitoria.