Spain's regions, which are being urged to rein in their spending in 2012 to meet central government deficit targets, forecast that they will spend an average of six percent less per inhabitant on healthcare this year, which, coupled with cutbacks already introduced in 2011, is expected to produce a 10-percent decrease in the funds destined for the sector. In numerical terms, and provided what has been budgeted is adhered to, the regions will spend an average 1,210.95 euros per person in the public health system this year, compared to 1,288.58 euros in 2011 and 1,343.95 in 2010.
The reductions will not be across the board, however, with some regions still expecting to pay more despite cutbacks. In the absence of data for the coming year from Castilla-La Mancha, according to figures compiled by the Federation of Associations for the Defense of Public Healthcare (FADSP) the regions forecast to spend less on healthcare per inhabitant this year than last are: Navarre, Extremadura, La Rioja, Murcia and Catalonia. Those where it is anticipated costs will increase are: Andalusia, Aragón, Asturias, the Balearics, the Canaries, Castilla y León and Madrid. Others, such as Valencia, the Basque Country and Galicia, will see their per capita outlay remain almost static.
What will not differ is the enormous disparity between what is spent in each region. In 2010 the highest difference was 556 euros, between the 1,066 expenditure per person in the Balearics and 1,623 in the Basque Country. In 2012, the widest discrepancy will be 497 euros, between the 1,061 of Valencia and the 1,558 of the Basque Country. That the difference has dropped by almost 10 percent in two years is attributed by the FADSP that the cutbacks have been applied equally in all regions, regardless of the figures that divide them.
In this way, the opportunity the crisis presents to even out treatment across the regions has been lost, and those that already pay the least are now at greatest risk. In a country where the incoming government preaches on equality as one of the bywords for the medical system (something Health Minister Ana Mato reiterated on Monday) it is clear that much remains to be done.
For the FADSP it is proof that the financing model to be used this year, under which funds granted by the central government for regional healthcare do not necessarily have to be spent on same, will not serve as a homogenizing factor. But the problems faced by regional administrations are common, and the cuts to combat them likewise: the debt owed by hospitals to pharmaceutical, sanitary and technological providers is astronomical. Combined, unpaid bills stood at over 10 billion euros last year. And it keeps on growing - 10 percent in the past five months.
Since the crisis bit, the regions have been applying ad hoc savings measures, mainly on pharmaceutical costs. The vaunted central purchasing system for acquisition of sanitary products and vaccinations has seen limited use. Catalonia has been the first to slash services by reducing consulting hours and operations.