The national government’s decisions on spending cutbacks, and the policies of the regions that the Popular Party (PP) also governs, are undermining the quality of Spain’s public health system. The citizens are clearly and painfully noticing this deterioration, and have been organizing massive protests, with some successful results. Thanks to the protest by health-care professionals, the regional government of Madrid has had to back down, though in a somewhat confused manner, from its decision to turn the Princesa hospital into a geriatric center.
On Sunday, thousands of disabled people demonstrated against the drastic cuts in the budget for the Dependency Law. The rather limited advances made since 2008 in the protection of the disabled are now being destroyed by indiscriminate cutbacks in public spending, besides the widespread non-fulfillment of existing commitments.
The public’s feeling of vulnerability is worsening, due to the secrecy surrounding new healthcare policies. The statements made by regional government spokespersons — which might best be described as pure rhetoric without foundation or quantification — merely repeat that the privatization of healthcare has no adverse effects on the quality of service to the public. But the users of medical centers are very well aware that this is not the case; that medical attention and medications are rendered more expensive by formulas such as co-payment and partial payment for prescriptions, and that the number of beneficiaries of public healthcare is beginning to diminish rapidly.
Meanwhile, the privatization of medicine is by no means a neutral policy in economic terms. The transfer of executives from the public health system to the private one, and vice versa — the well-known “revolving door” between state and market that the insufficient Spanish laws attempt to shut with ineffective norms on conflict of interest — indicates that the privatization of healthcare is a firm objective of PP governments. The cutbacks on public expenditure are merely speeding up the achievement of this objective.
The citizens rightly suspect that the PP’s priority seems to be, not that of maintaining a good level of public healthcare in a situation of budget restraints, but rather one of carrying out austerity measures above any other consideration, and to set aside slices of the healthcare pie to the profit of private business. A majority of the public is aware of the need to reduce public spending, and supports this demand. But the adjustments have so far been carried out with questionable criteria and priorities.
Public services, such as healthcare and education, have to bear cutbacks when they become necessary due to a slump in state revenues or the obligation to reduce the public debt. But the red line that must not be crossed comes when, due to indiscriminate or slovenly management, these cutbacks endanger the health of citizens or compromise their professional future with mediocre education.