Olga Gines, president the Madrid Catholic Hospitals Group; Ignacio Martinez, manager the Hospital Vithas Madrid Arturo Soria; and Carlos Rus, president from ASPE (Spanish Private Health Alliance)have shared their reflections two years after the outbreak of the pandemic in an informative meeting entitled “Public-private collaboration and the role of private healthcare throughout the pandemic” organized by OKSALUD.
The Director of OKSALUD, Beatriz Muñoz The session began by recalling that 25% of those affected by Covid in Spain have been treated in privately owned centers (more than 15% of the critics have been in the ICU of private hospitals).
Olga Ginés provided in her first intervention the specific data of Madrid, a region in which the proportion of affected people treated in private centers has reached 30%, and where “we have been fellow travelers” with the authorities with a single command that qualifies of «great success» because it allowed to offer a service «loyal and transparent with legal certainty and the patient in the center».
In the management of the health crisis “there have been 17 models, as many as Autonomous Communities”, Carlos Rus recalled. Among them, he has highlighted as particularly effective the Madrid model, where that single command was established that has facilitated coordination and assistance. Also that of Castilla y León, in which all Covid cases were concentrated in public centers while care for other diseases was referred to private entities that functioned as “clean circuits” for SAR-CoV-2.
Ignacio Martínez recalled that in the most critical moments, the available ICU beds have doubled and even tripled, “a job and effort by professionals of enormous value, especially in the initial phases.” At all times, collaboration from professional to professional, between private hospitals, and between private and public hospitals has been the norm: “Help was provided above all other considerations.”
Disseminating and preventive activity
With the sixth wave more controlled, from the hospitals the preventive activity is recovered “without lowering its guard” -warns Ginés-, which the three participants in the debate have highlighted as fundamental.
Rus has pointed out that there have been moments of the sixth wave that have reminded the first due to its harshness, and that without the vaccine the situation would have been considerably worse. “We need to send a clear message: the third vaccine is necessary.” His fellow debaters agreed on the importance of this outreach work.
Ginés has referred to the patient profile in the sixth wave as “older, multi-pathological, with a vaccine but carrying the effects of the previous contagion and, in the case of younger profiles, often without vaccination or with a single dose.” A situation that he summarized as follows: “The best vaccine is the one that is already in place, that is a reality.”
Carlos Rus recalled that a week before the first state of alarm for this health crisis was declared, there were contacts with the Ministry of Health to make themselves available “to guarantee assistance.” Over time, it has been seen that the practice of good medicine matters to the patient, regardless of his ownership. The nuance is that “we do not live from cases derived from public health, but we respond to society when necessary.” The fact that health is used as a throwing weapon in politics should not obscure the fact that the norm is collaboration and the search for quality in patient care.
Martínez attested to this perspective, emphasizing that “the differentiation between the public and the private is artificial”, regardless of whether the private owner is a generator of wealth in a free market, because health is a tremendous driver of the economy, professionals have the same dedication and interest in public and private centers».
Ginés supports this approach: «Health is one, integrated. It must provide quick, collaborative and technologically advanced responses to the needs of society, and it contributes to sustainability».
Looking to the future, Rus considers that it is necessary to continue cooperating, among other reasons because health is facing challenges such as “effective but costly” therapeutic advances and chronicity, which can put stress on services. “A state pact has been requested for Health and it is something very necessary,” he pointed out.
With this vision in mind, Martínez points out that we must continue to seek efficiency because “bad medicine is the most expensive in terms of resource consumption and threat to sustainability.” By being efficient and working on clinical safety, with transparency, we will make a greater contribution to healthcare.
the role of professionals
Throughout the debate, the value of professionals has been repeatedly highlighted. “People who think that a hospital is drugs and bricks do not know what a hospital is,” said Martínez. All the participants have had words of praise for the personnel of the hospitals, health and all areas, for their dedication and vocation to accompany the patients.
Both Ginés and Rus have highlighted that the lack of professionals is a key challenge for the future. Rus has defended the compatibility between the exercise of the profession in public and private centers, “which some communities make difficult” for the sake of greater flexibility and banishing the idea of these two separate health services.
With the awareness that the pandemic is not over yet and that, in any case, it will not be the last, all have expressed their willingness to continue working for a more integrated and stronger healthcare for the future.