Spain plans to privatise more healthcare- is this the way forward?

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02 Nov 2012 1:14 PM by mac75 Star rating in Valencia. 414 posts Send private message

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Madrid President Ignacio González on Wednesday unveiled plans to privatise a substantial part of the region’s health system as part of an austerity budget for next year. 6 hospitals will be handed over to private hands.

Is this the best way forward for Spain? To start privatising everything? Local TV chanels will be more than likely closed down or sold off to private compnaies aswell (although that doesn't really worry me) and there are talks of privatising more services. What are you views on this?


A donde el corazón se inclina, el pie camina.

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02 Nov 2012 1:28 PM by elaineG Star rating in Spain . 409 posts Send private message

Forget about privatisation: 
They could make very substantial savings if they centralised all services, not just the medical one, instead of having I believe 17 autonomous regions, duplicating goodness knows what.
And while they are at it, they could use just one language/dialect, instead of all the regional variations which involve significant translation costs.
And while I am on  my soapbox, if the EU also standardised to one language, the biggest EU expenditure, they (we) would  saving probably millions, if not billions.

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03 Nov 2012 6:30 AM by RonArt Star rating. 20 posts Send private message

Oh my God, please don't privatise healthcare. If you ever come to the US, don't get sick! We have one of the the most expensive healthcare systems in the world and it is ranked 37th by the WHO (World Health Organization) -- Spain is ranked 7th.

How could adding a profit-making layer of overhead lower costs? Think about it. If you buy the argument that the current system has problems that the new management will fix, wait till you see how the new management will solve those problems (by denying services, of course). I would vote for staying with the current system. If it needs fixing, fix it, don't dump it. 

ElaineG's idea of one language is great, regretfully no one is going to give up their mother tongue. At least you now have one common currency and a standard "visa" that lets people move about Europe easier than before, plus many other features (standards) that are common throughout Europe. 

Don't let healthcare go down that one-way street.

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03 Nov 2012 7:19 AM by elaineG Star rating in Spain . 409 posts Send private message

                          I did not say I thought Spain would adopt a one language approach.
 We all know that an ‘important Ethnic Group’ of a couple of hundred people, would prefer to starve than giving ‘their right’ to speak gobbledegook (guirigay) even if the rest of us must starve too.



   I am not suggesting that the universal language needs to be a one of the majority languages now spoken, English, Chinese’s  etc.,  but it could be Esperanto. That way everyone would be giving up their mother language so none would need to feel victimised.
 But I won’t be holding my breath.

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03 Nov 2012 9:46 AM by andenca Star rating in London. 44 posts Send private message


               I wonder if Elaine speaks any other language?   Esperanto would never thrive as a language is something "alive", that changes and progresses and develops as time goes by and no-one would feel identify with something that is "dead".

I do not disagree with you that we should have a common language and all schools in th EU should be bilingual so you learn your own language plus the "common" language as it happens in Scandinavia with English.

The problem is that if you do not use a language regularly, you do lose the language.

I am Spanish, living in UK and married to a Greek. My children learnt the 3 languages, however their main language is English, they can manage in Spanish as the have been in Spain frequently and travelled through S. America but almost lost their Greek as they hardly use it.



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03 Nov 2012 10:23 AM by elaineG Star rating in Spain . 409 posts Send private message


I wonder if Elaine speaks any other language?
My surname is Gonzales, I speak English also !.
But I really don't see what that has to do with the post I made.
The point was,  we should have  a common language to save the incredible waste of money spent on Translations pandering to people who are not confident enough being who they are as individuals.



This message was last edited by elaineG on 03/11/2012.

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03 Nov 2012 11:26 AM by cowiz Star rating. 2 posts Send private message

 As an American who lives part time in Spain, I REALLY hope that they do not privitize healthcare in Spain.  Our healthcare here in the states is SO expensive and I just heard the other day that the average wait time here to get in to see a doctor is 21 days.    In the States we are hoping for a national healthcare program because "for profit" insurance companies and hospitals add cost and complexities, i.e.; what is covered, what isn't, have you fulfilled a deductible, etc.  Whomever said to fix the system in Spain, don't get rid it,is right!



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03 Nov 2012 1:55 PM by camposol Star rating in Camposol. 1406 posts Send private message

Perhaps people will appreciate the NHS in UK. more.  However much they moan, it is the envy of the world!

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03 Nov 2012 3:32 PM by tech Star rating in Maidstone/Turre when.... 83 posts Send private message

 Yes our NHS is the envy of the world. That's why half the world come here to claim their 'free' treatment. Wasn't there a big outcry in the USA when a national healthcare program was proposed?

Hope I haven't drifted to far from the original thread.



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03 Nov 2012 9:17 PM by mac75 Star rating in Valencia. 414 posts Send private message

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 I agree the UK NHS is the envy of every country. Personally I do no think that they are going to solve anything by privatising hospitals,

I think it will be a terrible mistake. 


A donde el corazón se inclina, el pie camina.

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03 Nov 2012 9:30 PM by Roly2 Star rating in Almeria. 646 posts Send private message

 Coming in at 18th in the WHO for 2012 - I don't see how you can say the NHS is the envy of the world!!!!!   Health tourists travel to the UK because the level of FREE health care is better than the level of FREE health care they get elsewhere, and that is not an indication of quality. Having spent a good few years fighting NHS incompetency I would rather look to see what France is doing, to make them number 1.

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03 Nov 2012 9:46 PM by bobaol Star rating. 2253 posts Send private message

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 Why would the NHS in UK be "the envy of the world"?  Because it's free?  Many other countries have free healthcare, even the USA has county hospitals where everyone who turns up has to be treated.  The NHS is certainly not envied because of its care, one of the lowest survival rates for cancer in the Western world, long waiting lists to see a specialist, the now infamous Liverpool Care Pathway which effectively starved old people to death.  The doctors and nurses may be excellent but the system is over bloated, over managed and too political.  It relies on foreign doctors and nurses to keep going, nothing can be authorised without some pen-pusher saying if it is cost effective or not and politicians keep sticking their noses in and making changes because it seems the right thing to do.  £15 billion wasted on an IT system to join surgery records with hospital records throughout the country, a political scheme with no actual input from the medical staff.  Patients waiting weeks to get appointments with GPs and then stuck on a hospital waiting list for even more weeks before being seen.  No wonder chronic disease and cancer recovery rates are so poor.  A&E departments being closed all across the country and those that stay open being swamped by an increasing amount of drunk and domestic violence patients.  

I don't think you'll hear many people, outside UK, saying it's the envy of the world.  A soundbite thought up by the press about 40 or 50  years ago when it was a good system.  Those who work in the system are increasingly frustrated by it.  Bed management at crisis state, costs an arm and a leg to even park in the place when you're visiting, let alone as a patient.  Visiting a hospital as an out patient could see you waiting up to 6 hours and paying up to £10 to park for the privelege.  Chaotic and understaffed A&E departments, especially at weekends.  A service that costs £105 billion a year from taxpayers money but, ironically, spends less on healthcare per person than the USA and one of the lowest in Europe.  

So good on the doctors and nurses and yah boo sucks to the actual system.

Sorry, people often comment on rose-tinted spectactles but let's not put the NHS on a pedestal it no longer deserves.  

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03 Nov 2012 11:58 PM by Pasha01 Star rating. 40 posts Send private message

 1 in 4 in spain have no job or chance of getting a job, in the south it's 1 in 3. Please tell me how are they going to pay for health care?? The NHS is the envy of the world and thousands of people get amazing treatment. yes there will always be some that don't but that's the same in many other countries. I know of people in Spain and France that haven't faired very well under their systems. If you get ill in the USA, get ready to hand over your credit card or have insurance, if you don't have the where with all to pay, you will not get treatment for cancer, heart or any other major diseases, this includes children. All you get is very basic treatment. Dial 999 you get an ambulance to hospital and looked after, it would be even quicker if people stopped using it for stupid things that they could treat themselves, I know this to be true as I have a friend who is a paramedic, believe me when I say you'd be horrified at how many people dial 999 for a cut finger, spained ankle etc. However, they still get treatment and drugs. Do you have any idea, how much drugs costs, if you had to pay, most people would never afford them long term. I had to buy some human drugs for a horse of mine, they cost £1.28p per tablet, at the time there were no animal equivilents.  Luckily she only needed them 1 a day for 6 weeks. These tablets are used for Parkinson's disease, some patients need 4 plus a day.  Please stop slagging of the NHS, on the whole it does fantastic things.

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04 Nov 2012 12:39 AM by RonArt Star rating. 20 posts Send private message

 IMHO, socialized medicine is the only way that medical costs can be kept in check. Open the industry up to for-profits and they will charge whatever the market can bear. Which market? Well the one comprised of people with the most money, of course. The people with little or no money will have to settle for inferior or no healthcare services. Only by having health care providers as employees of the state can provider costs be regulated. .

Drug companies are for-profits. They are squeezing money from every source they can. For-profit health care providers will do that too. They'll get the most they can from individuals and/or from goverments that subsidize costs. It will not save money. 

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04 Nov 2012 4:46 AM by 66d35 Star rating. 243 posts Send private message

even the USA has county hospitals where everyone who turns up has to be treated.

You have obviously never lived there and have zero real experience of the US "healthcare" system.

My wife is American, and I have lived there.

Yes, they will treat you. However.... they WILL bill you, and they WILL pursue you for it to the point of bankruptcy. If you have a car, house, savings... you will lose them. My wife broke a toe one weekend, and needed hospital treatment. We got bills from the radiologist, the hospital itself, the doctor in the hospital.... $3,950 (and she was not even admitted, she was only there for 4 hours). Fortunately, we had insurance. Another friend had a heart condition. Admitted for 6 days for tests. $27,000+. Treatment was offered = $65,000 (extra). A family member of ours shot himself rather than bankrupt his wife and children when he developed cancer. They will sue you even if you have no money... they will come after your familiy if you die.

The reality of the situation there is spelled out quite nicely in this article:

The US system is overloaded with paper pushers and managers (to handle all that billing). Your co-pay to even walk in the door of your local doctor is likely to be $100+, even with insurance. Need a prescription? Could be anything from $50-$500.

The system there (in my opinion) is ruthless. heartless and soul destroying. It is not a model I would recommend anyone copying.


















This message was last edited by 66d35 on 04/11/2012.

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04 Nov 2012 7:58 AM by Finisterre Star rating. 26 posts Send private message

Well said, RonArt and 66d35.

Privatisation is so obviously going to be a disaster for the NHS in Britain, I am very sad to see they might be copying it here in Spain. Introdicuing a profit motive into something as important as healthcare is immoral even without the glaring, awful example of America, where they have the best healthcare in the world for those that can afford it, and will leave the rest to die.

It's a testament to how brilliant the NHS is that the complaints about it on this thread basically amount to second-hand tabloid rabble-rousing. No-one gives any statistics about 'half the world' coming to the UK for treatment, they just believe it's true because there's a tendency in the British character to want to believe that everyone except them is getting something for free.

The fact is that if you get ill in Britain, you can generally expect to be treated competently and promptly, in a clean hospital, without having to worry about the cost. The vast majority of the world would consider this absolute heaven. It's a shame that we don't appreciate what we have, especially since the coalition government are currently in the process of quietly selling it off.

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04 Nov 2012 9:00 AM by lifeinvejer Star rating in Costa de la Luz. 16 posts Send private message

Our experience of public health care in Spain at the local level is inefficient with needless revisits to the doctor eg for blood test results and referrals to the regional hospital for basic things that the primary health care teams should be able to deliver. Rather than privatise elements of healthcare Spain would do better to overhaul the huge waste of resources in the system. I suspect that given the public union resistance to doing things efficiently some politicians think its simpler to privatise some services. Given lots of factors around at present in Spain I can see why some politicians here consider that is the only way to create effective change.

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04 Nov 2012 10:15 AM by Roly2 Star rating in Almeria. 646 posts Send private message

 My comments are based on years of fighting against the NHS professionally, on things like (and this is just off the top of my head) - unnecesarry surgery, botched surgery, inappropriate surgical procedures including the use of outrageously outdated (but cheaper) techniques, infections caused by lack of appropriate care in surgical theatres - you get the drift.    Each and every time the NHS fails, it represents a life destroyed.  I don't know Bobaol's experience but he is right in his assessment, and it is not based on press headlines. The only thing I would say is that from my knowledge I think the 15 billion wasted on the overblown IT system which will never be fit for purpose - is an underestimate.   The real cost is closer to 30 billion.

Of course there are wonderful surgeons working in the NHS, but even conservative estimates indicate that 25% of surgeries are ineffective and can actually leave the quality of life for the patient substantially worse.   So for those who just throw up their hands and talk about their own successful procedures (and therefore how wonderful the NHS is), I would be asking first, was my procedure necessary?   And then I would be looking at some of the shocking statistics available.   

FREE certainly does not mean EFFECTIVE, it simply means free. 

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04 Nov 2012 11:46 AM by andenca Star rating in London. 44 posts Send private message

The subject is complex. We want free care for every one,  new technology and drugs are extremely expensive, we live longer and we have created a "medicalised" society where every one expects to get a pill for every ill or dyscomfort.

In UK, 90% of patient do not pay for prescriptions, this means they will make appointments for GPs to get their free paracetamol (which costs 90p over the counter) while non-minding to pay for his daily packet of cigarettes.

People live isolated lives and find difficult to contain their anxiety as there is not an extended family to talk to. Young parents will ask for urgent appointments the moment a child has a mild fever or a cough, sometimes more than once a week.

There is a lack of taking responsability for ones own health. You tell a patient that has diabetes and they answer "and what are you going to do about it".

The goverment insisted on access to a clinitian within 48h independent of it being clinically indicated and created NHS direct and walk-in centres. Now we have patients attending GPs as urgent appointments when the day before called NHS direct for the same problem, then went to a walk-in clinic and then called the surgery out of hours service during the night. How many opinions does one person needs for the same problem? Or is it that they just keep at it untill they get their antibiotics which will not help as they just have a viral infection?

All this demand for "instant" access to services has destroyed the continuity of care which politicians think is not important but which I think is essential or patient management.

I work in primary care and we audited patient's attendances to GP (we did not include out of hours or walk-in/a&e attendances) and many patients came up as having well over 90 appointments in the previous 12 months!

All these completely clogg up the system.

I am completely against privatisation of the NHS however it needs a radical change and lots of patient education.


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04 Nov 2012 11:54 AM by Roly2 Star rating in Almeria. 646 posts Send private message

 Totally agree with your comments andeca.  But while the most important factor is 'free' we will never move forward.  We need a sensible discussion about what could and should be paid for.  e.g. all those missed GPs appointments should carry a charge - say £10.00.   Quality and effectiveness should be the central  concepts, not free.  But that is why the NHS is only 18th in the WHO rankings.  

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