Enhancing Spain’s National Health System: Key Strategies
Some sources, advocates, and even some politicians draw attention to co-payment measures. These measures prevail in countries with higher health costs and worse health outcomes. All studies show that these measures have a very negative impact on equity, penalizing poorer and sicker people. Furthermore, this is happening amidst a crisis with over 4 million unemployed, and pensions are not expected to stop in the short term. In many cases, people are at the edge of survival.
However, the problems of our health system are clear and well-known:
- Very high drug spending (around 30%, but the exact figure is unknown because regions do not make hospital expenditure public, which is the fastest-growing component).
- Growing privatization, with governments mortgaging for very long periods at much higher costs than the public system.
- Technological overuse, a common feature of most developed countries.
- A serious lack of coordination in actions and a lack of health goals throughout the health system.
Therefore, progress in maintaining and improving public health should include the following:
- Information and Transparency: The National Health System must maintain consistent and transparent information for citizens on the functioning of health services. We all pay for public services and are entitled to know detailed information about their operation.
- Adequate Funding: The National Health System needs funding in line with its commitments to the population and their needs. This funding should be earmarked to ensure that funds intended for health are actually used for those purposes.
- Common and Coordinated Policies: The entire National Health System needs to develop and implement common policies to prevent discrimination against some groups and differences in performance across autonomous communities. To do so, developing an Integrated Health Plan would be essential.
- No to Privatization: We must clearly define the public health model and stop the massive diversion of public funds and concessions to private enterprise.
- Control of Drug Expenditures: We should establish mechanisms for better control of pharmaceutical spending through elements such as independent, high-quality information systems for professionals, increased use of generic drugs, and control of the pharmaceutical industry and its influence on healthcare professionals.
- Evaluation of the Use of Technology: The system must commit to maintaining the technical baseline of public health facilities through a continuous and sustainable policy of high-tech acquisitions.
- Personnel Policy: We must develop a policy that involves more staff in the system itself, making them feel identified and committed to the health system. Strategies include:
- Full-time employment to avoid conflicts of interest between public and private sectors.
- Development of core postgraduate training for specialists.
- Increasing the number of nurses and adapting their skills.
- Development of nursing specialties.
- Professionalization of health management.
- Development of career paths.
- Ensuring the independence, qualifications, and professionalism of middle management.
- Implementing measures to develop quality and excellence among healthcare professionals.
These measures aim to develop the character of excellence of our public health, enhance its potential, and improve its efficiency. As things stand, it seems that the biggest risk to the sustainability of the National Health System lies with those who are intent on driving measures that go against its core values: accessibility, free at the point of use, and clinical excellence.