The Costa Blanca People was granted an exclusive interview with the Mayor of Torrevieja Eduardo Dolón in order to discuss the events unfolding at Torrevieja hospital. For those readers who don’t already know the situation here is a brief summary: The hospital is publicly owned and privately managed by a company called Ribera Salud. The initial contract to run the hospital was for 15 years and is now entering its last year. Recently, the Valencian government announced that it would not be renewing Ribera Salud’s contract to run the hospital and instead, it would be publicly run when the current contract comes to an end in 2021.
Many readers have been asking questions to the Costa Blanca People and to Torrevieja Town Hall as there remains much confusion about the situation. So much so that some readers even believed that the hospital was going to close. To clear up any confusion we sat down face to face with the Mayor this week to find out if the large community of international residents here should be aware of, or worried about, the situation at the hospital. In short, his answer was ‘Yes, we should be very worried.’ Why? There are a number of reasons which we will outline below.
Track record
To get a picture of what the future might look like for Torrevieja hospital, we can look at what has already happened at Ribera Hospital in Alzira, Valencia. Also a publicly owned hospital, it was privately managed by Ribera Salud and then reverted back to the hands of the public health authority. All reports indicate that the standard of care at the hospital is not the same as it was. The waiting list has spiralled out of control and news emerged this week that the A&E department is on the verge of collapse. According to unions, the situation at the moment is critical and staff are demanding urgent resources to cope. Reports in ABC, La Razon and other news outlets this week claim that patients on trolleys are lining the corridors and there is talk of having to erect a tent hospital outside to cope.
The Mayor told the Costa Blanca People “If people are wondering what to expect when Torrevieja hospital is handed back to the public health system, then we have a perfect example. Ribera hospital was in the same situation, and look at it now just a year down the road. Waiting lists are up 150%, staff claim they have no resources, it is chaos.”
Language
There is no other public hospital in the Valencian Community (possibly, in the whole of Spain) where patients can be dealt with directly in a number of other European and international languages such as English, French and even Russian. One of the requirements to work at Torrevieja Hospital is language skills – this was a condition set out by Ribera Salud because the Torrevieja and Orihuela Costa area have a 50% foreign population. Campaigners believe that by reverting the hospital to public hands, the foreign language offering will diminish. Furthermore, the Valencian government plans to impose the Valencian language here too. Similar to the situation being forced upon schools (which requires children who don’t speak Valencian as a first or second language to learn core subjects through Valencian), the Mayor confirmed that a similar situation is unfolding in the public sector. He explained, “The staffing situation is very unclear, which I will explain further later, but in terms of language – if the hospital is run by Valencia, they are going to impose a requirement that staff have a qualification in Valenciano. This might sound reasonable, but if management are filling a job post and the candidate with less experience has Valencian, while the more qualified person doesn’t, you can imagine what is going to happen.”
Even in general terms, the language rules being brought in by Valencia will have an impact here in the Vega Baja. The regional government wants Valencian to be the principal language used in and by town halls – even in Spanish speaking areas like the southern Costa Blanca. What this means for residents is that all communications, letters and administrative processes in the town hall would first and foremost be in Valenciano. The Mayor added “If a citizen gets a letter from the town hall in Valencian, they will have the right to answer the letter in Castellano, and then the town hall must answer further correspondence in Castellano, but expecting people who do not speak Valenciano in the first place to understand the initial letter is unacceptable. This is an issue we (the PP) are currently fighting in the Valencian court, but it will impact on the management of the hospital.” Sitting in on our meeting was Gitte Lund Thomsen, the Councillor for foreign residents. Originally from Denmark, Gitte speaks seven languages, including Spanish and English – but not Valencian. Gitte was elected to local government was part of Eduardo Dolon’s most recent campaign, but when the next local election comes around, there is a real possibility that Gitte will not even be allowed be considered for a role in local government because she is not certified in Valenciano.
Staff
In the run up to the announcement of the renewal of the hospital contract, staff at Torrevieja hospital had had little communication and no confirmation from the Valencian government about their own contractual situations. From surgeons and specialists to porters and administration staff, hospital workers staged weekly protests outside the doors of A&E as unions demanded at least a face to face meeting with government officials to discuss what will happen to staff if and when the hospital management changes. The Mayor told us, “They are still waiting. They have been told the situation will be clarified within the coming year, but their future remains unclear. Those currently employed, 90% of them are on a fixed contract and good working conditions. Will this continue? They don’t know. They have been talking to staff at Ribera Hospital in Alzira, they were in the same situation last year before Ribera Hospital was handed back to the public system and the staff there are warning staff in Torrevieja hospital that promises have been broken and working issues remain unresolved.”
The Mayor likened the situation to premier league football. “The top specialists can demand higher salaries as they are excellent at what they do. A company like Ribera Salud has the financial backing to entice the best of the best. What happens when the money isn’t there to pay for the best? Look at what happened at Ribera hospital when it went back to public hands, 50% of their specialists have left! It’s like the best football teams – the ones with better resources can pay for the best and most skilled players, it’s as simple as that.”
Waiting lists
There is no denying that while we are in the middle of a global pandemic, the health system will be under pressure. That said, according to the latest figures from the health ombudsman, Torrevieja Hospital has an average waiting list four times lower than the average
Figures from the regional healthcare audit reveal that hospitals in the Valencian Community have an average waiting time of 151 days, Torrevieja currently has a waiting list of 35.
The Mayor remarked, “Now is not the time to be gambling with people’s health – we are in the middle of a global pandemic and what is already working well should not be changed.”
Investment, finance and political point scoring
Those opposed to the running of Torrevieja Hospital by a private company, the Mayor believes, are using the issue for political point scoring. “How can someone be opposed to getting the best out of healthcare? The reality is that for every euro spent on healthcare, Ribera Salud has the ability and experience to get more for that same euro than if it was being spent by the public system. No one has a problem that cleaning services or catering services are outsourced to private companies so if a private company does a better job on overall management, keeps waiting lists down and patient satisfaction high, then how can anyone have a problem with that. The reality is, as we have seen at Ribera hospital, bad management costs more money, costs more time and impacts directly on patients.”
According to the Sindicadura de Comptes, (the external independent body which oversees the financial administration of the Valencian Community), Torrevieja health department is 30% more efficient than other public hospitals in the Valencian Community – this translates into a €45 million euro annual saving for the public purse. The original management contract required that Ribera Salud invested €80m in Torrevieja Health Department over the 15 year term. However, accounts indicate that by July 2020, it had already invested over €117m.
In terms of future investment, Ribera Salud had announced plans for a 2021-2026 investment project in local health infrastructure, valued at €40m. This included projects such as €1m for the improvement of Guardamar health centre, investment in the latest state of the art machinery and diagnostic equipment and plans to construct a €6m health centre for Orihuela Costa to serve the growing population there. The Valencian Government has made no indication of a similar investment project.
A statement issued this week by Carmen Morate of Los Verdes (the Green party in Torrevieja) says that those in favour of leaving Torrevieja Hospital in the hands of Ribera Salud argue that people are happy with the situation as it stands. She says, “For example, the British, the most abundant foreign nationality in this area. But let me say that their opinion should not be an example because England has a shabby health system (I know, because I lived there) so it is not surprising that they are satisfied with the free universal healthcare they receive in Spain.”
We put this to the Mayor and to the Councillor for Foreign Residents, Gitte Lund Thomsen, who both agree that as foreign residents make up half the population of this area, their opinion is of vital importance and should not be simply dismissed.
What can be done?
The Valencian government says that there is no going back and that the decision not to renew the contract is irreversible. However, there is a citizens’ action group called Plataforma Sanidad Excelente which was formed back in February. When the situation at Ribera Hospital began to unfold, campaigners decided to form the group to try to stop the same thing happening in Torrevieja. While their initial campaign was unsuccessful, the group remains active and anyone who would like to find out more about the situation at the hospital is welcome to get in touch via the website www.plataformasanidadtorrevieja.es