Marciano S. Bayle, Carlos Ponte, Manuel Martin, Hixinio Beiras and Felix Payo
Social Movements against the privatization policy of the National Health Service in Spain
Federacion de Asociaciones para la Defensa de la Salud Publica, Spain
During the last years several social movements of general people have been produced, inside and outside of the health area, against the initiatives of the Government addressed to the privatization of the public health services. The purpose of this communication is to describe and analyse one of the peculiar structural forms that they have been developed: “The Platforms in defence of the Public Health”, which are playing an important role against the neoliberal measures and with the purpose of defending and improving the Public Health System.
1. What are the Platforms?.
The Platforms are considered as unitary organizations that arise in front of specific health or social problems, as the need of a new hospital or a particular sanitary or medical care service, the improper working of some health service, etc. And also in front of more general problems as governmental political decisions that affect to the whole population. Therefore, its working area is variable. It can be a neighbourhood, a city, a region or all the state.
Its composition is variable: worker unions (CCOO, UGT), or health workers by themselves (SATSE, SAE), Political Parties on the left spectrum (PSOE, IU, Nationalist Parties), Neighbours and Costumer Associations, City hall representatives, Professional Organizations (FADSP, SEMFYC).
Currently, the following platforms are operating:
- In State level with head office in Madrid.
- In several Autonomous Regions (CC.AA): Galicia, Asturias, Andalucia, Madrid, Murcia.
- In several cities: Córdoba, Cádiz, Lugo, León, Valladolid, Burgos, Salamanca, A Coruña, Orense, Valencia, Ciudad Real. Zaragoza.
- In some health areas and neighbourhoods.
2. Activities of the Platforms:
- Discussion, analysis and alternative of the health/social problems object of the platform.
- Diffusion of brochures, information leaflets, public acts, intervention in the media, popular celebrations, demonstrations, legislative initiatives.
- The most outstanding movement:
Medtec (Vigo,1996) against the privatization of a service of hemodynamic and heart surgery.
Protests against a law that decrease the public financiation of drugs prescriptions (1998).
Against the hospitals conversion in Foundations (Trusts): Getáfe and Alcalá (1988), Arriondas (2000).
Claming for the construction of new hospitals: Burgos (1999), Oviedo (2001), Pontevedra (2001).
3. Balance of the Platforms:
The result has been globally positive. In the case of the Foundations, the movement was essential to stop the Government policy. Also they were successful in more specific problems, for example: the maintenance of an old hospital in Santiago and to reconvert in a social clinic…
The Platforms, however, they have some problems:
- * Most of them are of informal character. Only a few of them had an statute or legal personality.
- They use to work in a irregular way. The members joint together only in face to specific problems and without regularity.
- They are influenced in a strong way by the political position of the different organizations that integrate them and by the relationships between them.
- They need an organization, this is the role of our FADSP, to perform the meetings, to propose objectives and to look for agreement and concurrence against the political differences between the organizations that integrate them.
4. Current objectives of the Platforms:
At this time, in the FADSP , the following topics in the Platforms
are outlined
- To make an active follow-up of the decentralization process of the Health Policy from the State to the Autonomous Regions (CC.AA) and Nationalities. This process have to be made with criteria of equity and economic sufficiency, otherwise, it is sure that it will cause an important problem for the immediate future of the public health service. From the FADSP and the state Platform they have been made already proposals in this regard.
- To obtain sufficiency sanitary financing. Our proposal is that the GDP must be increased in 1 point.
- Rejection of the copayment. The Health Ministry already has raised this idea, but the presence of the generalized refusal, it was delayed.
International Association of Health Policy 