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Professionals in the public and private healthcare advocate structural reforms of the NHS


The event was attended by Agustín Rivero, CEO of Portfolio Basic NHS Services and Pharmacy, Ministry of Health, Social Services and Equality, Enrique de Porres; ASISA CEO and José María Fidalgo, former Secretary General of CCOO, and Julian Garcia Vargas, who was Minister of Health from 1986 to 1991, who moderated the meeting.


The roundtable participants agreed on the need to promote comprehensive reform plan that allows designing the health system in the medium and long term, in addition to facing the difficult situation currently presents the National Health System (NHS). Enrique de Porres ASISA CEO, summarized the situation: "You need to make structural reforms in the medium to long term, although the reality we obliged to make short-term adjustments. Therefore it is essential to adjust those settings that are inevitable in the current situation to the set of structural reforms required by the system. "



Review of the Health Act


José María Fidalgo elaborated on this thesis and opted to carry out a reform of the General Law of Health and draw a reform strategy that relies on three principles: a political pact between the major parties, the involvement of the professional group, and the development of a narrative that allows citizens to explain the process of reforms that are necessary to ensure the viability of the system. In addition, José María Fidalgo stressed the importance of a good diagnosis of SNS based on the principles of system sustainability, sufficiency of it, equity and resource capacity to govern.


The former health minister, Julián García Vargas, called for improved coordination mechanisms of the health systems of different regions between them and the Health Ministry itself and recalled that, along with all the measures taken forward from the Administrations , is a must "foster responsible citizens."

Enrique de Porres, María Tormo, Julián García Vargas, y José María Fidalgo 
Enrique de Porres Mary Tormo, Julian Garcia Vargas and José María Fidalgo


A new portfolio of services


Meanwhile, Agustin Rivero, CEO of Portfolio Basic Services of the Ministry of Health, defended the opportunity of Royal Decree Law 16/2012, which, in his view, the basis of the reforms that are necessary to ensure the viability of National Health System. Rivero recalled that between 2009 and 2011, the debt of the system is increased by 173%, making it imperative to takeexpenditure control measures and announced that, since the entry into force of the new copayment formula last July, the bill had been significantly reduced dosage (in September, 25%): in three months have spread 10 million less of recipes and have saved 890 million euros.


Rivero announced that it will continue to review the portfolio of services and to eliminate outdated procedures and techniques, while more modern ones will be added according to technical criteria developed by an expert group. Similarly, he argued that some services will leave the core portfolio and will become considered supplementary or accessories.


Administrative Reform mutualism


More critical of the Royal Decree was Enrique de Porres, who warned that this rule does not cover the whole National Health System and hardly develop any aspect of private healthcare or administrative mutualism. ASISA CEO opted for the creation of a local sanitary mutual coordination between the three state (MUFACE, MUGEJU and ISFAS) that allows participating companies ofsystem having one contact with to discuss the future of a model, he said, provides the service at a cost 50% lower than the public system of direct management by the authorities.


For De Porres, "funding is a problem endemic to the model, which is aggravated by the lack of notice of public sector jobs, which causes aging of the civil service resulting in a worsening of the funding problems."

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