Until the summer of 2023, the Infanta Leonor General Hospital, in Vallecas, had a pain unit. An anesthesiologist, a rheumatologist or traumatologist, a nurse and an assistant technician came into the “operating room” — a small room where outpatient surgeries are performed — to provide care for a small number of patients who needed treatment for chronic pain. Many of them were post-operative people who needed infiltrations or nerve blocks to relieve pain that other methods did not relieve. Until one day there were no more appointments on the agenda, the anesthetist did not come, and the room was dedicated exclusively to the usual minor surgical interventions. For two years, talk about the Infanta Leonor Pain Unit stopped, but a few days ago news spread that the Community of Madrid is looking for a private company to carry out these procedures.
The Ministry of Health presented the contract file for “health care service in treating chronic pain for patients at the Infanta Leonor University Hospital.” “Due to the lack of material resources and specialized personnel to carry out the activities that constitute the service that is the subject of the contract, it is necessary to resort to external contracting,” says Health in one of the tender documents, signed by the hospital director, María del Carmen Pantoja.
“This strategy is a clear example of the deterioration that the PP regional government is inflicting on public health to justify its gradual privatization,” the CC OO denounced in a statement on Wednesday. “In doing so, they further reduce the workforce of public employees in the sector and inflate the income statements of some private health groups by pumping out millions of dollars of funds from all Madrid residents.”
The Infanta Leonor Pain Unit was not a service that required significant resources, neither material nor human. In fact, only three or four specialists were needed, and appointments, while successful, were only open one day a week, so they did not have a large influx of patients. “We did not have long waiting lists. The patient was treated by the specialist who referred him to the pain unit and he received treatment in the same place. I do not understand what resources the Ministry of Health is referring to,” says Maina Nuñez, delegate of Infanta Leonor at CC OO, a union that denounced the new “privatization” of Madrid’s public health system.
The workers of the Infanta Leonor and the opposition parties of the Madrid Assembly are amazed by the fact that Health is hiding behind the fact that it does not have the human and material resources to recreate a small pain unit like the one in this hospital. The contract on offer is being offered for a relatively low sum, €87,757.31 for implementation within 12 months, although it is recognized that this amount could reach more than €450,000 in the case of modifications and extensions (up to 60 months).
Carlos Moreno, a Socialist Workers’ Party deputy in the Madrid Assembly, says it is a “scandal” that the Ministry of Health does not have the resources for a pain unit that requires about five specialists. “It is very concerning that the public hospital is unable to maintain minimum staffing,” Moreno says. “As of September 30, the ministry has a balance of 14 million euros free of charge that can be used in the pain unit of the Infanta Leonor Hospital,” he adds.
A spokesman for the regional Ministry of Health responds, saying: “To ensure healthcare for its users in this region, with optimal quality, a tender has been issued to outsource this service.” He points out that this measure falls within the “maximum degree of legality” and that “it is not a unique case, whether in this hospital or in any other public health complex in Madrid, nor in relation to other services that do not fall within the service services of specific hospitals.”
Infanta Leonor Hospital is a public hospital that operates according to a hybrid model, where clinical services are provided by staff appointed by the regional administration, while other services such as cafeteria, security or laundry are provided by a private company. Outsourcing a pain unit does not mean that the private company that provides all of these services will take over those services, but rather that the department is looking for someone who can meet those needs outside of the center.
Marta Carmona, representative of Más Madrid, has no doubt that the Quirón group is the beneficiary of this new tender. “Quirón can apply for all contracts because it is infused with public money from the Community of Madrid, which is why it can present very interesting proposals compared to other companies,” he points out.
The representative links the model of this privatization to the model of Torrejon Hospital, whose director, as revealed by El Pais newspaper, asked the heads of the center to stop caring for patients who earn less money. “We have to keep in mind that patients treated in a pain unit are expensive patients, because many things have to be tried before they get better,” he explains. “If they go private, they won’t have to worry about finding the best treatment, but rather the cheapest treatment.”
According to CC OO, some Infanta Leonor patients who needed these treatments were cared for by a trauma doctor and two nurses at the Vicente Soldevila Health Center, in Puente de Vallecas. However, since there was no outside surgical area where operations could be performed, many of them were sent to the pain unit of Gregorio Marañon Hospital. “The problem is that Marañón deprives us of patients on many occasions because it is saturated,” says Maina Nuñez, CC OO delegate at Infanta Leonor.
Now, the Community of Madrid is seeking to outsource, or similarly privatize, this service. “It is not possible for the hospital to develop an appropriate service, due to the limitations of its own resources, and the complexity and specificity of the treatments because it lacks the necessary resources to do so, both human and material, due to the level of complexity and specialization necessary to be able to carry out these treatments with the required conditions and help in the recovery of patients who need them,” they reiterated in one of the tender reports.