One of the instructions to increase profits at Torrejon Hospital, a privately run public hospital, was to reuse single-use sanitary products. This was reported in the internal ethics channel by the sacked managers, and mentioned in documents to which EL PAÍS had access, although a spokesman for the Ribera Salud group, the company that runs the hospital, denies carrying out the practice.
It’s all part of Ribera Salud’s plans to increase its profits, which came to light when this newspaper published audio recordings in which the company’s CEO, Pablo Gallart, gave instructions to increase waiting lists and choose profitable activity to achieve EBITDA of “four or five million euros.”
Three members of the group’s health care management and the director of the Torrejon Hospital filed complaints in the ethical channel that included these orders, as well as the sterilization of single-use catheters. She warned, “This procedure is illegal, and according to the technical data sheet, this material cannot be re-sterilized.” A few days after these complaints were filed, these four signatories were fired from Ribera Salud, although the company confirmed that the dismissals were not related to these events.
The indicated catheters are used, among other things, in electrophysiology procedures, and are an essential tool in interventional cardiology for the diagnosis and treatment of arrhythmias. It can cost more than 2000 euros.
It is a device that contains very thin, flexible tubes and electrodes at the tip that are inserted through a vein or artery into the heart to study its electrical activity from the inside. In Europe, these products carry the CE mark for single use.
This type of material can only be reused in hospitals if the reprocessing (including cleaning, disinfection and all stages of reuse) is carried out by a reprocessing manufacturing company that meets all the requirements that apply to it (Regulation 745/2017 and Royal Decree 2023/192).
Up to 10 times
The instructions received by Torrejon hospital staff, which this newspaper has access to, go in the opposite direction. It is sterilized after use a maximum of 10 times, provided that it is in good condition. These are the guidelines introduced two weeks after the September 25 meeting in which Gallart asked his subordinates to use “imagination” to “identify operations that are not contributing to the company’s EBITDA (profitable).”
According to Ignasi Anguera, director of the electrophysiology unit at Hospital Bellvite (Hospitalet de Llobregat), all electrophysiology catheters sold in Europe are single-use, and there is only one way to reuse them: sending them to a company that renews them and re-applies the CE stamp for single use.
“In the European Union, there is only one, and it is in Germany. Some of them are disposed of due to requirements for sterility and technical and mechanical efficiency. In the end, a percentage can be reintroduced. This, if they meet the requirements, can be done several times, but a small number, between two and four, at most,” says Anguera.
Bellvitge Hospital is immersed in this reuse scheme, which is common in other countries. But it must be done through this approved procedure, taking the necessary safety measures and, as the hospital states, “through a comprehensive cleaning and sterilization system, along with up to twenty mechanical, microbiological and visual tests, among others.” The end result is a catheter that has the same guarantees, functionality and CE marking as a new catheter, thus rejoining the hospital supply chain.
In complaints submitted through the ethical channel of the Ribera Group, the dismissed directors warned of “bad practices” that could put “the health of patients” at risk. One of them, the medical director of Ribeira Salud, said goodbye in an email to about two dozen people, saying he could not “give in to the threat” of managers carrying out dangerous practices on hospital users.
Investigations in Torrejon
Due to what El Pais newspaper published this week, the Ministry of Health has launched an investigation to check whether there are irregularities at the Torrejón de Ardoz Hospital. Gallart, CEO of Ribera Salud, resigned from managing the center, although he continues in his position in the group, which announced an internal audit.
Some of the instructions from Gallart to his leadership may have been inconsistent with the privilege that Ribera Salud received to manage the general center, such as selecting operations and rejecting “no” patients. individual“Expensive, that is, they do not belong to the influential population, that is, about 150,000 residents of Torrejón and some neighboring towns.
The management model on which the hospital is based was invented by the Ribera Salud group itself, which promoted it at the end of the 1990s in the Valencian Community. It has since spread to Madrid and Galicia, which is also governed by the People’s Party. It consists of the company building the hospital and managing it for a period of time – 30 years in Torrejon’s case – for a fixed fee paid by the Ministry of Health to serve a specific population. This means that the less money you spend on support and the more you save on operations, the greater the benefit.
Unlike other franchises, there is no payment for the services provided: the fee covers the entire activity. For all patient purposes, the center is integrated into the public network. Yes, you get additional income for each user. “No.” individual“Who serves, i.e. residents in other areas of Madrid who request to go to hospital under the Community Freedom of Choice Law, which allows the choice of center and specialist.
The Madrid government has pumped in an additional €88 million in fees in the last five years to Ribera Salud to run the Torrejon hospital. Added to this is an additional bailout of 32.7 million euros in July after negotiations in which the group claimed that without this amount it would not be able to repay the debts acquired in its investment in Madrid, which in 2022 reached 124 million euros.
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