The president of Andalusia has publicly expressed that in the next electoral period he wants to “transform the Andalusian health system so that it is more flexible, more digital, less rigid and less opaque. Bring it into the 21st century”. And I said it before the election so people would understand.
I added that “those who don’t want to vote don’t vote and those who want to modernize healthcare love it”.
If I can vote in Andalusia, I will tend to vote without a doubt. I believe that our country’s biggest problem, aside from doubts about its effect on health and well-being and the completeness of its solution, is what affects our health care.
The main structural problem of the health systems of our autonomous communities is neither economic nor political. It’s organizational. But saying yes, even if you are valuable, is not enough. Now it’s time to explain how.
In the last few years, Andalusia’s health requirements have increased very significantly, exceeding cumulative increases of 50%. Andalucia has indeed moved from the bottom of sanitary gas to the mid-high positions of the autonomous ranking.
However, this effort was not recorded in terms of product in terms of the number of surgical procedures or hospital facilities similar to last year.
That’s why it’s not a question of money. Nadie will be able to respond to the Andalusian president – even if they want to – which has not been reversed in the public system. The question is: what happened?
Oh yes, there it is health policy has failed in light of the results. Not if you implemented the model. Because modernization is no longer pleasant; Modernize and manage better.
The SAS delegates focus on the request to cancel the Tarificación de Convenios y Conciertos SAS Order.
The first legislative period started badly when the first person in the Andalusian government was to convert the public health enterprises of the community – called “health clinics” but competing in indicators and efficiency with the best public hospitals – into a statutory management model published directly by the unions, which represents a real brake on the production and efficiency of this product.
We cannot explain the results in quality assistance, because in the model of public management for administration, it is not public, or at least not public to anyone. From now on, under the influence of the social noise and the political environment, there were erratic and complex decisions that led to the questioning of the concerts – or the assumption that it is a veteran – or the criticism of the Balearic PSOE for support measures to ensure private health care for tourists in the Balearics This community is organized in real life.
In truth, if you want a 21st century healthcare system from an autonomous community, you need to be treated a lot less. Here, without intending to lecture the President of the Council and in my humble opinion, there are some suggestions that should hopefully not be followed:
1. Reform the management model and work regime
The actual model is designed to throttle and manage condition, not maximize results. A strict, homogenous and inflexible legal regime prevents the reward of merit, the differentiation of productivity and the attraction of talent, which is incompatible with increasing the productivity that exists among people. A modern system requires:
– Professional management.
– Objective evaluation of results.
– Performance related incentives.
– Real organizational flexibility.
In this case, any reform will be cosmetic.
2. Real transparency of results
When the president talks about opacity, it’s not a metaphor. Currently in Andalusia – as in all cases in Spain – the citizen cannot consult in a clear and accessible way:
– Clinical results adjusted for completeness.
– In real time in the center.
– Comparative indicators within hospitals.
– The result is quality and patient safety.
Modernization means publishing comparable, audited and comprehensible data. Transparency does not weaken the system; on the contrary, it improves it.
3. A real trade-off with hope lists
No one can talk about modernization while more than a thousand Andalusians wait months for an intervention or a diagnostic test. Reduce list requirements:
– Use all available resources.
– Do not dogmatize public-private sector cooperation.
– Incorporate mutual work in checking and monitoring absence in the process.
– Stable medium-sized objects and clean spaces.
It is not a matter of ideology; It’s about solving people’s problems so they can solve them in a timely manner. This is what Andalusians will appreciate the most and what will have the greatest effect in the next elections.
4. Digitization and innovation with AI
You cannot talk about digital transformation and ignore that a very significant part of aid delivery is private. Concerts, derivations and structural collaborations take place in Andalusia. Patients circulate in systems; clinical information must also be provided. Model XXI exige:
– Historia clinic interoperable real.
– Integration of public and private data.
– Advanced use of popular analytics.
Let’s also implement AI innovation with planning.
AI is not marketing, it is a clinical tool. It can reduce error rates, optimize agendas, improve diagnosis and free up medical time. However, it requires management, evaluation and proper deployment.
Andalucia, if you really want to modernize, you cannot ask as expected, while other systems are advancing before the failure of the common national project.
“If the organizational model does not change, the wish lists will continue, the professional frustration will continue, the perception of opacity will not go away and the appetite will continue to grow with commensurate results.”
5. Better access to pharmaceutical and technological innovation
Slow adoption of innovative therapies creates desire and lost clinical opportunities.
There is a part that apparently does not depend on the board – the official authorization of the Spanish Agencia del Medicamento y Productos Sanitarios or related to the price commission -. However, once these filters pass, there is a need to homogenize protocols and simplify processes so that innovation applies to all Andalusians and access to medicines does not depend on the province or even the hospital in question.
6. A real priority for mayors and employees
Envejecimiento is a great destination. We need:
– Real social-health integration from the assumed point of view.
– Powerful home care.
– Redistribution of gas due to chronic disease.
– Effective coordination between health and social services.
It’s not just efficiency; It is dignity and social justice.
7. Primary care with autonomy and I pay for results
No more hiring more doctors. Hay que:
– Give professionals organizational autonomy.
– Medir results in health.
– Support prevention and solutions.
– Integrate multidisciplinary teams.
Without autonomy, the Primary will continue to be the heart of the system.
8. Focus on high completion
The evidence is clear: more volume, better results. Not all hospitals have to be completely finished. Equidad does not consist in dispersing the whole; equidad guarantees the best possible result. Rescheduling courses are not limited to hospitals; be better organized and more efficient.
In the end, a clear principle must prevail. Which future model should take priority in this order:
1. Productivity.
2. Healthy results.
3. Efficiency.
Because you enjoy more without results, there is no progress; es complancia
The Andalusian president said he wants to change the system and that those who are not sure don’t vote. It’s perfect. But change requires building structures, accepting resistance, and defying historical inertia.
Now comes the difficult part: to maintain this determination while fighting resistance. Therefore we will see: unions, corporations, ideologies and guts.
Reformar de verdad means to inconvenience; bother until you get the results and note composition firsthand. And yes, everything will change.
Presupuesto sin reforma es más de lo mismo. Andalusia increased its health turnover, and it was necessary. But if the organizational model does not change, the wish lists will continue, the professional frustration will continue, the perception of opacity will not go away, and the taste will continue to grow with commensurate results.
Don’t stop with more gas: let’s manage better. It creates strong courage, cohesion and discipline. Now is the time to show it off.
*** Juan Abarca Cidón is the president of HM Hospitales.
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