No One On Duty: Health service

Education and the fiasco over trilingual teaching have meant that arguments and debates concerning the regional government's management of public services have tended to neglect the equally important health service. The weight given to these arguments may well now be shifting, and they are ones which further damage the government and make the possibility of the Partido Popular forming the next government even more remote.

Last month, the regional health minister, Martí Sansaloni, asked the finance ministry of José Vicente Marí for a line of credit of 40 million euros. He needed the money as without it salaries for the rest of the year would not be paid. Sansaloni had held out the begging bowl last year as well. Then, he only wanted 20 million in order to ensure that salaries were paid. The request for credit in October has to be seen in the context of what had been an increase of over 25 million euros to the total health budget for 2014. It was up to 1,195 million. Yet, despite this increase the credit requirement doubled. Nevertheless, Marí's finance ministry agreed to the request, but only 36 million. Sansaloni has to find four million euros' worth of savings over the final weeks of the year.

Sansaloni, who inherited the health job following the departures of two previous ministers, has had his share of difficulties since becoming minister. They have included the controversial case of Alpha Pam, the Senegalese immigrant who, as he was "sin papeles", was denied treatment at Inca Hospital that, as an emergency case, he should have received. His death and the fallout from it have clouded Sansaloni's time as minister, but this was something of an exceptional case. Far less exceptional is the day-to-day running of the health service and how that service is now operating. Or not.

In July, the PSOE opposition demanded answers related to what it described as the bad administration and absolute inefficiency of the health service. It pointed to a 30% fall in operations and to a waiting-list increase of over 100% - 51 to 121 days. In September, Sansaloni was in Madrid for a meeting to consider the challenges facing the Spanish health service. At that gathering he spoke of the need to change the tendency from greater costs to lower budgets and said that in the Balearics the health service was working with over one thousand fewer workers but good results and no fall in care.

So, he presented a different picture of the health service to the one which PSOE did. Moreover, when he spoke of lower budgets, he neglected the fact that the Balearics health budget had risen by just over 2% in 2013. He wouldn't have known then that the budget for 2015 was also set to rise and more substantially so, by over 10%.

That budget for next year actually contemplates some cuts. Son Espases, Son Llàtzer, Inca and Manacor hospitals will also have reductions in spend; not huge, but reductions nonetheless. It will be interesting to see, whoever is health minister this time next year, whether credit for salaries has to be asked for once again. But the question is, why is there this need for credit? As staff numbers have been slashed to the extent they have, as thousands of drugs and other products have been removed from the health service's "catalogue", why does the health service still find itself incapable of operating to a budget, one which is in any event higher?

The remedial measures that Sansaloni has had to adopt in order to meet the terms of the finance ministry credit include not covering for staff who are sick or on holiday. This has given rise to situations such as those in Puerto Alcúdia, Sa Pobla and Puerto Pollensa, where there have been no medical staff on duty at given times at the local health centres. The El Pi party has added its voice to that of PSOE in describing this failure in staff cover as "bad management policy" with "citizens the victims". From what Sansaloni had to say in September, it would have been thought that such a failure couldn't occur because IB-Salut, the Balearics health service, was not experiencing any fall in care. But it clearly is. And moreover, it is a fall in care despite budgets having risen and despite cuts to staff and drugs which were said didn't result in poorer levels of care.

A curiosity of the current government is that, for all the austerity that was spoken of, its total budget is now higher - by 362 million euros - than in its first year of government. The health service accounts for some of this. But where's the money going? People might want to ask that question in May when they're heading for the polling stations, bearing in mind that in November they found there were no medical staff on duty at their health centres.