Showing posts with label IB-Salut. Show all posts
Showing posts with label IB-Salut. Show all posts

Friday, July 10, 2015

Family Relations Are Good For Your Health

Well, it was hardly unexpected. For new members of the regional government, there was the potential pitfall facing the health minister, Patricia Gómez. And blow me, she has tripped up in precisely the fashion that had been suggested. It is, therefore, wholly to have been expected that the Partido Popular - minus a leader but being represented in parliament by the presentable Marga Prohens - should shout nepotistic foul. When you, as newly made health minister, go and appoint your husband as director-general of the IB-Salut health service, then you should anticipate that some flak might come your way. The surprising thing is that there isn't more of it.

Juli, otherwise known as Julio, Fuster is Mr. Gómez. He had been in the running for the health minister's job, but the missus got it instead: it would have been less likely that she, had Juli secured the ministerial post, would have got the IB-Salut post. Marga has described the appointment as "unacceptable", "neither transparent nor good government" and "an insult to the intelligence". She might also have added that it looks like a bit of a carve-up.

President Armengol insists that there are now two people who are "professionally magnificent and exceptional" in terms of their CVs in situ at health. Patricia, meanwhile, does not consider there to be any conflict in the appointment when the "director-general has a brilliant professional career" which rises above his personal background.

I'm not for one moment doubting that either of them is anything other than professionally magnificent and exceptional, but no conflict? Come on, of course there is. Marga's accusation of lack of transparency might be said to not hold much water when Fuster's name is there for all to see on the government's website, but the allusion she makes to transparency is perfectly understandable. What were the criteria for the appointment and who else had been in the running? Anyone?

But even assuming that Fuster matched the criteria perfectly (which I'm sure he does) and was a superior candidate to others, Marga's transparency charge cuts deep into what we believed we would now be getting from governments. Open ones, free of suspicions; transparent ones with no hints of anything conducted behind closed doors. Transparency is code for being against corruption, of which there is absolutely no suggestion in this instance, and I'm most definitely not saying there is, but in the murkiness of all that brought Podemos (and now others) to the conclusion that the time was right for a "new politics", there often lay allegations of nepotism, of favouritism, of "amiguismo": more than just allegations; they were fact.

It was nepotism and cronyism that went a good way to bringing Spain to its knees. This was because of the appointments to boards of banks - mainly smallish, local savings banks - of those with no banking experience and seemingly no ability to ensure good governance or to not succumb to the occasional temptation.

There is no reason, let me stress again, for believing that the appointment has been made for anything other than perfectly sound professional reasons, but the merits of Fuster are not, in the current climate, what matter above all else. What does matter is perception. If the public (and opposition) perceive negativity because of a suspicion of nepotism, then I'm terribly sorry, Patricia, but there is conflict.

When, during the lifetime of the previous administration, the tourism minister Carlos Delgado appointed his girlfriend (later his wife) to a post as adviser to the ministry (on a salary of some 50,000 euros), PSOE and Més demanded that he resign. Carlos defended the appointment, saying that Lourdes, the girlfriend, was highly qualified for the role (something to do with communication at the ministry) as she was a journalist and spoke five languages. No doubt she was perfectly qualified, and the PP leadership at the time didn't, despite Bauzá's mission to preside over a government minus any hints of sleaze, see anything amiss, until the story blew up in the leadership's and Delgado's faces: he was forced to withdraw the appointment.

The circumstances may be different, but is the principle not the same? And where, one has to ask, are Podemos in all this? As they seem to have poked their noses into mostly all parts of the new government's organisation, does Fuster's appointment not strike them as being maybe contradictory to what they avow?

Fuster is eminently suited to the post. He was previously the IB-Salut director during the first PSOE-led government from 1999. So yes, he's surely the right man and, yes, the health service will be in good hands. But. The new politics. What's changed? Ada Colau in Barcelona has appointed her husband to her team. The co-ordinator at the Madrid mayor's office is the husband of the niece of Manuela Carmena (the new mayor). Podemos types both.

Thursday, November 06, 2014

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.

Tuesday, February 21, 2012

MALLORCA TODAY - Ambulance workers protest over non-payments

More problems for the heavily indebted Balearics health service IB-Salut. Ambulance drivers and personnel attached to the company SSG protested yesterday over payments not made by the health service, which include the Christmas bonus.

Tuesday, January 31, 2012

Cry Wolf: Hay Mucha Crisis

Permission if I may. The next time someone says "hay mucha crisis", may I be allowed to punch them out?

I have come to the conclusion that many a Mallorcan rather likes there being mucha crisis. It has become a comforting state of being over the past three to four years; comforting in that it allows any form of enquiry that might require the handing over of money or the taking of action to be met with a shrug and a smug look of superiority. Hay mucha crisis but my crisis is better than your crisis, or is it that it is not as bad as your crisis? There's mucha and then there's mucha. Or even muchísima.

The chanting of the c-word is so predictable that it has caused a disruption to normal, everyday, banal intercourse. What's the point of asking how things are going when you know beforehand that they are not going and that they are accompanied by mucha crisis. You can't ever be sure that there really is mucha crisis, but you can be sure that it is being used an excuse even if it is merely poca or ninguna.

Maybe there's a business to be made out of making t-shirts emblazoned with the legend "don't tell me there's a crisis", so that whenever you encounter a Mallorcan in whatever situation it might be he or she might be deterred from parroting the "HMC" line. Except no one would buy the t-shirt because there is of course mucha crisis. Or they might buy one so long as they are given a hefty discount or can pay in instalments, and also so long as you can go along and collect the instalments, only to find that they have no dinero because there is ... you guessed it.

If and when there is no longer mucha crisis, how are people going to cope? Crisis dependency has taken hold. It will require treatment at crisis addiction clinics to restore the crisis dependent to normality. But there's little chance of post-crisis Balearics having a health service that is sufficiently restored to good health to be able to cater for the needs of the crisis addicts. So deep is the health service in crisis that it will take years to pay off its debts, if they ever are to be paid off. 550 million euros in the red at the end of 2011. A mere bagatelle to pay off.

Want crisis? I mean, really want crisis? Then look no further than IB-Salut. Oh, it functions well enough, despite the debt, but it is an example of how mucha crisis can border on the inhumane, as is the case with immigrants from some African, Asian and South American countries who have little or no resources or who can't prove that they have and who are being denied a health card that would enable them to get health assistance.

All sorts of questions arise from this, such as having paid into the social security system or not, but don't let's think this is something confined to people from some part of deepest Africa. What if you're British but unable to prove that you have work? There seems some confusion among IB-Salut health centres. In fact, some don't really know, though one or two do. Off you go. Hay mucha crisis, and that's the end of the matter.

A correspondent asked the question of his local health centre (not that it affected him but he wanted to find out). If you are not working, then would you get a new health card? It would depend, came the answer. On what wasn't clear. Hay mucha crisis explained it all, or rather didn't explain anything.

Proving entitlement or having entitlement is reasonable, but what isn't is the confusion that is allowed to creep in with the mucha crisis shrug and justification. It is heartless, callous and confirms that it is the case that your crisis, if you are not Mallorcan/Spanish, is worse. As the same correspondent puts it, even if you have lived in Mallorca for years, you are still a foreigner and you can get lost.

Mucha crisis changes everything. The debt-ridden health service is only a part of it. Let me cite the correspondent once again, one who is anything but a newcomer to the island. The fear is that everything is going to implode. I don't know that it will. Apart from the indignados' protests and some strikes, mucha crisis has not taken on a worrying dimension. What lies ahead in the next few months, one can't really say, but perhaps there is hope that there is some comfort in there being mucha crisis. It is one of resignation more than agitation.

There is mucha crisis, of course there is, and it is being experienced by all sorts of people. 25% unemployment in the Balearics. Record number of households with everyone out of work. One in four people at risk of poverty or social exclusion. These people know about mucha crisis. It's the mucha crisis of the wolf-criers that makes so many despair. There's no sympathy when "hay mucha crisis", and they are down to their last finca or two.

* Just for those not up to speed with the native, "hay mucha crisis" (there is much crisis) is pronounced like "eye, moochah cree-sis".


Any comments to andrew@thealcudiaguide.com please.


Index for January 2012

Alcúdia's Roman ports - 21 January 2012
All-inclusives, increased potential of - 25 January 2012
Antoni Maria Alcover and language - 30 January 2012
Baltasar Garzón, Manos Limpias and - 17 January 2012
Catholic Church and Partido Popular - 3 January 2012
Christian names and surnames, Mallorcan - 23 January 2012
Economic crisis, health service and foreigners - 31 January 2012
Gay tourism, Cala Rajada and - 22 January 2012
Jaume Matas trial - 14 January 2012
José Manuel Soria, tourism minister - 12 January 2012
Language in the public sector - 18 January 2012
Local newspapers in Mallorca - 9 January 2012
North-south divide in Mallorca - 24 January 2012
Olympic Games, expat perspective on - 2 January 2012
Opening hours, shop - 10 January 2012
Partido Popular, splits in the - 7 January 2012, 15 January 2012, 20 January 2012
President Bauzá in discussion with the opposition - 26 January 2012
PSOE, leadership of - 13 January 2012
R&D, Spanish - 5 January 2012
Renewable energy in the Balearics - 19 January 2012
Retailers, leading Spanish - 27 January 2012
Spanair collapse - 29 January 2012
Spanish Government budget - 1 January 2012
Table football - 28 January 2012
Three Kings, racism and - 6 January 2012
Tourism law, opposition to - 4 January 2012, 8 January 2012
Tourist office privatisation - 11 January 2012
Water resources plan and land classification - 16 January 2012

Friday, July 22, 2011

The Sick Man Of Mallorca: Chemists

The chap who runs my local pharmacy, who I suppose I should therefore refer to as the pharmacist, habitually wears a resigned expression. It is one that has been forlornly chiselled from years of what happens over the counter.

This sufferance is at its most patient when he has been on the receiving end of a German interrogation. "They ask so many questions," he once sighed. Observing a German tourist in full chemist-shop inquisition mode confirms what he says. The boxes of creams, pills, sprays are first examined and the leaflet then removed and gone through item by item, a difficult enough process if you can read and speak Spanish but considerably more so if you can't.

Get in a chemist shop queue behind a bunch of Germans and you are most likely to die before it comes to your turn. However, as I pointed out to the pharmacist, his fellow island men and women could test the patience of any saintly Joan, Jaume or Cati the chemist. His resigned expression can swiftly turn to a laugh.

Mallorcans have an unnerving habit of repeating everything you say to them. In the pharmacy, such parrotting results in delays that not even German hypochondriacs could cause (and trust me when I say that Germans are hypochondriacs; it's a consequence of their health system).

Another unnerving Mallorcan habit, one especially among older Mallorcan stock, is to stare blankly at an interlocutor once the exchange has supposedly ended. The blankness demands that the whole exchange is then repeated. Not once more but at least twice more. An ingrained and conditioned compliance with Spanish bureaucracy demands that any encounter is done in triplicate, and the chemist shop encounter is no different.

The British tourist, on the other hand, is unlikely to delay the pharmacist for too long. Indeed, the encounter can be over very swiftly if the Brit tourist senses he or she might not be being understood and so leaves in embarrassment. But actually verbalising symptoms is rarely necessary. Pointing is a universal language, as in pointing at a violent sunburn, at a throbbing head and a green tinge to the gills, at a Vesuvian mosquito eruption.

Ask yourselves this. What is the most important service required by a tourist? A bar, a supermarket, a taxi? No, none of these. It's the chemists. It's why I am full of admiration of my pharmacist, his fellow pharmassistants, and indeed all other pharmacy personnel in Mallorca's tourist areas. Just think what they have to put up with. Next time you see Helga from Hamburg dissecting the meaning of all the "uso de otros medicamentos" etc., then you'll begin to understand why I am sympathetic to their cause.

And this cause is all the greater because they don't get paid what they should get paid.

Publicity that has been given to the rotten state of finances at the tourism ministry has tended to overshadow the fact that IB-Salut, the regional health authority, is also on the critical list. It is IB-Salut that is meant to divvy up to the pharmacies, and it hasn't. For May and June, some 36 million euros remain unpaid. The chemists are threatening to pull down the shutters on 29 July and it is uncertain how long they might keep them down.

There would still be a chemist in a local area that stays open, but the convenience of having five chemists, which, as an example, is the case in Puerto Alcúdia, would go.

Shutting the shop might seem like cutting off the chemist's nose to spite his face, but unlike the pathetic attempt by bars to protest against the effects of the smoking ban by closing for a few hours (a protest only undertaken by a collection of bars in Palma and one that had absolutely no impact), this lockout is potentially far more serious and far more meaningful.

Everything in Mallorca pretty much links in with tourism, and the chemists are no exception. They are, as I suggest, one of the most important tourism services. There is going to be some major inconvenience if the chemists go ahead with their threat and if it is observed with anything like solidarity. Idiot barowners closing for a couple of hours is irrelevant, airport workers striking can be put down to bolshy unions, but chemists effectively going on strike is a very different matter. When people's health comes into the equation, the potential harm to reputation and image is way greater than anything that baggage handlers or air-traffic control can conjure up.

It needs sorting out, and it needs sorting out pretty damn quick.


Any comments to andrew@thealcudiaguide.com please.

Wednesday, July 20, 2011

MALLORCA TODAY - Chemists in Mallorca threaten not to open

Pharmacies in Mallorca, owed millions of euros by the regional government through the indebted public health authority, IB-Salut, are threatening to close on 29 July unless they are paid. Chemists would therefore open only for emergencies and on a "guardia" basis, i.e. those shops in a local area which maintain service in any event when others are shut. The duration of this closure has yet to be decided, while the chemists are also considering other measures, such as not accepting "electronic prescriptions" (which many do not like anyway).

Tuesday, November 30, 2010

Chain Reaction: Bankruptcies and non-payments

Spain's economic woes are receiving plenty of airing, but what about what is happening on the ground? The crisis is such that one has an impression that much economic life in Mallorca is all but grinding to a halt, brought about by a lack of credit, non-payments, negative cash flows and bankruptcies.

Businesses in Mallorca are caught in the chain reaction of the absence of liquidity in both the private and public sectors. Of the latter, those affected are suppliers to town halls and other governmental bodies and those linked directly to government agencies. Take chemists, for instance. Some had started posting notices to the effect that they could not supply prescriptions through the local health system because the health agency, IB-Salut, was not paying them. IB-Salut, and its problems have been known about for months, is another division of regional government, like the tourism ministry, so in debt that the government is having to bail it out. The government has at least sought to reassure the chemists and patients of the health system that prescriptions will be guaranteed.

The town halls, notorious as bad payers even in the good times, can typically take six months or more in honouring invoices. The Council of Mallorca has had to reach into its pockets to give the town halls some cash that they cannot otherwise raise because central government has imposed restrictions on their capacity to borrow and thus get into further debt.

It's not all bad news. One town hall, Alcúdia's, is being reimbursed by central government, following a protracted legal battle to get back IVA which was wrongly charged to its services agency, EMSA. The 600,000 or so euros that the court has so far agreed to could rise. In the meantime, the repaid IVA will help to clear debts the town hall has to suppliers.

If only all town halls or businesses could benefit from such windfalls. If only, especially for smaller businesses, there were mechanisms to prevent their bankruptcy when faced with what is an increasingly common occurrence, the protection of voluntary administration by larger businesses which then do not make payments while they buy time to try and sort out their affairs. For the smaller businesses, their suppliers, there simply isn't the time. And so they try and come to agreements with their own creditors or go bust and then find themselves blacklisted by banks.

The main business sectors affected have been construction, hostelry (in its widest sense, to include hotels as well as restaurants etc.) and transport. And there have been some big names that have got into difficulty. One of these is Marsans, formerly the ultimate owner, through the hotel chain Hotetur, of the Bellevue complex in Alcúdia. The sale of Marsans' businesses earlier this year looked as though it might have brought salvation. The problems have persisted, though the new owners seem to have arrived at a solution that will see creditors paid and so stave off a court order that was to place Hotetur in voluntary administration, one that creditors had not sought when urging the court to force bankruptcy in pursuit of the money they were owed.

Even if a solution is found, there is also the effect on local business confidence to be taken into account. In the case of the huge Bellevue, any uncertainty sets the rumour mill ablaze, one not helped by staff being paid only 70% of their October salaries (as was being reported in the middle of November). Just the threat of administration for a major employer and purchaser of services, to say nothing of supplier of tourists, is sufficient to drain even more life from the sick body of the local economy.

Lawyers have expressed concerns about the bankruptcy law which came into force in 2004. It was one, they say, drafted at a time when things were good and when bankruptcy was relatively uncommon. Since 2008 the trickle has become an avalanche. While voluntary status has its benefits for the company facing bankruptcy, it does little for suppliers.

One lawyer has described the system as an abuse of the law, and the overwhelming majority of companies that enter administration subsequently fail, some of them emerging later under new names with new owners, for example, a son or daughter, thus getting around the banks' blacklist. It has been said that the law makes it easy to simply close and disappear but also to get re-established in a different guise. And then perhaps to set the same chain reaction in motion, of smaller businesses, the suppliers, being left unpaid and ending up going to the wall all over again.

The chain reaction is likely to continue, likely to get worse. You can also describe the situation as a vicious circle, and the question is when or if the circle will be broken, because there is no sign of it being so.


Any comments to andrew@thealcudiaguide.com please.


Index for November 2010
Bankruptcies, non-payments and - 30 November 2010
Capdepera, new agriculture and - 13 November 2010
Catalonian independence, Joan Laporta and - 16 November 2010
Celebrity advertising, Rafael Nadal and - 3 November 2010
Chinese tourists - 24 November 2010, 25 November 2010
Christmas, spending and - 15 November 2010
Dunes in Can Picafort and Playa de Muro - 2 November 2010
Ensaïmada - 8 November 2010
Euro, Europeanism and Ireland - 23 November 2010
Facebook and tourism promotion - 4 November 2010
German versus British tourism - 9 November 2010
Golfers in Balearics, low number of - 27 November 2010
Graffiti artists face prison sentences - 28 November 2010
Guardia Civil and Catalan incidents - 18 November 2010
Hotel over-supply - 1 November 2010
Hunting - 11 November 2010
Inca hospital and patient information - 12 November 2010
Loneliness, expatriate - 5 November 2010
Mallorca identity and resorts - 22 November 2010
Muro employees paying salaries back - 25 November 2010
Playa de Palma regeneration - 20 November 2010
Pollensa and local tourism - 21 November 2010
Pope and Spanish secularism - 7 November 2010
Pumpkin, Muro fair and - 14 November 2010
RNE3, Siglo 21 and - 26 November 2010
Royal wedding (Kate and William) - 19 November 2010
Surnames and spelling rules, new - 6 November 2010
Tourism secretary-of-state and ministers - 29 November 2010
TripAdvisor and review sites - 10 November 2010
Underage drinking in Spain - 17 November 2010