Indecent Haste: Alpha Pam

The Balearics health minister, Martí Sansaloni, considers the case of Alpha Pam, the Senegalese man who died of tuberculosis, to be closed. Closure has come, according to the minister, because the director of Inca Hospital, where Pam was not treated as an emergency (which by law he should have been, despite not having the right papers), has been dismissed and because disciplinary proceedings are being taken against three other members of the hospital's staff.

Sansaloni might consider the matter closed but this closure has come with unprecedented haste. Matters do not usually get closed quite so swiftly in Mallorca and they have not previously been closed quite so swiftly where Inca Hospital is concerned. There is the case of the alleged breaches of data protection law that were committed by personnel at the hospital and which involved Partido Popular representatives at Inca town hall. This came to light two years ago. As far as I am aware, its investigation and processing through the national agency for data protection and courts has yet to be fully resolved. But as no one died as a result of this apparent illegality, then things can be spun out. When someone does die, best to seek closure quickly and hope everyone forgets about it.

Unfortunately for Sansaloni not everyone is likely to forget about it. And those not doing the forgetting include Santa Margalida town hall (Pam lived in Can Picafort), the Senegalese community, the main PSOE opposition and the now ex-director of the hospital, Fernando Navarro.

The town hall is demanding that compensation be paid to Alpha Pam's family. This demand has been echoed by PSOE and other opposition parties, who are also demanding a full inquiry by a parliamentary commission into what happened and into what they claim was a situation whereby Sansaloni and President Bauzá knew but did nothing to prevent immigrants without papers and health cards being billed for emergency treatment (which they shouldn't have been). This charging is now being rectified, but it was indicative, so government opponents maintain, of the approach to dealing with illegal immigrants and those without a health card, an approach that allegedly contributed to Pam's death.

The government insist that two mistakes were made at Inca, one having been a  medical error in diagnosing bronchitis and not TB, the other having been a failure to apply the rules regarding the treatment of those without papers in cases of emergency. It was a failure to follow these rules that led to the removal of Fernando Navarro, a charge against him that he utterly refutes. Navarro seems determined to defend his honour. The matter will therefore surely not be closed.

PSOE and the opposition are right to press for a full inquiry. If nothing else, there is an inconsistency in the government's insistence that there were two mistakes. If Pam died as a result of the misdiagnosis, then he did not die as a result of a failure by the hospital to attend to him. Something doesn't quite stack up. Moreover, Sansaloni's willingness to so quickly consign the case to history leaves a nasty taste in the mouth. The expedition in investigating the circumstances surrounding Pam's death, the apparent expedience in sacking Navarro, the consequent exculpation of the health ministry and the exigency with which closure has been sought and gained all reinforce a feeling that the Pam case and its handling amount to a failure of decency. And one comes back to the alleged data-protection abuse affair to which none of this speed has applied. Investigations shouldn't have to drag on for months or years, but a death is a more serious issue than the leaking of patient information; it demands a decent period of reflection and not convenient rapidity. 

Members of the Senegalese community on Mallorca met the other day with Senegal's foreign minister, who was in Palma to discuss, among other things, the lack of health care for Senegalese citizens. The minister spoke about the "pain" that his government felt over Pam's death. One thing it may hasten, however, is the return of immigrants to Senegal; the minister was looking at ways to facilitate repatriation. Senegal would like its people to return in order to help with the development of its agricultural industry, so perhaps, in a respect, some good might come of the Pam affair. If they have limited employment opportunities in Mallorca and questionable access to health care, then they would probably be better off returning, but such an eventuality would not remove the need for there to be a full appreciation as to what happened in the case of Alpha Pam. Sansaloni's belief that the case is closed is wrong.


Any comments to andrew@thealcudiaguide.com please.

MALLORCA TODAY - Santa Margalida looks for compensation for Alpha Pam

A change of mayor there has been in Santa Margalida but there is no let-up in the grievances between the town hall and the regional government. The latest issue has to do with the scandal surrounding the death from TB of the Senegalese resident of Can Picafort, Alpha Pam. The government accepts that his death should have been avoided as he wasn't diagnosed with having TB and so therefore treated as an emergency at Inca Hospital, whose director has been sacked. The town hall is to call on the government to compensate Pam's family.

See more: Ultima Hora

When Humanity Collapses

In September last year, a decree was issued that was designed, it was said, to ensure the sustainability of the Spanish national health service. This sustainability was to be guaranteed by removing rights to health care to immigrants without proper documentation and a health card. Illegals, in all likelihood. The implementation of this decree has claimed its first victim. A 28-year-old Senegalese man died last week of tuberculosis because he was refused treatment at Inca Hospital.

Let's not beat around the bush. This is a total disgrace and a savage indictment of the Spanish political class. I know there will be those, because I can already hear their voices, who will argue that illegals, those without papers, those who don't pay taxes, etc., etc. cannot expect to benefit from the health service if they don't contribute to it. This is a point of view with which I am not totally unsympathetic. But a man has died. This is the point. By any standards of humanity, this should not be allowed to happen.

The death of the man, Alpha Pam, has brought forth different versions of how he was dealt with by the local health service. The Balearics health service maintains that he did not take documentation from the centre of primary attention (which presumably means Can Picafort's health centre, where the health service says he had been attended to) when he went to Inca Hospital and so the necessary tests couldn't be carried out. There are other versions, such as a further one on behalf of the regional government which states that he was misdiagnosed in Can Picafort, and he had apparently been to the health centre there on several occasions over several months. The group Médicos del Mundo (MDM) insist that he wasn't attended to in Inca because of a lack of papers and health card. It also insists that he wasn't assigned to a family doctor and that when, on one of his various visits to try and get assistance, was told to go to emergencies in Inca when the health centre was informed that he had relatives who had been hospitalised with TB.

So, who's telling the truth? Not that this really matters to Alpha Pam any longer. For one reason or another, he is dead. If his death is, as MDM believe, the result of the "politics of austerity", then let us wonder at what it is going to cost to fly his body back to Senegal. Someone will have to pay, and it probably won't be his family.

Any number of organisations, in addition to MDM, have been weighing in with their views. They include the college of lawyers in the Balearics, which has said that his death is evidence of discrimination and that Pam's basic dignity, which should be assured under the Spanish Constitution, was not respected. The Catholic Church has also expressed its concern, the Bishop of Guadalajara having made a similar point about basic rights as the lawyers. The church's charity, Caritas, has accused the Spanish Government of failing to guarantee fundamental rights. Let it be noted that these criticisms are from an institution, the Catholic Church, which is normally a strong supporter of the Partido Popular. They are not criticisms of the rabid left.

Because of the national government's decree, Alpha Pam's death is a national matter, but it is also very much a Mallorcan matter. The Balearics health minister, Martí Sansaloni (you'll remember him, because he was the third appointment to a post that had been notable for its revolving door), has been attacked for his heartlessness over the matter. His resignation has been called for and there is a suggestion that legal proceedings should be initiated against the minister for failing to ensure emergency treatment regardless of circumstances.

It should be noted that the September decree did not exclude from medical care children, pregnant women and those whose conditions are emergencies, even if they have no health card or papers. Something, therefore, has gone wrong in the case of Alpha Pam, because he was an emergency. And it should be further noted that, regardless of Pam's status, tuberculosis is contagious. As such, therefore, a lack of treatment represented a health risk to others.

The generally held view is that the regional government is trying to squirm its way out of what is not a simple embarrassment; it is reprehensible. If it tries to avoid its responsibility, it, and by extension the national government, are revealed as more than just heartless. They are inhumane.


Any comments to andrew@thealcudiaguide.com please.

Visiting Hours: Inca hospital and patient information

You're in hospital. You are suffering all manner of indignities. Pointing Percy at the potty thing and missing. Being woken by the interrogation-like strip lighting at six in the morning in order to take the pill that is delivered in its little plastic cup.

Bad enough. But there is worse to come. Someone from the local council decides to pay you a visit. Nice of them to think of you? Possibly, and they would say that they were. Being nice, that is. The only problem is that they might have some ulterior motive. Or they've got hold of your details when they shouldn't have.

If you happen to be admitted to Inca hospital, then you can count yourself lucky if you don't actually live in Inca. If you don't, then the council won't bother with you. Not that they would ask you where you live. Oh no, because they already know. How? Because they've got the gen. Name, address, telephone number, hospital room and some medical detail - the particular care unit and nature of the admission. They pick it up in a sealed envelope left at reception every week or so. Or they did. Ever since the story broke a week or so ago as to what has allegedly been going on with patient information at the hospital, the visits would seem to have stopped. And the foregoing is what is alleged to have been happening.

The apparent breach of data protection at the hospital is being taken seriously enough that the national data protection agency (AEPD - Agencia Española de Protección de Datos) is saying that it will act even if there is no specific "denuncia" forthcoming.

The basics of the case are these. Patient information has allegedly been passed to Inca town hall and specifically to the Partido Popular ruling party. This has then been used as the basis for visits to patients by representatives of the town hall. In a way it could all be innocent enough. Just saying hello, how are you. Being nice, in other words. But the suggestion is that the visits are intended as a bit of an electioneering exercise. Patients not resident in Inca have been ignored.

Since the rumpus kicked off there have been all manner of denials and explanations from the town hall. One reason given for the visits is that they seek to establish if social services help might be required. Fair enough perhaps. But involving social services, be they from Inca or any other town, should surely be the domain of the hospital's welfare department. Or am I missing something here?

Regardless of the purpose to which the information has been used and regardless of whether the information was asked for or not (and there have been conflicting reports regarding this), the town hall has no right to have the information. Assuming it has ever had it. The town hall is denying that it has patient lists.

One has to consider this case in the context of data protection law in Spain. At the First European Congress on Data Protection that was held in Madrid in March 2006 the then Spanish Minister of Justice, Juan Fernando López Aguilar, said: "The country is a pioneer in fulfilling its commitments to the guarantee and protection of rights and individuals, and in the tools to manage data. In Spain we have not made it easy for dealers in personal data who attempt to violate the law."

This wasn't bluster. Spain does take data protection very seriously. You only have to remember your history to understand why Spain, along with Germany and the individual German "Länder", are among the strictest of adherents to the principle of data protection. So the apparent flouting of this principle is something which the data protection agency is right to take seriously.

The story has taken a number of twists and turns. The town hall, in the person of the former mayor, Pere Rotger, admits that visits have been made for some time. But that lists of patients have never been used. He says that no one has complained; on the contrary, they are thankful for the visit. The current mayor, Rafel Torres, says that town hall representatives, such as the head of health, do make visits and quite openly so. Again without the aid of information. The Partido Popular is challenging the opposition PSOE socialists to prove that its representatives have used information, adding that the PSOE has also made visits to patients.

The town hall is mounting a strong defence. As you would expect, especially as a contravention of the law could land someone in choky. This though would be an over-reaction, if it is proven that the law has indeed been broken. The case smacks of, at worst, naïvity. What seems to have started out with the best of intentions and has probably continued to be so has backfired. But a question remains. Why would patients from other towns be ignored and seemingly knowingly be ignored?


Any comments to andrew@thealcudiaguide.com please.