benefits account for 35% of autonomous budgets.
No community, except Catalonia, has developed a special savings plan.
EMILIO DE BENITO Madrid 16 MAY 2011 - 15:24 CET
staff Hospital Clinic of Barcelona by cuts in public health in Catalonia. / Carlo Ribas
The NHS is a cat too fierce for anyone to dare to put the Rattlesnake cuts. Or at least, to do so publicly. Since the end of decentralization in 2002, the powers are autonomous, but, except in Catalonia, there has been no director who has explained where the scissors put him in the service most valued by citizens. And the Catalan than it is only half-measures with the frozen face of protests, yet other communities to come together after the election of 22-M.
The cake is handled is not small: it is, according to 2010 data from the Ministry of Health, an item that sum of 63.768 million euros, 6.1% of GDP. But with the rejection public opinion to the cuts, communities have found a formula to rely on the central government. They propose, agree, and the Ministry of Health that gives the face. That is what happened last year in the Inter-Territorial Council had agreed savings measures.
Of these, the first affected staff. Although doctors and nurses are employed, your employer is the same communities (with the exception of Income, which manages the health of Ceuta and Melilla). And so came the 5% cut in salary that affected other public employees. Given that staff costs are 43.4% of health, it throws 27,675.3 million in wages. After that 5% means savings for communities, which are paid, of 1,384 million.
The fall in costs is estimated at 2,500 million a year
The second step was to create a central shopping get better prices from suppliers. The system has not yet yielded results, he has been to create a new figure. Its approval was passed on 8 April and, in principle, will begin with the purchase of flu vaccine next year. Although the idea was unanimously supported a year ago, only eight of the 17 have been assigned: Aragón, Asturias, Baleares, Cantabria, Castilla y León, Comunidad Valenciana, Extremadura and Madrid.
Figures
total expenditure. In 2010, health care consumed 63.768 million euros, 6.1% of GDP .
Personal . payroll spending is the most important item: 43.4% of total (27,675,000). The reduction of 5% of salary meant, therefore, a saving of 1.384 million .
pharmaceutical spending. In the 12 months from April 2010
Hospitals. represent approximately 40% of drug costs. The savings in this game has been about 300 million .
Total . Health has saved an estimated 1.275 million in drugs.
There is no political bias that have been targeted. Three governed by the PP, and lack some of the most prominent among those governed by the PSOE, as Andalusia. Health sources played down these absences, and explain that some of those who are not already had biennial contracts with suppliers, and others, such as Andalusia, believe they can get good prices alone. The estimated savings from this initiative will 3.3 million euros, according to the ministry, but may increase if more communities are targeted or if it extends the centralized purchasing to other products (working in contracts with absorbent, diapers, adult incontinent).
heading remains juicy. Two royal decrees approved last year involved a price reduction of drugs and medical devices, and a tightening of the calculation of prices ( the maximum subsidized), which has become the cheapest drug within those generic, rather than the average of three more flights as it was before March. The results have been withering on the pharmaceutical bill (which pay for drugs administrations that citizens buy prescription). In total, data are taken
This figure is solo según el cálculo más conservador, ya que presupone que el gasto farmacéutico de 2011, antes de las medidas, iba a ser igual al de 2010. Teniendo en cuenta que siempre, hasta ahora, había habido un aumento, el ahorro real es mayor. Por ejemplo, si se considera que entre 2011 y 2010 el incremento hubiera sido del 3%, el ahorro llegaría a los 1.100 millones.
Y a esta cifra le falta la de las compras hechas por los hospitales. Teniendo en cuenta los datos de la patronal Farmaindustria de que las ventas a centros hospitalarios son aproximadamente el 40% de lo que venden a farmacias, eso querría decir que el ahorro a las comunidades por los recortes sería de otros 300 millones aproximadamente.
So in total we can speak of a reduction of about 1,200 or 1,300 million. The Ministry of Health is more specific, and in April announced, though without giving a breakdown, which pharmaceutical expenditure had fallen by 1.275 million in 10 months. If you add the savings in salaries, we can speak of a cut of 2,500 million. Is it too much? In absolute terms, sure. But in relative terms represents about 5% of health spending, and less argues that the deficit has only Catalonia.
Recipes in the spotlight
Posts cut, preferring to communities in drug purchases. Galicia was the first who tried, by developing a catalog of products that could only be prescribed the cheapest. The system was, at bottom, similar to that established by the Ministry of Health when setting reference prices, but the products concerned do not coincide. The result was that both systems overlapped, which had less access Galicians to drugs than the rest of the country's population. The Ministry of Health argued that inequality to appeal, and the Constitution, the admissible, froze its implementation.
Castilla-La Mancha is considering a parallel system of recipes. Some products (cheaper) may be prescribed by the computerized system with primary care physicians (one of the most advanced communities in electronic prescriptions). The other, more expensive, need to be prescribed on paper, what a way to keep in your wallet, but to discourage their use.
Andalusia also has launched a new system: to auction the supply of some medicines and health products. The idea is that between equivalent products, who will bid to win more cheaply. This means, in practice, go beyond the reference price system in terms of lower prices. Health to be seen whether he accepts it.
