Healthcare Citizen Audit: Defending the Spanish Healthcare System

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In a context where the Spanish Welfare state seems at stake, the Madrid branch of Equo decided to launch a campaign for an “Auditoria Sanitaria” (Healthcare Audit) in order to fight against the privatisation of the Health System in the Comunidad de Madrid. This campaign has pushed EQUO-Madrid to the front line of the healthcare defenders but also has helped to attract new people to the party, has brought the chance to get into the traditional Media and to build new links with civil society organisations. GEF interviewed Nuria López, a member of EQUO Madrid and an activist in the Healthcare Audit campaign, to talk about this particular campaign.

EQUO calls for an “Auditoria Sanitaria Ciudadana”!

In words of Nuria López, EQUO Madrid is calling for an “Auditoria Sanitaria in order to denounce the lack of transparency in the Madrid healthcare privatisation process and to ask for the real data and accounts that have ”forced” the government  to privatise hospitals when the Spanish Healthcare system was functioning well and was considered among the best according to international rankings”

The Partido Popular (PP), the government in la Comunidad de Madrid, started a privatisation process in 2004 when they launched an unreasonable plan to build 8 new private hospitals in the city in the space of 4 years (in the end just 6 were built). The plan was arranged between the construction industry, banks and health companies that had links with the government and saw the healthcare system as a business opportunity. In addition, the Madrid government has recently presented an “Action plan to guarantee the sustainability of the healthcare system” that will imply the complete privatisation of 6 more hospitals and 27 health centres. Following this latter privatisation wave Nuria López claims that 33% of the Madrid population will be forced to go to private hospitals and private health centres.

EQUO also fears that this privatisation process will result in economic ruin for the public sector as previously occurred in Valencia. The Alzira hospital in Valencia that was the first public hospital entirely managed by the private sector managed to lose €5 million in 3 years and therefore had to be rescued with public funds. After this rescue the same enterprises won the hospital concession again with even more favourable contract conditions, raising the amount paid for every patient of the hospital to these companies by Valencian institutions.

Facing this situation EQUO-Madrid decided to launch the Healthcare Audit Campaign with a double aim in mind:

  • Allowing citizens to know the real Public Healthcare data and accounts that could justify the government’s argument that a private Healthcare System will be more efficient than a public one. According to Nuria López “The government is implementing an ideological programme, using the crisis as an excuse. If they had any data to prove their case they would already have published it.”
  • Denouncing the opacity and lack of transparency of the privatisation process. Equo is demanding to make public firstly who are the people/enterprises that are benefitting from it and secondly what are the social and economic risks of privatising the healthcare system. Equo has gone to this effort to highlight the links between many banks, health companies and politicians and to bring to light the habitual revolving door of PP politicians and these same enterprises.

The campaign building process

EQUO is a new party that advocates for a different way of doing politics, a way which tries to build the Party as an open platform for citizens to participate in politics and express their concerns. That’s how the “Auditoria Sanitaria” campaign was born.  In the November 2012 Equo Congress in Madrid the privatisation of the healthcare system appeared as one of the major concerns in the so-called “laboratorios de Ideas”. This is a way to structure meetings that gives a voice not only to formal party members, but also to supporters of the party who wish to share their concerns and ideas.

An Equo protest against healthcare privatisation

After listening to personal experiences of the consequences of the healthcare privatisation process, EQUO felt it was the moment to denounce it and become one of the lead forces against it in Madrid. In order to achieve this EQUO organised a range of successful activities and actions, all with a limited budget:

Leaflet and a website: EQUO made a simple but effective 4 page leaflet and a website explaining, without populist slogans, the complex process of privatisation, its consequences and why a Citizens Heath Audit is necessary. “The key of the leaflet and the website was to provide what people are demanding: content and the real data on the consequences of the privatisation. Information that is not being provided by the government”

–  Informative tables: To reach new citizens EQUO decided to campaign in the traditional and always effective way of setting up information tables and handing out leaflets on Madrid’s main streets “After giving them the leaflets we were surprise how people were interested in our proposals and wondered what they could do to help. We realised the direct contact is really important as people liked to explain to us the particular problems they were facing with this health system reform”. 

Animated films: Juaquín Reyes, a well-known Spanish comedian, gave Equo for free two little animated films to support the campaign. These animated films which had a huge impact in the media and the public showed villain characters as Darth Vader or Freddy Krueger asserting they are evil “but not as evil as to privatise Public Healthcare”.

Action in the Anti-Corruption Prosecutor’s Office: EQUO lodged a text to the Spanish Anti-Corruption Prosecutor’s Office to push the office to investigate suspected irregularities with the privatisation process, such as the favourable conditions that the PP is giving to some healthcare enterprises and  the habitual revolving door practices. The action had a huge success in the media and helped EQUO leap into the traditional media[i].

Laboratorios de Ideas: EQUO-Madrid also organised two big events with the aim of bringing together  all the people fighting against Healthcare privatisation and to give them a communication channel and place to share experiences. EQUO invited experts on healthcare planning, politicians, journalists, members of the Debt Audit organisation (close to 15M), people from the healthcare anti-privatisation movements, heath staff organisations and unions, and individual citizens concerned with the topic. “People are demanding changes and new ways of political participation. We were amazed with the positive response of citizens and different associations when we offered them a debate and participation space to express their concerns. In fact, we were what a political party should be like, the catalyst of society’s concerns.”

Successful outcomes of the ongoing campaign

Nuria López explained that EQUO-Madrid usually faces budget challenges when launching a campaign. EQUO is financed through its membership fees, and it does not receive public subventions. Even though the campaign had a small budget, EQUO-Madrid managed to organise all the actions, events and even create the website thanks to the voluntary work of the party members.

Despite the budgetary problems this campaign has meant a huge leap forward for EQUO-Madrid as they have reached Spanish state television, have been interviewed on important radio shows and have had their press releases published in newspapers.

This campaign has also brought a really important element to the party: EQUO has started to create a network with civil society organisations.  “In Spain nowadays civil society organisations don’t want to get involved with political parties as they are seen as partly responsible of many of the current problems. But with the “laboratorios de ideas” and this campaign, we have managed to create solid links with these organisations and finally put into practice the alternative way of doing politics that EQUO is calling for.  These links were proven last 23 February (in commemoration of the failed “coup d’état” in 1981 by some members of the Spanish military) when a huge demonstration brought together the so-called “Marea Ciudanana” formed by more than 300 organisations, including other mareas (heath, education, judicial) under slogans as “Stop the Financial Coup d’état: We don’t own it we don’t pay it”. Thanks to this campaign Equo ended up being a convenor of the demonstration and being at the front line with other civil society organisations.

The next step of the campaign that also pumped up in the last laboratorios de ideas with civil society organisations is to create a section on the website to collect information and comments from citizens on the privatisations process. This joint platform could be a really useful mechanism to provide ideas to continue defending the Healthcare system.



[i] Initially EQUO wanted to lodge a formal complain, but another consequences of the attacks to the Spanish Welfare has been to introduce high taxes for any judicial procedure, taxes that were too high for EQUO to assume.

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