Disparities in Public Funding Expose Challenges in Madrid’s Private-Concession Hospitals Amid Health Law Reforms
Madrid’s private concession hospitals receive significantly lower public funding than public hospitals, prompting governmental reforms to strengthen public healthcare.
- • Quirónsalud and Ribera Salud hospitals in Madrid receive up to 85.6% less funding per patient than public hospitals.
- • Hospital tariffs have not been updated since 2023 despite rising operational costs, risking further underfunding by 2026.
- • The new Spanish health law aims to prioritize public management over private, emphasizing transparency and equality.
- • The law does not annul existing contracts but allows regional reversions of privatizations, aiming to reduce territorial inequalities in healthcare.
- • Quirónsalud claims to provide superior service despite lower funding, but funding disparities raise sustainability concerns.
Key details
Hospitals in Madrid managed under private concession models, specifically those operated by Quirónsalud and Ribera Salud, are receiving public funding at rates up to 85.6% lower than their public hospital counterparts, highlighting significant financial disparities in the region’s healthcare system. According to recent data from 2023, these hospitals under the Alzira model have not seen tariff increases in line with rising costs, with funding levels frozen since 2023 despite growing operational expenses. For example, the Hospital Universitario Infanta Elena received 560.7 euros per citizen, versus 636.4 euros for public hospitals in the same complexity category, while others like the Hospital Universitario de Torrejón de Ardoz received 575.4 euros compared to public hospitals averaging 893.45 euros. Meanwhile, the Hospital Universitario de Alcorcón public facility received as much as 1,247 euros per patient.
The financial shortfall for concession hospitals has been partly attributed to infrequent updates of patient tariffs, with the Ministry of Health signaling that without further revisions by 2026, these hospitals will continue to operate on outdated funding formulas, worsening their economic conditions. Quirónsalud defends its model by asserting that despite lower tariffs, their hospitals offer superior service portfolios.
In response to these disparities and growing concerns about private sector influence in Spain's healthcare, the government is advancing a new health management law designed to strengthen and prioritize public healthcare within the National Health System. The law underscores that public management should be the default approach, with private management limited to exceptional, justified cases.
This legislation addresses issues of territorial inequality, rising private healthcare spending, and the expansion of private insurance as a reaction to long public waiting lists. It emphasizes transparency across the system, requiring evaluations and sustainability reports, though it does not retroactively annul existing contracts but allows regional governments the option to revert privatizations upon contract expirations.
The law’s broader goal is to reduce disparities between regions, ensure equitable healthcare access, and prevent a market-driven approach that could marginalize vulnerable populations. By bolstering public healthcare, the law aims to guarantee that all citizens can access care based on health needs rather than profit motives, tackling structural inequalities exacerbated by the current funding model in places like Madrid.
This article was translated and synthesized from Spanish sources, providing English-speaking readers with local perspectives.
