A public health agency that excludes 12 million patients? | Opinion

Progress in establishing a state public health agency is excellent news for those of us who work in the health sector, as with any initiative that recognizes the need to strengthen communication with all available resources, in a coordinated manner, with a national vision and community. Given the pandemic from which we come, having effective mechanisms to deal with potential threats to public health in the future is undoubtedly crucial.

For this reason, we strongly agree that a future government public health agency is an essential tool for developing coordinated surveillance across the national territory, able to respond to the information needs to monitor the health status of the population in terms of well-being, disease and mortality, as well as the risks and factors that cause them. We consider the approval of this regulation very appropriate, as it will help to avoid the improvisation of the epidemic and the difficulties that have arisen regarding the provision of information by independent communities in the face of the regulatory vacuum that has existed until now.

Everything would be perfect were it not for contradictory regulatory data that, again, generates uncertainty and insecurity, as it does not respond to this supposed common goal of protecting public health. Take the example – included in the bill – which refers to “strengthening communication with all available resources in the state public administration, regional and local administrations, academic and research entities, to formulate an integrated health policy, ensuring health security and addressing present and future challenges to public health in an accessible manner”.

It is difficult to understand why the private health sector resources, which are part of the national health system and of paramount importance to the purpose of the future agency, are not mentioned. Above all, because this rule, on the one hand, provides for the obligation to provide information to both public and private organizations, which is reasonable, but on the other hand, it does not acknowledge the existence of these resources or their participation in the discussion.

Let me focus on this paradox, as the private health sector has shown, throughout the period of the pandemic, its full readiness to cooperate at all times with the relevant departments in collecting useful information to combat Covid-19. This data provision remained constant throughout the pandemic and began even before March 14, 2020, the date of the first state of alert declared. And this was necessary and important, because one in three patients taken to a Covid hospital in Spain was treated in private health, either by insurance, joint or drawn from the public, as well as 29% of those affected who needed assistance in the intensive care unit. .

We represent 52% of hospitals in Spain and our resources must be taken into account when facing future public health challenges, given that 42% of surgical interventions, 31% of stays and 31% of emergencies are registered in our country. It is a logical question. Initiatives that exclude or ignore the private sector should be avoided, for example, the most recent steps taken in terms of interoperability.

And is that, does it make sense for a digital medical history that doesn’t integrate all of health? What is the use of these digitization efforts if the diagnostic tests, treatments, or operations they were able to undergo in the special circuit are not included in the patient’s history? Or in the same way but vice versa.

The true interoperability of both circles, public and private, is what can truly benefit both the patient and the daily life of health professionals, avoiding administrative hurdles and speeding up diagnosis. To avoid falling into false arguments, let us not forget that the clinical history belongs to the patient, the person who should authorize access to their health data to their physician, not to the health centre, regardless of ownership.

The only guarantee to avoid duplication of evidence is the true interoperability of all healthcare resources. We are not the only ones who understand this method. Let us remember that the digital interoperability reform in which the Ministry of Health is operating responds to the EU recommendation that includes public and private healthcare, without exceptions.

According to reports, the European Parliament’s draft regulation on the European Health Data Area states that in order to exchange electronic medical records and record personal health data, it is necessary to have all health systems in place. The European Commission intends that health data registration cover all types of healthcare providers and serve as the basis for a future interoperable medical record, with which we, as patients, can go to any part of Europe and obtain our clinical record.

For this reason, whether we are talking about improving prevention in matters of public health, or moving towards interoperability to avoid costly repetition of procedures due to lack of access to medical records of people who have been treated, we must prioritize subscribers. In this case, it involves the formulation of effective and comprehensive regulations around the dialogue with all those agents who, in one way or another, contribute and work to improve the health of the population as a whole. The private health sector is supported by 12 million patients in Spain who will not allow themselves to be restricted or marginalized because their freedom of decision-making will be violated.

Carlos Ros He is the chair of ASPE (Spanish Private Health Alliance) and CEOE . Health Committee