The Minister of Health on Madrid: "Manipulating waiting lists by deceiving patients is not new"

BarcelonaA new scandal in the Madrid healthcare system, stifled by years of cuts and privatizations, has once again exposed the shortcomings of the public system in the State's capital. Officials at one of the city's major hospitals, the Ramón y Cajal, ordered last year that the severity of some sixty patients awaiting surgery be downgraded to improve the situation of waiting lists, according to internal documents that have been accessed by El País. According to the information, two department heads at the center made changes to the priority of operations without assessing the affected patients or consulting the surgeons who had determined the severity of the cases.

Still according to this newspaper, which cites an email sent by one of the two officials to a doctor outraged by the events, the reason for the modifications was to meet the productivity targets required by the Community's Ministry of Health, governed by Isabel Díaz Ayuso's PP. The hospital maintains that it has not committed any irregularity, and sources from the ministry consulted by the Efe agency deny interference in the waiting lists. In turn, the Minister of Health, Mónica García, has accused Ayuso's government of “manipulating” the lists and “deceiving surgeons and patients”. “One does not play with the health of patients”, she stressed on X, and added that the events reported this Tuesday are not new and that, for the moment, they are not “penalized”.

All of this, according to El País, took place between February 28 and March 14 of last year, when 57 patients awaiting orthopedic and trauma surgeries at Ramón y Cajal were moved from preferential priority –which requires that they be operated on within 90 days– to normal, which extends the margin for performing the operation to 180 days. A fact that, furthermore, impacts the productivity bonuses of the hospital's department heads. The documents to which the news refers would demonstrate that behind these changes were the two cited officials, who have not wished to make statements.

The same newspaper explains that among the affected patients were people diagnosed with spinal anomalies, carpal tunnel syndrome, or dislocations. Also, at least one three-year-old minor, whose parents were not notified of the change in priority. Several surgeons complained, but they clashed with those responsible for the changes. At least one of the doctors who protested was reprimanded with the opening of a disciplinary proceeding.

Unify criteria

In light of this situation, Minister Mónica García recalled that the Spanish government presented new criteria for transparency and traceability of waiting lists in July, which were not approved by the autonomous communities. "We hope they are approved now," she stated in her message on X. These criteria were intended to unify how the autonomous communities collect and communicate health data, as they are responsible for health competencies and until now each one does so differently. This scenario causes, according to sources from the Ministry of Health, not all communities to share data with the same level of exhaustiveness.

The Spanish government's proposal was to cover those areas that do not have a homogeneous information system at a national level, such as primary care, mental health, and therapeutic tests. The Ministry of Health maintains that it is "crucial" to have comparable data on access times to outpatient clinics to favor the early resolution of citizens' health problems and also to incorporate waiting times for mental health consultations in the face of the "sustained increase in demand." Regarding therapeutic tests, the ministry led by García argued that it is necessary to establish criteria similar to those already in place for operations and diagnostic tests.

"The goal is not only to offer figures, but also to provide advanced analytical tools that allow for better planning and evaluation of public policies," the Ministry of Health defended in July, when it announced the criteria that the autonomous communities ultimately decided not to approve. Having data is essential to define the priorities of health policy, and waiting lists are a great indicator of the system's efficiency, but at this moment it remains very complicated because not all territories collect data in the same way.

The sector raises its voice

The scandal in the Madrid healthcare system has already caused an uproar in the nation's capital. The medical union Amyts was not surprised by the news, as it maintains that “practically all” healthcare centers manipulate waiting lists, something that according to the union many departments do to hide negative data from the Ministry of Health: it is not a problem “exclusive to Madrid,” they say. On the other hand, the Association for the Defense of Public Healthcare of Madrid (Adspm) has requested an “immediate” investigation into the facts from the Madrid Ministry of Health, as it considers them to be of “extreme gravity”.