Catalan nationalism, neoliberal style

With the catchwords "fiscal pact" and "national transition" - terms whose practical translation is unknown - the Generalitat (Catalan regional government), in the hands of the rightist CiU Catalan nationalist bloc led by Artur Mas, is implementing an undeniably neoliberal policy shift. The Generalitat holds that the numerous cutbacks are intended to curb spending. But their scissors have so far mainly snipped away at public health, the backbone of the welfare state. Catalonia is once again in the vanguard of what may become a general practice throughout Spain.

In line with this policy, the regional health department has in its hands a document, titled Governance of the Catalan Health Institute (ICS), which speaks of cutting up this entity's eight hospitals, 285 first-aid clinics and other premises, creating some 20 management firms that would support themselves with profits through private-sector agreements of various types, including shareholdings. This is one of the objectives proposed by the document, and implies the dismemberment of the ICS, the largest public company in Catalonia, with more than 400 health centers and 40,000 workers on its books.

There would be nothing objectionable here if CiU had previously legitimized this neoliberal program at the ballot box - that is, told the voters what it planned to do. But this was not the case. The party has preferred to hide its plans from voters behind the familiar rhetoric of the defense of the welfare state. Artur Mas has been very scrupulous when it comes to suppressing the inheritance tax - "this is in our program" - and very lax when his cabinet has applied spending cuts.

The Catalan health proposal would allow the hospitals to function with full autonomy, seek new channels of financing, and offer their services to private clients as well. These criteria, taken to their limits, would allow paying patients to be operated on before those from the public health system, in hospitals built and equipped with public money.

On the eve of elections, political parties shun terms such as taxes and co-payment. In Spain, indeed, there has been no serious discussion of the public health system, apart from the usual demagogy. And in the present crisis situation such discussion is urgent, if the system is not to be limited to healthcare without cost to the patient. Because we have a right to demand a quality system of public service which attends to the patient's needs within a reasonable period of time.

The uncertainty generated by the crisis, and by the lack of political agreement on essential matters, constitute a breeding ground in which we have seen the germination of such plans, or hidden agendas, which threaten the essence of a universal, free, high-quality public health system. The Generalitat cannot flatly deny what is written in a document with an official letterhead. The opacity of its attitude, and the neoliberal tendency of the text, do not inspire any confidence at all.