Unpaid bills for pharmaceuticals

The stand taken by the pharmaceutical laboratory Roche, concerning 12 dilatory Spanish hospitals, is very worrying. The Swiss firm, specializing in oncological medication, has begun to demand of these hospitals — all of which are more than 700 days behind in payments — that they pay their bills, in full or at least in part, if it is to go on supplying them with products. Some of the hospitals concerned have already seen slight delays — of a matter of days — in their delivery of treatment to cancer patients.

So far, Roche, which sells some 80 percent of its products to hospitals, has been the only laboratory to take such a drastic measure. The rest of the pharmaceutical companies say that they are waiting to see the effects of the supplier payments plan set in motion by the government, which ought to begin to produce results over this month.

It is imperative that these results be forthcoming, because the industry estimates the total debt owed by all the hospitals throughout Spain at 12 billion euros, of which 6.4 billion are for medication and 5.6 billion have to do with healthcare apparatus, instruments, bandages, dressings, and so on.

The situation, then, is a critical one, and the consequences of a failure in the supplier payments plan could be disturbing indeed. The health minister, Ana Mato, has stated that her department will oversee the payments for medications supplied to hospitals, so that shortages or lapses in supply will not occur; and she believes that the solution lies in the implementation of the plan. But the real problem lies in the fact that the credibility of the political administrators of the public health system is at a very low ebb.

The pharmaceutical industry itself, the employees of the healthcare sector and the patients all suffer — and repeatedly complain about — the financial difficulties now being faced by the hospitals, and the delays in treatment. However, given that the healthcare system has been decentralized from the national government to the regions, the regional governments that are worst affected by these problems downplay them, and deny that there are any problems in terms of supply, as if the mere fact of saying so were enough to dispel the fears aroused by the situation.

Indispensable apparatus

But the reality is that this by now chronic practice of tardy payment is causing a genuine deterioration in the quality of medical assistance in many Spanish hospitals, beginning with the failure to renew or replace various types of medical apparatus that nowadays are indispensable for the diagnosis or treatment of serious diseases.

One urgent item on the agenda is the establishment of the long-promised central purchasing office for pharmaceuticals and other hospital supplies. In the shorter term a hierarchy must be worked out, in which priority is given to the payment of certain suppliers, without whose products the public health system will suffer irreparable harm.