A risky cutback

María Dolores de Cospedal, secretary general of the Popular Party (PP), warned on becoming regional premier of Castilla-La Mancha that she would undertake “painful” cutbacks. Her policy of expenditure containment is, indeed, ambitious, but also indiscriminate. The premier has reduced the sums spent on welfare services and now, in search of further savings, has just closed the night-time emergency medical services of 21 small municipalities in this extensive region. The protests have been prompt. The clamor comes not only from villagers affected by the move and from the opposition, but also from mayors and politicians of the PP, while four municipal councilors in Honrubia, near Cuenca, have resigned.

Cospedal has made controversial and, in fact, questionable decisions in her struggle against the deficit, such as withdrawing subsidies for women’s shelters, and eliminating the salaries of deputies in the regional assembly. Her position in this case is hard to defend — not just from a social viewpoint, but also from a budgetary one as well. The paltry saving — between one and 1.7 million euros, according to opposition and Medical College estimates — does not justify the withdrawal of protection for some 100,000 citizens, many of whom are elderly (and thus tend to have more health problems), living at distances of up to 50 kilometers from emergency services that can attend to them in cases of extreme need.

The regional government says that these emergency services were “little used” by patients, thus overlooking the role such social services play in maintaining the tissue of rural settlement. Contrary to the agrarian policies promoted by both Spain and Brussels, which aim to foster the development of rural areas, the government of Castilla-La Mancha, a region with broad rural areas of low population density, has been closing local schools and health services, thus fomenting the process of rural depopulation.

Dramatic consequences

The closing of these clinics in 21 of the 182 municipalities where they exist will cause, at the very least, anxiety among the local people, and is a risky measure. The consequences may be dramatic, if the emergency is of a serious nature. After a frantic drive on a rural road, the patient may face an overcrowded emergency clinic. The concentration of medical centers in fewer towns is aggravated by the cutbacks already suffered in the hospitals. And all for a relatively puny saving in a region whose budget amounts to 7.44 billion euros.

Castilla-La Mancha is not the only region where healthcare is under discussion. The Madrid regional premier Ignacio González is proposing the privatization of the management of six newly built hospitals in Madrid. To render the public health-care system first precarious and unreliably funded, and then to privatize it, cannot be the best way to defend its sustainability.