Alba Vergés, Minister of Health of Catalonia, highlights her key priorities within the thriving region of Catalonia as well as the factors that have created a unique ecosystem. Furthermore, she highlights the department’s relationship with the pharmaceutical industry and the need to think about sustainability in today’s healthcare environment.
This year Catalonia has its largest healthcare budget ever. How do you plan to spend these funds?
40 percent of the budget of the Catalan government is dedicated exclusively towards the Catalan healthcare system, which includes important areas such as assistance, public health, research and innovation. Our main objective, and a fundamental right for all citizens of Catalonia, is to maintain a sustainable universal healthcare system and eventually increase our funding through better policies for our citizens.
Our responsibility is to spend our budget in the best way possible. For Catalonia spending such a large amount on healthcare is seen as an investment into the wellbeing of the people. Our issue is that economically Catalonia is a region that excels compared to many other areas of Spain, yet the Spanish government decides and divides the budget for each of the 17 autonomous communities. Therefore, when other regions suffer economically and cannot contribute to such a large amount towards the Spanish GDP, Catalonia receives less money and in turn, we must spend less on healthcare. This at times is frustrating, though as a government we must find new ways of being innovative in how we spend our budget
What are the fundamental pillars of the Catalan healthcare system?
The fundamental pillars of our healthcare system are equality, commitment and the universal right to healthcare. Access to healthcare does not depend on factors such as whether you are working or not, if you are retired or if you have enough money for a certain treatment. The only factor is the health of the patient, and we are dedicated to them. Furthermore, the Catalan population is quite spread-out across the entire territory, so it is important that access to quality healthcare is possible, even in rural areas.
How do you ensure the standard of care is of high quality across the entire region?
The key is to have in place a world-class primary care system. Although this area has suffered over the last years, our intention is to improve it in the future through smart investments. Additionally, we understand the value of establishing strong relationships between Catalan hospitals and primary care sites. Also, to maintain our commitment to high levels of care, we will aim for specialization. For example, pediatric oncology used to be treated in five different hospitals at certain levels, while, after our latest reform, it is concentrated only in two highly-specialized Catalan hospitals.
What has been at the top of your agenda since assuming your current position?
First and foremost, to ensure that the Catalan population understands that dedicating a huge amount of the region’s funds towards healthcare is an investment in them. This will need a mindset change, and we are ready to take on this challenge.
We have always had a good relationship with the hospitals and research centres, though now we must go beyond that
Additionally, we must place greater importance on primary healthcare and the professionals working in these areas. For example, according to OECD statistics, Catalonia has a large rate of doctors, but not so many nurses. This is something we must rectify.
Another key theme is the connection between the Ministry of Health and the universities. We have always had a good relationship with the hospitals and research centres, though now we must go beyond that. These universities are shaping our medical professionals and scientists for the new age of Catalan healthcare, with an ageing population, chronic diseases and personalized care. If we are able to establish this connection, we will ensure Catalan professionals are better prepared for the future.
How would you evaluate the relationship between the Ministry and pharmaceutical companies working within Catalonia?
There is a good relationship. Pharmaceutical companies have a long tradition in operating and investing in the region, and historically hospitals worked hand-in-hand with them in areas such as clinical trials. Nevertheless, we need to work harder in making this relationship more transparent in the future.
Catalonia has the largest private hospital network in the country. What is the impact of this sector on Catalonia?
The private healthcare sector is important in Catalonia. We have a diverse range of private suppliers and organizations, though most of them are integrated within the public system, and there are very few purely private hospitals. We have a very well-integrated system.
Additionally, there is a very good dialogue between the public and private side as 90 percent of their funds are coming from us. We also see them as an integral and important part of achieving for Catalonia the right to universal healthcare as they maintain equality and sustainability in the region.
How well prepared is Catalonia take on board the new wave of innovative therapies, such as personalized medicine?
I think that we are well prepared to introduce this innovation into our system. Despite the many challenges associated with promoting market access to these therapies, it is important we do so as innovation is a key priority for us. We understand that personalized medicine comes at quite a high price point, and we are actively engaging in close dialogue with the industry to find sustainable solutions: as they want to obliviously gain market access, though we must make sure we can accommodate these therapies. It is about finding a balance that is possible in the long-term for both parties involved.
In fact, to achieve market access for many of these innovative therapies we are utilizing a result-based payment approach. This holds companies liable for results, while in the meantime allowing us to reach our healthcare targets for Catalan patients
Do you feel the sustainability of healthcare could be a future issue?
Obviously, it is a challenge. Though if we can properly identify the key priorities and areas we want to invest, such as in primary care, then it will make this challenge easier to overcome. Also, in today’s environment, there is a large amount of data that is assisting in better ways to create a sustainable healthcare environment.
Catalonia is internationally recognized as an R&D hub. Why is this the case?
The region excels in a large part due to the world-class public healthcare system, which incorporates universities, hospitals, research institutes and researchers, along with the collaboration of companies involved in R&D efforts. However, we want to improve this even further, and are now working on giving more tools to our researchers and medical professionals so we can catch their ideas at an early stage and help them grow. Additionally, we are encouraging the participation and creation of international research groups
What is top of your agenda for 2019?
Currently, we want to have a gender perspective in how we approach care. This means not just having blanket treatments, but seeing which conditions are affecting each particular gender. For example, endometriosis in woman or prostate cancer in men. This will give a more tailored approach to Catalan healthcare, and attack conditions that have a significant impact on each side of the population.
Also, we are looking to put in place an improved screening process for Hepatitis-C. As there now exists a cure for the disease, we are on a mission to rid the region of this chronic condition.
A final message?
Catalonia historically has always been an open door for companies to operate in and professionals to undertake their work, and it is no different today. We are an international location that continues to be a hub of activity and we welcome everyone from all corners of the globe, from the US, Europe and Asia, to Latin America and Australia.
