Carlos Rus: “Deaths could have been avoided if they had had all the resources”

What is being the contribution of private health in the fight against the covid?

We had long insisted to the Government and to the autonomies that those responsible for public Health are also responsible for the private sector and that we are a strategic and flexible resource for when required. A message that was difficult to get through but that has come true during the pandemic. Because in the end the numbers sing and one out of every four hospitalized patients has been in the private sphere, whether for insurance, mutual or derived from the public.

From your perspective, what is failing in managing the pandemic?

It continues to be difficult for them to give visibility to the private sector. There are areas where we are supporting even before it was necessary and we have always been in that position. A constructive attitude is necessary, that our role is recognized and that we are not afraid to say that we are fighting the pandemic jointly between the public and the private sector.

How is it explained that during the first wave, images of collapsed public corridors were seen while private centers were empty?

We had two scenarios: one in which we were absolutely overwhelmed, as happened in Madrid, but there were other areas where we had centers full of professionals but without patients.

How is it possible?

Because a stable framework of collaboration was lacking to take advantage of all the resources. We have been demanding three marks. One, the sanitary, as has happened in France, Germany or England, where before the confinement ended, they had sat down with the private sector and it had been established how they were going to work, what resources they needed … But it took a second frame, the social one. Know, according to the level of contagion, the measures to be taken. Because society reacts better when it knows what is happening. And then there is a third, which is the result of the other two, and that is that in the business environment it is possible to react based on the circumstances, which gives a greater capacity for foresight.

This here has not been done?

The Government did it at first but entering like an elephant in the china shop, because the same measures were taken in areas that had very different situations. But when the baton passed to the communities, what we have are 17 different scenarios generating significant complications in all areas, because depending on where you are you can do some things or others.

What do you propose?

More unity is needed and, regardless of ideologies, act as managers. All in one. Because even in the first wave it is true that the Government set the standards, but the communities continued to have enough room for action. And there were many in which coordination tables were established and that have had an impeccable performance, and others with which it has been impossible to coordinate.

In the first wave, there were communities in which control tables were established and which have had an impeccable performance, and others in which it has been impossible to coordinate.


Even now?

Even now

Does ideology influence when seeking the collaboration of the private sector?

Yes, the ideological signs are present. On occasion, Minister Illa, who can be counted on the fingers of his hand, has recognized our role. But there have been critical moments when we have missed being mentioned.

Why do you think you haven’t?

I think because of its government partners.

Would you say that the weight of Unidos Podemos is noticeable when assessing the role of the private sector?

Yes, but above all in letting go, in sitting with us in an open way… because political proclamations are one thing and reality is another. And there is no community in Spain that can do without the collaboration of the private sector. None.

What is the profile of the patient who is referred from the public network?

It’s complicated. During the pandemic it was the same as the public one. In areas of high contagion, any patient if we had a place. In the others, they sent us non-covid.

“No public or private system is prepared for a pandemic, only to solve pathologies”


If the resources of the private sector had been better used, would fewer people have died?

This is very difficult to answer because it is true that there were resources available in some communities while others were overwhelmed. And here the question I ask myself is whether equipment or patients should have been moved.

And what is answered?

Initially, moving teams, but in a second moment, patients. Because you can move a lot of equipment but the facilities are what they are. No public or private system is prepared for a pandemic situation because they are prepared to solve normal pathologies, not for something exceptional. But at that time there was fear that the situation that was taking place in Madrid, in the center, would soon spread to other communities. It was believed that we were all going to end the same and that stopped what would have been reasonable. Because the unreasonable thing is that there were overflowing areas and others, hand over hand.

So the answer to the question is yes?

Yes, deaths could have been avoided if all the resources had been available.

The first wave caught us off guard, but do you think the second and third could have been avoided?

The two were waiting. The second was surprising because it was expected in September and appeared in August. The third was expected for the end of January or the beginning of February and it has again been advanced. And this one with greater virulence for the time of year. In the end the waves are a consequence of social activity.

Will there be a fourth?

What is not known is whether the third and fourth will be followed or will be differentiated because everything will depend on the restrictions that are adopted. Perhaps by May a change will be appreciated due to the weather and the effects of the vaccine.

Are “Black Friday” and Christmas left over?

The increase in infections would not have been so exponential if contacts had decreased. But the third wave was going to arrive, that was known, just as the flu is practically non-existent this year due to the covid measures.

Have you been paid for the services provided so far?

We have suffered a different economic impact compared to any other sector because we are the only one who was asked to continue with all the resources available even in centers that did not treat COVID. We have been at the disposal of the health authorities, as ordered by the state of alarm, with centers in many parts of Spain without activity but with personnel. And we have not been able to adapt the staff to the needs. That and the deprogramming of all activity has meant that we have a very high economic impact. And there are still many communities where last year’s covid patient care has not been closed and, therefore, nothing has been paid.

What do you think of the lawsuits that have been announced by some of the ASPE members for lost profits?

Being a sector especially affected by not being able to adapt the workforce to the circumstances, what we ask is that the costs that this has implied be assumed, not the loss of profit. Supermarkets have reinforced staff but they have worked. We have also increased them because they have asked us but we did not have patients to attend to.

What is the solution for future situations?

That no activity is deprogrammed that does not subtract resources necessary for the covid. If we can continue to consult and perform interventions that do not require ICU, let’s do it. And if there is a time when healthcare pressure makes it foreseeable that our resources will be needed, let’s deprogram any activity that is required. In 24/48 hours we are able to do it.

“We have been at the disposal of the authorities, with centers in many parts without activity but with personnel”


How is it explained that we are waiting for the vaccines like May water and that not enough personnel have been available to administer them.

There are personnel if you have private health, what is lacking are enough vaccines to reach the objectives set by the Government.

They have offered to cooperate in the vaccination. In what conditions?

Yes, we did it in December. The conditions have to be agreed, but they will be economically acceptable.

What response have they had?

The Government is evaluating it and the autonomies are adding to the need to have the private sector.

Has the coronavirus, despite everything, helped you make money?

Unlike. This crisis has caused us serious economic damage. We have had to invest in adapting our infrastructures in the regions with the highest incidence of contagion and we have been forced to supply ourselves at extremely speculative prices. It is a burden that has knocked down many centers and has put the viability of others at risk.

Is the pandemic changing the concept of private healthcare?

I think so. In the end, the population is aware that we are and have always been available and that we act putting social responsibility before business purpose. Proof of this is that the centers are there with their templates, although it is being a very difficult situation economically.

Has an increase in the preference for the private sector been detected, given the collapse of the public system?

Not especially.

Do you see a pandemic hospital operating like the one that has been built in the Community of Madrid?

It is clearly a necessary hospital because what was seen in the first wave led to the conclusion that such a facility was needed. And it is also working well, although many hoaxes are running about problems in the bathrooms that are not true. A pandemic hospital is a hospital. And making the decision to build it for something that gets longer is logical.

“We have offered to cooperate in the vaccination but the conditions have to be agreed”


See it in private orbit?

It wouldn’t make sense for profitability. We are entities that are privately financed.

And field hospitals, are they really good for anything?

Of course yes, as long as they are activated in those cases where there are no other resources available. What has happened in this country during the first wave, with private hospitals operated without patients and some regions investing in additional field infrastructures in those same territories, has not happened in any other country in the European environment. Has no sense.


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