The Madrid Health Service (Sermas) closed 2021 with a surplus of 402.23 million euros, the second in its history. The figure halves the result of its peak year, the year of covid, when reached a surplus of 821.3 million. It therefore cut the profit with which the worst year of the pandemic ended by 51%, according to the report on the agency’s annual accounts, to which it had access. infoFree.
To make a comparison: in 2018 Sermas had a surplus of 43.85 million euros and 57.27 million in 2017. In 2016, it was only 11 million. The previous year, he had lost 192 million. But its biggest deficit is in 2019, the year immediately before the pandemic, when its accounts recorded a difference of 886.8 million euros.
This surplus of 402 million, after the 821.3 million of the previous year, was recorded the year in which Madrid became the community that spends the least on public health per inhabitant: 1,236 euros, 713 less than Asturias, the one that has allocated the most public money per inhabitant to health. In 2021, in addition, they remained one in six health centers closed in Madrid, out of the 90 that were closed the year of covid. And in which they continued without activity also the 37 Primary care emergency services (SUAP) that the government of Isabel Díaz Ayuso has promised to open from next October. As they developed three waves of covid contagion and three phases of vaccination.
Additionally, in 2021 some 800,000 people were on the waiting list –surgery, outpatient consultations and/or diagnostic tests–. Total times for diagnosis and treatment of health condition lasted between eight and 10 months, report says Diagnosis of health and the health system of the Community of Madrid, developed by the Federation of Public Health Defense Associations (FADSP) and CCOO. According to his calculations, Madrid should invest more than 3,000 million euros in public health to match the rest of Spain.
On the contrary, the Community of Madrid leading in 2021 per capita spending on private healthwith 789 euros, according to another report, prepared by the Foundation Institute for the Development and Integration of Health (IDIS), which brings together the main private health groups, from Fresenius to Adeslas or Asisa.
The ballast of the private management of hospitals: 1,235.6 million in provisions
If in 2020 the large surplus was surprising, in 2021 both the result and the decline compared to the previous year are also remarkable. Whereas in 2020, Sermas revenues increased by 32.06%thanks to the transfers he received to deal with the ravages of covid-19in 2021 they suffered a reduction of 7.8%. In 2020, spending also exploded, an inevitable increase due to the tsunami that public health had to face because of the coronavirus: 11.23%. On the other hand, last year Sermas spending contracted 4.46%.
However, the item that most influences the reduction of the Sermas surplus in 2021 is that of provisions –reserves to meet future payment obligations–. In 2020, Madrid health system officials highlighted 837.12 million euros of “excess provisions”. But the Chamber of Accounts, in its audit report for that year, found that Sermas had recorded excess provisions the sum of the complete games of 2019 and 2020, instead of recording only the increase suffered by this concept as established in the general public accounting plan. In this way, he had “artificially” increased both income and expenditure by 769.3 million euros. These provisions are reserves. take care of the payment of the settlements of the agreements and concerts that the Government of Madrid has signed with private companies managed by many public hospitals in the Community. With the legal claims that these private groups presented due to discrepancies in the final amount of the settlements, the total of the provisions recorded by Sermas increases in 2021 no less than 1,235.6 million euros, six million more than the previous year. According to the annual accounts, legal claims against Sermas by private hospitals increased by 11.35% in 2021. For example, the Quirón group is asking the Ministry of Health for 7.2 million euros only for the compensation it owes for the management of the hospitals of Villalba and Valdemoro.
But the debt of the Community of Madrid to these private companies is much greater. In 2018, the report of the Autonomous Chamber of Accounts revealed that the regional government had a debt of 722.3 million euros with the five hospitals under administrative concession: the four managed by Quirón Salud and that of Torrejón de Ardoz. in 2021 The country published that Brussels had forced the Community of Madrid to surface this debt, which until December 31, 2019 had increased to reach 944 million euros. According to the latest annual report of Fresenius, the multinational owner of Quirón Salud, the debt amounts to 1.25 billion for medical assistance to public health patients in previous years.
Fewer transfers, fewer supplies
However, after the slap on the wrist by the Audit Bench, the 837.12 million in provisions that increased Sermas’ income in 2020 were reduced to just 33.75 million in 2021. These 803.37 million euros of reduction in provisions are added to the reduction of 106.41 million suffered by transfers and subsidies received by Sermas once the peak phase of the pandemic has passed. Transfers are the main source of revenue for the Madrid health system: 99% of its revenue budget, which amounted to 10,557.7 million euros in 2021. In 2020, due to covid, this item had climbed 22.72%, including 1,955.6 million more than in 2019.
Even so, Sermas maintains a record surplus as it has also cut spending in 2021, by 4.46%. In this case, the primary responsible for savings was the reduction in the consumption of surgical equipment and care, which saw a reduction of 38%. Translated into euros, the refueling station fell by 24.53%, once the covid emergency is released. On the contrary, personal expenses continue to risel, although less than in 2020. Last year they increased 6.86%, one point less than the year of the pandemic.
In the balance of the figure of Sermas an increase of 143.77 million euros in the item of property, plant and equipment which corresponds to the value of Hospital Nurse Isabel Zendal. The figure exceeds the 130.32 million in which its construction was recorded in the 2020 accounts, to which are added another 11.97 million in medical equipment. The cost, therefore, double the value originally planned78 million euros.
Madrid’s health service had a surplus of 821 million in 2020, the black year for residences, hospitals and toilets