Health does not detail the cost of the ambulance company, scheduled for 2025

The public health transport company of Navarra Bidean will come into operation in first half of 2025 but, for now, Its total cost to the public coffers is unknown.. Yesterday, the Health Minister, Fernando Dominguezwent to the Provincial Parliament, at the request of UPN, to report on this company that The previous Government was created in April 2023. And he did so with an “unfavorable” report from the Government Heritage service, which he considered would be “more burdensome” and, furthermore, that it was not demonstrated that the change would provide “a higher quality of the provision.”

Domínguez stated that the Heritage report makes an assessment “through the prism of the principles of economy and efficiency.” And he pointed out that the increase in costs had already been recognized in previous reports, especially in an initial phase, due to the subrogation of the personnel of the private companies that now provide the service as well as the need to invest in ambulances, permanence bases, personnel and structure. But, according to the counselor, it was also recognized that Medical transportation “is an essential service” “which requires a coordination structure with health centers” to make improvements, optimize routes and save unnecessary trips, fuel and waiting times for users, among others.

In this sense, Domínguez made it clear that when talking about health services “Cost and price are not as important as the quality, safety and efficiency that patients gain.” He also recalled that in the medical transportation table that was established in 2016 and was made up of numerous entities “everyone agreed with the public medical transportation company.”

THE FIRST STEPS

The medical transport service is currently run by two private companies, Baztán Bidasoa, which covers 77% of the service, and SSG, with the remaining 23% in the areas of Tudela and Sangüesa. Between them they made 250,082 services transport in 2023 (37,548 urgent). The cost in 2022 was 19.2 million.

Now, Salud is working to launch the public company. Thus, it has formed a board of directors of 12 people and has appointed manager, Alberto Lafuente, as well as a legal person responsible and a person responsible for economic resources. “The first steps of a company of this magnitude are key and work is being done being aware of this and the importance that a service such as medical transportation represents for the healthcare chain,” he noted.

Bidean has been included in a budget line of the 2024 General Health Budget with an item of 1.2 million for personnel and operating expenses (rental, IT, strategic plan, acquisition of terminals, etc.).

However, Domínguez said that the largest investment is planned for 2025, although he did not detail it, with the subrogation of more than 350 workers of the companies that provide the service now, the rental of the warehouse for the Pamplona base, adaptation of bases, medical supplies and renting of ambulances. Salud plans to amortize this disbursement in five years and, to be more efficient, proposes a commitment to the training of workers (includes purchasing a driving simulator and clinical simulation training), to new technologies for the management of the fleet and its routes or for 60-month leasing for vehicles.

PATIENTS AND STAFF

Health wants to put to the patient at the center of the service with measures such as seeing the location of where your ambulance is, connecting with the company quickly after your procedure and giving your opinion on the treatment.

Regarding personnel, the counselor said that it will be necessary hire about 30 people more, since after the subrogation the working hours of the 350 workers who now depend on the private sector agreement will be shorter (1,592 hours compared to the current 1,728).

He added that, from a logistical point of view, they are negotiating rental contracts for the Pamplona and Tudela bases and they are meeting with mayors to renegotiate contracts based on the rest of Navarra.

At the moment, under a Dynamic Purchasing System that seeks to set the conditions for the works to be contracted, two tenders: one of 1.4 million for 5 years for the tender of 10 conventional ambulances and one bariatric ambulance (for overweight people) and another for the supply through renting of 43 ambulances, with a budget of 5.7 million for five years.

At the logistics level, work is being done on information systems to have computer tools that allow the management of routes, personnel, equipment, etc. According to the counselor, the first investment in the computer system is 82,000 euros and the maintenance will be 48,000 for the rest of the years.

Yesterday, the majority of parliamentary groups were in favor of the constitution of the public health transport company but demanded that it be done “with all the guarantees” and keeping in mind that the cost is the most efficient for the Administration. UPN, for its part, did not take a position. He asked for more transparency and for the service to be provided with quality. Vox considered that “it is not the most appropriate time” to enter into these costs due to the current resources available.

Cristina López (UPN), criticized the situation of unjust enrichment in which the companies that now provide the service find themselves. “107 million have been paid. It is not good for the workers or the patients or their families,” he said. He also warned that there are “many unfulfilled commitments. “We don’t know how it’s going to end.” And he alluded to the fact that the Heritage report indicated that greater quality in the provision was not demonstrated.

Maite Esporrín (PSN) insisted that we should not look only with economic criteria. He asked that it be launched as soon as possible but “not without the assurance that it will be carried out successfully.” “We cannot afford failure,” he added.

Txomin González (Bildu) highlighted the “inability” of the Administration to supervise specifications and ensure that they are strictly complied with. He considered that it is time to start the company but asked that the decisions made be as efficient as possible for the administration. Isabel Aranburu (Geroa Bai) pointed out that the model has many advantages over private management but recognized that it is “complicated and expensive.” “We want it to be done with all the guarantees.” Irene Royo (PP) He was in favor but as long as it is done in the “best and most efficient way.” “If it is managed inefficiently, it detracts resources from other services.” AND Daniel López (With You) He pointed out that the provision of the service should prevail and not the amount. “You don’t spend on public services, you invest.” Maite Nosti (Vox) He said “the current service is being overblown.” “It is not inappropriate and if it were the SNS would have had to intervene.”