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Thousands rally in defence of Madrid public healthcare

At least 200,000 demonstrators rallied in Madrid on Sunday in defence of the region's primary care, warning plans to overhaul the system would "destroy" local healthcare.

Published: 13 November 2022 14:10 CET
Spain protest
Hundreds of thousands of protesters marched during a demonstration called by citizens under the slogan "Madrid stands up for its public health. Against the destruction of primary health care" in Madrid on November 13, 2022. Photo by Oscar Del Pozo / AFP

Hundreds of thousands of demonstrators rallied in Madrid on Sunday in defence of the region’s primary care services, warning plans to overhaul the system would “destroy” local healthcare.

On a sunny afternoon, huge crowds rallied at four points across the capital and marched on city hall in a mass protest under the slogan: “Madrid rallies in support of public healthcare and against the plan to destroy primary care services.”

Primary care services in the Madrid area have been under huge pressure for years due to a lack of resources and staff, with the situation worsened by poor regional management, unions say. A regional government spokesman said there were 200,000 people.

“Healthcare for all, your health should never depend on your wallet,” read one huge green banner as thousands of voices chanted “Public healthcare!”

The protest convened by local associations and municipalities takes aim at the health policies of the regional government of right-wing leader Isabel Diaz Ayuso — including a push for public-private healthcare partnerships and its restructuring of primary care.

READ ALSO: Why Spain is running out of doctors

The protest comes ahead of a planned strike by nearly 5,000 regional family doctors and paediatricians scheduled for November 21, due to “the overload of work, endless appointments and lack of time with patients.”

They will join an earlier strike by medical staff over the new model for non-hospital emergency centres, which have seen some offering only video consultations due to a lack of staff.

Speaking to reporters at the rally, Monica Garcia of the hard-left Más Madrid party said the health policy of the regional government, which is run by the right-wing Popular Party (PP), was destroying the public health system. “What they are doing is an unprecedented disaster,” she said.

“Ayuso needs to step up, listen to this demonstration and take political responsibility: either her health minister goes or she goes, or the whole Popular Party government goes,” she said. 

“There is a very simple way to retain professionals and that is to treat them well: give them contracts that are not just for a month, a week, a weekend. When a government is incapable of doing this, it is because there are political interests at work.”

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POLITICS

The plan for Catalonia to handle its own finances separately from Spain

Catalan separatists are pushing for 'financiación singular' to gain greater fiscal autonomy from the Spanish state, but the proposals are tied up with politics at the national level.

Published: 24 June 2024 14:06 CEST
The plan for Catalonia to handle its own finances separately from Spain

The recent regional elections in Catalonia in May were hailed by political pundits as the end of the procés and turning the page on the Catalan question. The evidence for this was that separatist parties lost their majority in the regional legislature for the first time in over a decade and that the Socialists (PSOE) won the most votes overall.

However, since then things have been far from simple. The PSOE candidate, Salvador Illa, is yet to secure an investiture vote and the political horse trading is ongoing with ramifications for Prime Minister Pedro Sánchez’s fragile majority at the national level.

The controversial amnesty law pushed by Sánchez’s government then got clogged up in the courts, despite being approved in the Congress, and Catalan separatist parties managed to cling onto the role of speaker in the regional parliament. Catalan lawmakers elected Josep Rull, a member of the hardline separatist Junts per Catalunya, which is led by exiled former Catalan President Carles Puigdemont.

READ ALSO: Separatists retain speaker in new Catalan parliament

The important context to understand here is that the Sánchez government is dependent on separatist parties, including Junts and the more moderate Esquerra Republicana de Catalunya (ERC). After inconclusive general election results last summer, Sánchez essentially made a deal with the Catalans in exchange for their votes to maintain his position in La Moncloa.

Catalan finances and national politics

Now separatist parties, particularly ERC, are leveraging this support in order to gain concessions from the national government. The main way they’re doing this is through a demand for financiación singular — ‘singular financing’. That is to say, how Catalonia raises and uses taxes, and whether or not it should be allowed greater fiscal autonomy closer to something like the Basque model.

ERC secretary general Marta Rovira has said in the Spanish press that greater fiscal autonomy “is the minimum that can be demanded,” and alluded to the conditionality of their support for Sánchez: “The Socialists must know that if Pedro Sánchez is not able to move on the singular financing… it will be very difficult for ERC to support him. Salvador Illa must bear this in mind.”

la financiación ‘singular’

But what is singular financing? Former president of the Generalitat, Pere Aragonès, described the plan as “full fiscal sovereignty” in the election campaign, and essentially what the ERC is proposing is a bespoke fiscal arrangement for Catalonia that allows the Generalitat to collect (and keep) more of its taxes.

This would be a step, albeit financial rather than constitutional, towards greater regional autonomy for Catalonia and likely viewed as a political victory for separatists.

For critics of Sánchez, it would be more evidence of his capitulation to Catalans.

Singular finance is an idea inspired by the so-called “Basque quota”. This is basically a fiscal arrangement that allows the Basque government control of most of its taxes but means it must also contribute a set ‘quota’ to the Spanish government.

READ ALSO: Spain’s contested Catalan amnesty bill comes into force

In Catalonia, the long-term aim would be something similar: for the Generalitat to collect all (or more than it currently does, at least) of the taxes paid in Catalonia and then transfer to the Spanish state an agreed portion of that.

In terms of cash, this would mean that the Generalitat would collect billions more in tax (some estimates put it as high as €52 billion overall) and more than double the €25.6 billion it received in 2021 under the current model.

Proponents of the singular finance model also suggest that giving the Generalitat greater fiscal autonomy would do something to redress the so-called ‘Catalan deficit’, the difference between what the Catalan economy contributes to the Spanish state coffers and what it receives in return investment. Generalitat estimates for 2021 put this figure at over €20 billion in 2021.

Therefore, the demand is not only political but economic. The ERC claims that changing the fiscal model would do something to resolve what it calls the “chronic underfunding” of the region.

Negotiations for a singular financing model, which will be tied up in the investiture negotiations for Illa, which are themselves tied up in the fragile arrangement at the national level, will likely continue for many weeks.

If no candidate has won an investiture vote in the regional parliament by August 25th, further elections will be called.

READ ALSO: Which Catalans want independence from Spain?

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