A new DGAIA case emerges: 'Illegalities' detected in Salut implicate ERC and Junts

The Audit Office tightens the noose on the previous Govern of Pere Aragonès. After uncovering irregularities in the DGAIA within the Department of Social Affairs, it has issued a harsh report on the management in the Department of Health. Specifically regarding the 2022 fiscal year, when the Junts councilor Josep Maria Argimon was in office.

The case is very similar to that of the DGAIA, as it also involves irregularities in contract awarding and financial management. In this case, the audit has been very harsh and speaks of "serious breaches of legality."

The DGAIA scandal has directly affected ERC, which now finds itself embroiled in a new case of irregularities during its government. Argimon (Junts) was a councilor until October 2022, when he was replaced by Manel Balcells (ERC). This highlights the management of the Generalitat in the hands of the pro-separatism parties.

Very harsh report from the Audit Office

Quico Sallés has uncovered in El Món the details of the Audit Office's audit. It has published a comprehensive report on the compensation system for hospital and specialized health care services corresponding to the year 2022.

The analysis harshly criticizes the management and administration of contracts and agreements with providers. The audit, led by the auditor Maria Àngels Cabasés, points out several "serious breaches" in the procedures. It highlights deficiencies in key areas such as internal coherence, effectiveness, and economy.

Acute hospital and specialized care services, funded by the Servei Català de la Salut (CatSalut), account for more than half of public health spending. In 2022, these services represented 54.2% of the total health care expenditure. This system, which involves public hospitals within Catalonia's network of care services (SISCAT), managed a significant amount of activities: more than 854,000 hospital discharges and almost 770,000 diagnostic tests, among other interventions.

The report points out a "lack of coherence between the objectives of the compensation system and the guidelines of the Health Plan." It criticizes that CatSalut has not clearly justified the allocation of certain services and programs. Nor the criteria for setting the amounts allocated to providers.

In particular, it highlights the discretion in the allocation of resources to specific programs. According to the auditors, this violates essential principles of equality, transparency, and general interest.

Costs could have been inflated

Additionally, the audit questions the effectiveness and economic criteria behind the agreements between CatSalut and provider entities. The grouping of several hospital centers into a single agreement is not based on uniform criteria or principles of efficient economy. According to the Audit Office, this model could be inflating costs, suggesting that the same services could be acquired at a lower price.

It is also highlighted that the current compensation system doesn't meet legal standards. Many services provided by the Institut Català de la Salut are not supported by the programmatic contracts established by legislation.

In terms of effectiveness, the audit detected mixed results. Although incentives to increase surgical activity were effective, penalties to avoid hospital readmissions did not achieve the desired impact.

Similarly, the introduction of financial incentives to promote home hospitalization resulted in a notable increase in such interventions. Meanwhile, other initiatives, such as outpatient surgery, had already reached their maximum objectives and lost effectiveness.

The efficiency of the system is also called into question, especially regarding the use of public resources. There is a warning about the inefficient use of these resources. Particularly in hospital emergencies, where the system presents distortions that can create incentives contrary to Catalonia's urgent care policies.

Additionally, it is noted that the lack of alignment between the payment system and other CatSalut funding policies could lead to overfunding of certain provider assets.

Audit Office recommendation

The report concludes that the compensation system doesn't guarantee effective public action in terms of effectiveness, efficiency, and economy. The auditors also highlight that the lack of formalization of contracts and the untimely signing of additional clauses harm the transparency and legality of the process.

As a recommendation, the Audit Office urges the Generalitat to conduct a regulatory impact assessment on its regulatory projects. It urges CatSalut to sign annual clauses with provider centers before starting the activity. This intervention is key to improving the quality, accessibility, and efficiency of health services in the region.