On the days when the elderly in nursing homes suffering from covid-19 were rejected by public hospitals, their colleagues with private insurance enjoyed a safe-conduct to be cared for in a hospital bed in Madrid. The Community imposed its admission triage only in the network of public hospitals, giving an escape route to those who have the capacity to pay for private healthcare.
Private network operators and their clients confirm to EL PAÍS that thanks to this coverage they were able to overcome the exclusion designed by the Community of Madrid during the worst of the coronavirus pandemic, between mid-March and mid-April.
To avoid the collapse of its public hospitals, the Ministry of Health developed protocols that excluded elderly people from terminal residences and with dependencies such as moving in a wheelchair. Those documents assigned to the 475 residences in Madrid a reference geriatrician in a public hospital in their area, to decide by telephone whether it was possible to refer the sick. But this triage was not imposed on the extensive network of more than 40 private hospitals and clinics in Madrid, despite the fact that the Minister of Health, Enrique Ruiz Escudero, enjoyed a single command on public and private health since March 12.
“We had five or six cases of residents who came from residences in stressed areas,” says the manager of the Santa Elena Clinic and president of Catholic Hospitals in Madrid, Miguel Ortegón.
Asisa, an insurer that manages the Moncloa Hospital, with 235 beds, says that the Ministry of Health never told them that they had to select the elderly according to the criteria of the exclusion protocol. “Fortunately, at no time did we have to deny entry,” says a spokeswoman. Nor was any client from Sanitas, with three hospitals in Madrid, or QuirónSalud, with seven centers of their own, according to their spokespersons, rejected.
The daughter of a resident in a center of Madrid capital tells that she herself called Sanitas to go and pick up her mother, a large employee who had not passed the public health cut. It was April 3, one of the most critical days of the health crisis in Madrid. She says that in an hour of the clock an ambulance picked her up. It was fortunate that they did not have others in that nursing home, according to this family member who begs for anonymity because she does not want to expose herself to public attention. He was admitted with bilateral pneumonia and spent a month in the hospital. He believes his mother would have died had it not been for that private coverage. This is what the workers at that center have told them. “I am very clear. I imagine that a lot of people who have not had my chance have lost their lives. ”
When a patient became seriously ill, the hospital staff had to call the liaison geriatrician of the public reference hospital to assess the transfer according to their symptoms, the saturation of the emergency department and the criteria of the protocol. If the patient had private coverage, the caregivers simply called their insurance to request an ambulance.
The patients of the Public Health System depended on the evaluation of a network of 22 liaison geriatricians created by the Community of Madrid during the pandemic. They were on October 12, Alcorcón, Clínico San Carlos, Cruz Roja, El Escorial, Fuenlabrada, Getafe, Gregorio Marañón, Infanta Cristina, Infanta Elena, Infanta Sofía, Fundación Jiménez Díaz (private with public concert), La Paz, La Princess, Mostoles, Prince of Asturias, Puerta de Hierro, Ramón y Cajal, Rey Juan Carlos, Severo Ochoa, Sureste and Villalba.
Health without surnames?
During the critical period, nearly 90% of the lives lost in Madrid residences the 5,975 deceased with covid-19 or symptoms in those centers from the start of the pandemic until this Tuesday. Around 300 families of deceased have already joined various collective complaints against the Community and the residences.
There are no official data on the number of elderly in nursing homes that were cared for by the private hospital network during the critical period, but there are figures available that are an indication that those with higher incomes more easily circumvented triage. According to data from the Community on March 25, only 20% of the 102 deaths during the pandemic who lived in the 25 public residences of the regional government did so in a hospital. Meanwhile, 36% of the 301 dead residing in private nursing homes had been hospitalized.
This difference in treatment between private and public hospitals calls into question that during the pandemic a “health without surnames”, as some have called it, has completely functioned. Private healthcare, with 6,068 beds in Madrid, has made a great effort. On April 14, he had admitted more than 1,250 patients referred from the public network of hospitals, according to data provided by counselor Escudero. But the intervention of Health did not consist of imposing a contribution to the companies, but it was the private hospitals themselves that proposed to the Ministry on a daily basis their quota of available beds.
The group that coordinated the transfers from the public to the private network was made up of 12 people, two of them representatives of the private network, who held a morning videoconference daily, according to the president of Catholic Hospitals in Madrid. Private hospitals provided their share of available beds, always making sure that there would be space available for private insurance clients. Sanitas had its occupancy rates around 95% in the worst days. Catholic network hospitals such as the Santa Elena Clinic, which added about 20 beds to its usual 76, were almost at the limit. Sometimes Sanidad would send them buses at dawn loaded with sick patients.
“They called us from the public and told them that we could give them 3, 4, 5, 7 beds, but you always had to reserve space for the patient who came with insurance,” says Ortegón.
Do you know of discrimination or irregularities in a residence in the Community of Madrid? Contact the reporters [email protected] or [email protected] or send a message via Twitter to @FernandoPeinado or @jdquesada
Information about the coronavirus
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