1 Apr, 2014 @ 12:30
1 min read

Spanish medical chief proposes fining bad patients

THE head of the Spanish Medical Association has called for fines for patients who turn up at hospital emergency wards when they are not in ‘urgent’ need of medical help.

Juan José Rodríguez Sendín has also proposed fines for patients who fail to pick up test results or go to the wrong hospital, as part of a campaign punish patients for improper use of the national healthcare system.

He claimed that ‘those who go a lot’ to the doctor, do so because ‘they’re scared’ and ‘think it will delay their final day’.

“When people don’t take their names off the waiting list, when they deliberately put their name down twice, when they don’t pick up their diagnoses or prescriptions, or when they go to the ER rather than to a regular health centre,” are some of the reasons he listed for proposing the fines.

But his words have been met with anger by many. The President of Spain’s health patient watchdog, Carmen Flores, called the proposals ‘an utter disgrace’.

“What happens is that when you have toothache or a high temperature, you’re put on a waiting list for a week. Are we going to have to pay because of that?

“He is not helping doctors by suggesting this. I imagine they don’t support his claims because threatening to make patients pay is neither decent nor humane.”

Tom Powell

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  1. Spain has got fines and demolitions on the brain. Spain comes out with so many daft things but this has to be one of the most crazy so far. Please tell us it’s an April 1st special lol.

  2. @ Fred….Maybe you should compare what you call “a joke” to the cuckoo land management style that pervades the entire NHS in the UK…..Children left to die in favour of funding boob jobs….Managers given obscene pay deals…..paying staff to keep quiet about deathly mistakes….millions wasted on useless IT projects….It is endless and, most scandalous of all, front line staff are regarded as expendable pawns and rewarded with derisory pay deals. Basil Fawlty couldn’t hold a candle to that lot.

    Juan Sendín may have been rather brusque in his wording but in principle he speaks of reality.

  3. Brian, is the attack Fred campaign still going on? This is about Spain not the UK, get back on track, we know Spanish hospitals are good but aftercare and feeding when not in A & E has to be done by relatives in hospitals so swings and roundabouts, and Hospitals are even worse in Africa but let us stick to Spain on this one. The Spanish will fine every foreign person to make some money, that will be the problem and it will lead to more deaths as people will not be able to make a call on if a condition is serious or not, chest pain as an example, the hospital may say it is indigestion, they even charge people for treatment at the moment even if they have an EHIC card… Fines in Spain are increasing, the latest is to say your electric was fiddled with, iberdrola cut you off and demand €2,000 before they connect you again, that is happening now.

  4. @brian, I keep on topic and try not to get involved in comparing countries, but I’m sure a lot of what you talk of also happens in the Spanish health service too but is not reported. In this case I am specifically saying that fining people for being “bad patients” is madness, in my opinion.

  5. @ Reap….I attack no-one in the OP (or any other publication’s) columns….But when ‘Fred’ launches into another Spain bashing session, yes, I will either agree or disagree with him, according to my views, to which I am entitled…In fact I frequently agree but see no gain in duplicating what he has already said.

    @Fred…I am not going off the subject…The only reason I offered a comparison to the UK is that, like many other people here who still have to pay UK tax, it drives me to distraction when I read (NOT necessarily in the Daily Mail) of such profligate waste (as I described beforehand) in the UK NHS and the staggering incompetence of (the now retired Nicholson)….My daughter recently gave birth in the UK and the nursing staff were remarkable…Even more so in my view when, after talking to a couple of them the total indifference senior management have towards the pay structure of junior staff I found utterly deplorable.

    I have no doubt that there are issues (not always reported) in the Spanish health service but I have yet to encounter anyone who has a bad word to to say about it. That is to say ‘anyone’ not trying to get something to which they are not entitled.

    And yes Fred, of course ‘bad patients’ also exist in the UK, but there, they are tolerated to the point of stupidity…. Go to any UK A&E department on a Saturday night and it will be brimming with idiots who can’t summon the intelligence to drink responsibly and, if in Spain such behaviour (and that mentioned by Sendín) is to be challenged monetarily then it saves US money in the long run.

    What you describe as ‘madness’ Fred is, in my view, simply the stark realisation that ANY health service is just that and not a bottomless pit to which people can abuse out of their indifference towards it’s cost…That isn’t madness, it’s responsible management.

  6. Brian, wages in the UK for medical staff are higher than Spain and talking of waste, there is much more in Spain by means of corruption, people employed to do jobs that do not exist, reduction in GDP because of the way they manage the Country, businesses, self-employed… Spain wastes a lot more money per capita than the UK if you look at the hidden costs, that is why we in the UK have little unemployment and that place is sinking. As said before, for a retired person with a good pension who does not need to earn a living Spain may seem like a good place but there are many others not in that position who would not agree, especially the Spanish, unemployed etc. For you great, but please think outside of your bubble and UK bashing on a regular basis, I love it here.

  7. According to my information there is 20% of patients who go to the doctor for no reason.

    For the most part it’s older people who feel lonely and bored.

    It is relatively common for some patients go weekly to the doctor.

  8. @ Reap…I can’t disagree with much of what you say regarding widespread corruption here…But, returning to the Spanish health service, in general, pay rates are lower, of course they are, but in terms of financial and budgetary controls , that is to say, securing value for money, the announcement by Sendín demonstrates that in this health service there is at least some indication that there is a planned commitment towards the Spanish taxpayer.

    If, as you say, you live in the UK, you cannot be unaware of the almost daily revelation (and I’m not talking about Daily Mail verbosity) of unbelievable incompetence within the UK NHS hierarchy, the obscene payouts to muppet managers, and a government health minister who lacks the cojones to address the issue. And in this respect Sr Sendín deserves credit.

  9. @brian, yes there have been monumental balls-ups in the UK health system, but please let us keep to Spanish hospitals and the proposal to fine people for being “bad patients” otherwise the thread will get into a slanging match.

    Mr Sendín is embarking upon an impossible task, a task which itself would need even more administration and infrastructure just to implement. How about a new IT system just manage all the fines for people? What if the fines are not paid? Emargoe them! Get them in court. They appeal. On and on it goes, forever.

    The solution is better communication with patients and more information and more efficient procedures. That would solve a lot of the issues here, which let’s face it, are trivial. Ooh a person failed to pick up their test results – they must be fined and shamed. No. Communicate with them, offer them an alternative way to get the results sent to them. The health service is paid for by its patients remember and the oath doctors take is to treat all patents, not just “good patients”, whatever that means.

  10. @ Fred….I fear your softly softly approach, (ok, communicating with the laggards and hangers on), will put us once again at keyboard loggerheads. But no, I seek no ‘slanging matches’. What you call “trivialities” multiplied across the nation can and do add up.

    It’s not a matter of labelling patients ‘bad’ or ‘good’ nor is it about a conflict with any oath, but a sensible and compassionate but firm approach to the scroungers of the health service. The wording of the statement of Sr Sendín may well have been confrontational, I agree, but the essence was overdue.

    Whilst no-one can justifiably leap to the defence of all the other disagreeable (for want of more appropriate adjectives) acts this government get up to, any legitimate tightening up on wastage has to be worth it no matter how individually “trivial” it’s components. I refer you to Tesco’s publicity slogan.

  11. @brian, hold on – you said “it’s not about labelling patients good and bad” and then in the next paragraph labelled those same people “laggards” and “hangers on” lol. Those same people are also patients. Every little does help, but it’s no “little” thing to fine people and then enforce those fines. Fines have to be enshrined in law and law is complex, and slow, especially in Spain.

    A decade or so ago, Spain brought in a new electronic system for prescriptions and it is estimated this has saved around 9-10 millon visits to the doctors by their patients. Those are the sorts of things Spain needs more of – greater efficiency and communication – that’s really lacking here. We need more patience with the patients lol.

  12. @ Fred…..I admire your ability to quote out of context….But I’m not going to lubricate further ‘you said’, ‘I said’ nonsense.

    All attendees at surgeries, A & E, hospitals and Health Centres are potential “patients”…You surely must agree that a percentage of these visits are quite unnecessary and that, as Sr Sendín claims create, one way or another, wastage though indifference to the cost impact they cause….You don’t need education, patience or levels of communication to make people realise this.

    Yes, you need legislation to fine people…Just like you need legislation to penalise people who deliberately ignore (for example) traffic regulations….And hey, don’t now draw a comparison between the two. I use it as an example, nothing more.

  13. @brian, I see you now use the word “deliberately”. Well, can it really be proven that a patient deliberately did not pick up their test results? Can it be proven that a patient deliberately made an appointment that was not required? One can quickly see that these are impossible things (indeed nonsensical things) to try prove and disprove.

    As for your example comparison. I’m not sure what you want me to say. You make a comparison which you then tell me to use as an example, but I can’t compare them lol. What else can one do with them if not compare them? Anyway, the answer is that traffic regulations are nothing like the issue being talked about at all, so the comparison should simply not have been made in the first place lol. As I stated, the answer is to make the system itself better to lessen the instances of these problems.

    Fines for healthcare is not something that will work in my opinion. It will probably make people even more scared to visit their GP.

  14. @ Fred……OK, to focus on the fines which, after all, seems to be your bone of contention…..in passing any judgement one can only study comparisons, we have league tables in all aspects of life and it fuels a path of progress.

    So, as I recall, in the UK, if you fail to attend a (NHS) dentist appointment, you lose your slot…Do it again and you get struck off his/her books….In the private sector your fee’s are increased AND you get charged for wasted surgery time….Is this not a version of “a fine” ??.

    In essence, and on the face of it it seems draconian, I agree, but it is accepted, it works, and newspapers don’t make a meal of it….And that is why I drew the traffic comparison, because people DO deliberately flaunt their obligations BUT have the opportunity to appeal against a fine (for circumstances beyond their control) just as they hopefully) would for any alleged abuse of health care.

    No doubt we would however, agree that any appeal process being enshrined in the same legislation may well be deposited in the arena of lengthy governmental prevarication.

  15. @brian, losing a slot is not really the same as fining or penalising someone financially. I think you’ll also find that a doctor in the UK cannot refuse to see a patient unless they are physically abusive, and even then in some cases they will not be denied treatment (if they are mentally ill for example).

    Anyway, I’m sure that Spain will bring in these fines because fines are such a big part of everything in Spain – it’s very much a denuncia culture here.

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