Ministry of Health to develop improvements to achieve a more progressive National Health System in line with demands of a developed society

The Minister for Health, Carolina Darias, stressed this during her appearance before the Health and Consumer Affairs Committee in the Upper House of Parliament, where she set out the general lines of her department for this term of office.

As explained by Carolina Darias, her ministerial department's priorities over the coming years will be to strengthen and extend the capacities of the National Health System (Spanish acronym: SNS), along with urgent attention to the pandemic caused by COVID-19 and the culmination of the vaccination process that began in December 2020.

To this end, actions will be carried out to strengthen care, preventive, equity, cohesive, professional development and health intelligence capacities, and the capacity for adaptation and resilience of the SNS.

By implementing these improvements, continued Carolina Darias, the Government of Spain will actively collaborate in the construction of the European Health Union, also a priority aim over the coming years.

Care capacity

The Minister for Health specified that the aim of strengthening the care capacity is to create a care system that balances healthcare, preventive activities and actions to promote health, while extending the dimension of rehabilitation to preserve and improve people's lives.

Accordingly, the Strategic Framework for Primary and Community Care will be urgently boosted, the development of the Chronicity Strategy will be addressed and the Mental Health Strategy will be updated.

A Reorganisation and Consolidation Plan will also be developed of the network for quality and equitable reference centres (Spanish acronym: CSURes) and the design of the Investment Plan will be culminated for high-technology equipment in the SNS, which is already being worked on.

Preventive capacity

As regards preventive capacity, the Minister for Health announced that the fight against tobacco addiction and obesity will be strengthened, along with the prevention of alcohol consumption among children.

To that end, the department will draw up a Comprehensive Prevention and Control of Tobacco Addiction Plan and a Strategic Plan on Health and the Environment, and particular emphasis will be given to preventing obesity, both in education centres and at a local level, to eating habits and to promoting physical activity and sport, together with the Ministry of Culture and Sport.

In addition, remarked Carolina Darias, a clear emphasis will be placed on preventing alcohol consumption through a law that protects children from its effects. The draft bill "is already prepared", which will shortly be put out for public consultation.

Capacity for equity and cohesion

Strengthening and improving the capacity for equity and cohesion, underlined the Minister for Health, will be achieved by developing universal access to the SNS in Spain, increasing the portfolio of services and benefits, and strengthening the co-governance of the system.

To achieve that, Carolina Darias announced that the regulatory tool of the Law on Measures to Enhance the Equity, Universal Nature and Cohesion of the National Health System will be employed, the draft bill of which will be ready in the second quarter of 2021.

"As well as guaranteeing universal access to health protection, the idea is to strengthen the capacity for equity and cohesion of the system", explained the minister in regard to this regulation, highlighting that it will also seek to avoid the inclusion of new health co-payments, "modelled on those established for medicines", in such provisions as non-urgent health transport and orthopaedic products".

This same law, continued Carolina Darias, will also introduce the incorporation and effective participation of patients in the governance bodies of the National Health System and will include a modification to the Care Guarantee Fund, with the aim of making its regulatory implementation viable.

"This is thus a law to guarantee a fully universal system, strengthen cohesion and enhance the equity of the Welfare State", underlined the Minister for Health.

In addition, strengthening the capacity for equity and cohesion will have a second pillar: the extension and strengthening of the portfolio of provisions and services of the SNS. Hence, recalled Carolina Darias, the gradual extension of Dental Healthcare will be addressed, along with the standardisation of early attention in the portfolio of services, boosting early detection and supporting the development of Early Care Centres.

Professional capacity in the field of health

In addition, and in relation to extending and strengthening professional capacities in the field of health, the Ministry of Health will work within the framework of the Resource Committee of the Inter-territorial Council of the SNS to ensure the adequate provision of professionals and to continue working on professional careers and Specialised Health Training (Spanish acronym: FSE).

At the same time, explained Carolina Darias, work is being done on the draft Royal Decree to regulate the cross-cutting training of Specialised Health Training, and the procedure and criteria are being established for the creation and maintenance of specialised fields and areas of specific training. Along the same line, she referred to the need to address, in a structured fashion, the stable incorporation of researchers in the SNS, together with the incorporation of new professions.

Similarly, continued the Minister for Health, the State Register of Health Professionals will be pushed through to be finalised this year, and a Strategic Plan to Train Health Professionals will be designed and set in motion.

Lastly, Carolina Darias explained that her department will promote a modification to the Framework Statute, defining new recruitment models and a reduction in temporary employment to ensure greater flexibility and thus strengthen areas that are difficult to cover, particularly in the field of Primary Healthcare.

Health intelligence capacity

The health intelligence capacity of the SNS would provide the framework for research capacity, the development of innovation and the capacity to effectively manage available knowledge, along with the capacity to evaluate risks and define adequate responses at all times.

Accordingly, the Minister for Health explained that work has been done over recent months to develop the Digital Health Strategy of the SNS, in collaboration with the regional health authorities and the participation of the sectors and parties involved.

This is a strategy that is structured, specified Carolina Darias, around three main strategic lines, boosting data analytics and the exploitation of information and intelligence of the SNS; boosting the health network, and the development of the digital public services of the SNS.

As the Minister for Health explained, the introduction of a totally electronic system for the award of places for Specialised Health Training and different applications to enhance efficiency in pharmaceutical management are other digital projects on which her department is working.

The Digital Health Strategy, specified Carolina Darias, will be developed over the next five years and is fundamentally tied into the execution of the funds associated with the Recovery Assistance for the Cohesion and the Territories of Europe (REACT-EU) mechanism and the Recovery, Transformation and Resilience Plan of the Government of Spain.

Digitalisation is also fundamental in the Personalised Precision Medicine Strategy, which the Ministry of Health is working on, hand-in-hand with the Ministry of Science and Innovation, indicated the minister.

Capacity for adaptation and resilience

Providing the SNS with a greater capacity for adaptation and resilience is a strategic goal of the government, which stems from the combination of its basic capacities - care and prevention - and from the development of professional and intelligence capacities.

This was underlined by the Minister for Health at Tuesday's appearance before the Upper House, in reference to the capacity for adaptation and resilience as "the disposition of the health system to continue meeting the goals assigned to it, despite the changes that may take place in its environment".

In this regard, she recalled how the Social and Economic Reconstruction Committee has identified three areas for priority action, of which two are reforms that will be financed by the 'Next Generation EU' recovery fund, with the aim of boosting a change towards a more robust, flexible and resilient model.

To that end, and with the regulatory backing of the General Public Health Act, approved in 2011, the creation of the State Public Health Centre is planned, along with the transformation of the National Network for Epidemiological Monitoring (Spanish acronym: RENAVE) into the National Network to Monitor Public Health, as a more modern, flexible, faster and efficient system.

Similarly, remarked the Minister for Health, the availability of health products and essential critical medicines will be guaranteed, along with the strategic reserve of health products, which is already operational, and the strategic deposit of critical medicines.

Along this line, she recalled how the government has taken other important steps to "consolidate and strengthen the capacities" of the national production of essential products and pharmaceuticals.

Furthermore, as regards the vaccines against COVID-19, Minister Darius stated that the Ministry of Health, together with the Ministry of Industry, Trade and Tourism, and the Ministry of Science and Innovation, has undertaken a major exercise in mapping productive capabilities, both in relation to the production of the active ingredient, and to the final stages of the aseptic filling of medicines.

In this regard, she mentioned the four agreements reached so that Spanish manufacturers form part of the production process of the different vaccines against COVID-19.

The Minister for Health also highlighted a set of actions for this term of office aligned with improving the financial efficiency and sustainability of pharmaceutical spending in Spain.

Accordingly, a medium- and long-term Pharmaceutical Policy Strategy of the SNS will be drafted, in collaboration with the regional authorities and all the other agents involved.

European Health Union

The Minister for Health also referred to our country's contribution to the construction of the European Health Union as one of the main pillars on which the government's health action will be structured during this term of office.

"Strengthening and extending the capacities for adaptation and resilience of our health systems at a European level is another goal of the European Health Union initiative", remarked Carolina Darias, who also pointed out the "important transformations" that this initiative will lead to.

In this regard, she recalled how the pandemic has shown the importance of fast and effective European coordination mechanisms. "Examples like the European Vaccine Strategy highlight the strength of united action and the great capacity and scope we have to boost joint work", she stressed.

Along this line, she also referred to the proposals presented on 11 November on the renewal of the current legal framework to address serious cross-border threats to health, and to strengthening preparations to tackle crises and the response capacity from the main European Union agencies, such as the European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA).

Subsequently, continued Carolina Darias, the European Commission presented the Pharmaceutical Strategy for Europe on 25 November, which will be established over the next three years and which seeks to modernise the regulatory framework and support the research and technologies that reach patients.

"It is a question of guaranteeing that patients have access to innovative and affordable medicines, and of promoting competitiveness, innovative capacity and the sustainability of the pharmaceutical industry in the EU", stated the Minister for Health, who indicated that this Strategy constitutes "a key component of the construction of a stronger European Health Union", which "must contribute to establishing an EU pharmaceutical system with a future perspective that is resistant to crises".

The Minister for Health also referred to Europe's Beating Cancer Plan, presented on 3 February, and to the future creation of the European Health Emergency Preparedness and Response Authority (HERA).

In this regard, Carolina Darias indicated that Spain is in favour of guaranteeing a sound framework on the preparedness, monitoring and evaluation of risks, early warning and the EU's response to all serious cross-border threats to health, provided that they respect the jurisdiction of Member States and the pertinent national authorities and take into account pre-existing structures so as to avoid duplication.

Non official translation