With the slogan, “2023 and Public Health without Solution, this Sunday 15th of January, the 97 Marea Blanca (97th White Tide) took place, called by the Mesa en Defensa de la Sanidad Pública de Madrid (MESAP)-Marea Blanca to denounce the serious problems that are being generated in the Madrid health system due to the privatisation of more and more services, the reduction of personnel, the closure of primary care centres, the lack of investment, the transfer of funds to private health care? and the latest measure of the president of the Community of Madrid, Isabel Díaz Ayuso: the new Plan de Urgencias Extrahospitalarias.

This has led to a strike since November by primary care doctors, the area most affected by the closure and privatisation policies of the Madrid Regional Ministry of Health.

At the end of the demonstration, the Manifesto was read out, which is reproduced below.


2023! and Public Health without a Solution!

The Mesa en Defensa de la Sanidad Pública de Madrid (MESAP) – Marea Blanca calls this 97th Marea to continue demanding health as a fundamental human right. Thousands of reasons motivate us in our resistant and insistent decision to defend our public health, a fundamental service, which has the task of safeguarding the health of the whole population in an ethical and fair way. We could recount thousands, but let’s start with some of the most significant ones.

I DEFEND Public Health because I demand the fulfilment of Human Rights. Life is one of the fundamental rights and monitoring the health of the population is part of the task of governing.

Because, according to the Universal Declaration of Human Rights, all human beings are equal, without distinction of race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.

Because we can prevent the ambition and greed of a few from charging our public services and our democratic rights,

Because public health care is the property of the citizens, as it is paid for with our work and taxes, and it must comply with the social determinants, which are key to health and fundamental in the prevention and fight against inequality.

Because politicians must manage it well, guaranteeing the right to health with universal criteria, therefore, they cannot alienate it or market it. The money that citizens contribute via taxes for healthcare is public money, and speculating with health is a serious crime.

Because the function of the Political Managers is to guarantee Health above all; to do so, they must provide the Public System with sufficient human and economic resources, starting with Primary Care.

Because Primary Care, the first step, the entry and axis of public health, aims to guarantee the highest possible level of health and wellbeing for citizens, with care that is person-centered, prompt, close to the citizen, scientific and carried out by health professionals with dignified and stable contracts.

Because Primary Care provides continuous care throughout our lives from before birth to the end of life; with 24-hour care, in morning and afternoon shifts; covering nights, holidays and weekends with Emergency Services, both urban and rural.

Because Public Health Budgets should reach investments of at least 7.5% of GDP, 25% of which should be dedicated to Public Health, in order to comply with the health model outlined in the General Health Law of 1986, which is still in force.

Because the repeated plans of reorganisation of the Out-of-Hospital Emergency Departments by the Department of Health and the Human Resources Department of this Community, consisting of opening without complete health teams (doctor, nurse and orderly), are putting the lives of the population at risk.

We DENOUNCE these plans and express our total rejection of such malicious management by those who do not defend our community.

Because for more than three years, there have been 200,000 citizens without a doctor assigned to them; because their doctor has retired, is on sick leave or on leave of absence, and these work posts have not been filled, in violation of Law 12/2001 on Health Organisation of the Community of Madrid.

Because also, according to the Spanish Association of Paediatrics, there are 212,258 children here who do not have a paediatrician assigned to them or a family doctor who performs these functions.

Because the application of the Royal Decree Law 16/2012, of 20 April, meant a profound change of model, eliminating the right to Health Care for thousands of people in an unjustified way, a right recognised until then to all people living in Spain, regardless of their administrative situation.

Because since October 2021, the Regional Ministry of Health of the CM has left 30,000 unregistered people without healthcare, without prior notification and without a re-accreditation period. That is why we call for the repeal of Royal Decree Law 16/2012, and to allow access to a fully Universal Health Care throughout the territory and to all people, regardless of their administrative circumstances.

Because the Community of Madrid has announced and approved that the Patient’s Clinical History will be interoperable between Public and Private Healthcare, taking advantage of the approval of the so-called Omnibus Law that unashamedly and without consensus opens the way to the privatisation of Public Services, favouring access to confidential clinical data to private health insurance companies, endangering their lives, circumstances and decisions,

Because in Hospital Care we continue with long Waiting Lists that put pressure on users and produce shameful and unacceptable delays: very effective, so that patients are forced to go to Private Health Care; yes, they will be referred for simple and profitable tests and interventions, without complications, and once they have been operated on, they will not be taken care of as clients.

Because we do not want Referrals, they are a silent privatisation that is not perceived by the users, but day after day the referred patients multiply the millions of euros that are diverted from Public Health to the pockets of shareholders of private companies.

Because we do not want vulture funds like Elliott, the most aggressive in the world, to operate in hospitals in the Community of Madrid, taking 1 out of every 2 € budgeted in public health.

Because it is necessary to defend a public health system that has been sickened by privatisation.

Because the amount that commercial companies and speculators move in the public health system already exceeds €30,000 million. More than 40% of public resources in health care go into private hands.

Because the governments that we want and need must express their explicit will to recover all that has been privatised (Hospitals and Health Services).

WE COULD ADD THOUSANDS OF REASONS depending on each experience and the model that a consolidated democracy must maintain, but let’s state them loud and clear

Because Public Services are a sensitive matter to be pampered in order to consolidate under the power of the sovereign people, being the skeleton of our democracy, and

Because, in short, without Public Health there is MORE INEQUALITY every day and our country needs everyone with good HEALTH or we will be squandering our future for a few vultures.

Whoever governs, public health is defended. Make sure you don’t betray yourself.