{"id":2676486,"date":"2026-02-14T17:41:30","date_gmt":"2026-02-14T17:41:30","guid":{"rendered":"https:\/\/www.pressenza.com\/?p=2676486"},"modified":"2026-02-14T17:41:30","modified_gmt":"2026-02-14T17:41:30","slug":"2026-una-oportunitat-historica-per-al-sistema-sanitari-public-catala","status":"publish","type":"post","link":"https:\/\/www.pressenza.com\/ca\/2026\/02\/2026-una-oportunitat-historica-per-al-sistema-sanitari-public-catala\/","title":{"rendered":"2026, una oportunitat hist\u00f2rica per al sistema sanitari p\u00fablic catal\u00e0"},"content":{"rendered":"

L’any 2025, pel que fa al servei nacional de salut de Catalunya, va ser l’any de dues sacsejades documentals que ennuvolen el seu present i futur.<\/p>\n

Al mes de febrer, la CUP va fer p\u00fablic l\u2019informe \u201cAn\u00e0lisi negocis jur\u00eddics del sistema sanitari integral d\u2019utilitzaci\u00f3 p\u00fablica de Catalunya (SISCAT).<\/em><\/strong> Valoraci\u00f3 dels contractes de serveis sanitaris d\u2019atenci\u00f3 hospital\u00e0ria i especialitzada\u201d<\/em><\/strong>.\u00a0 Aquest informe posava damunt la taula dues q\u00fcestions:<\/p>\n

– El sistema sanitari concertat es troba sense cobertura legal. Tots els concerts estan caducats i ja no es poden prorrogar legalment. No es tracta d’un fet puntual sin\u00f3 que tot el sistema de concerts \u00e9s fora de la llei, sense cobertura jur\u00eddica. Aquesta conclusi\u00f3 no \u00e9s pas una q\u00fcesti\u00f3 ideol\u00f2gica sin\u00f3 jur\u00eddica i el mateix Cercle de Salut aix\u00ed ho reconeix (tot i que fa refer\u00e8ncia a un informe de la Sindicatura de Comptes\u00a0 https:\/\/cercledesalut.cat\/bloc\/un-informe-demolidor-de-la-sindicatura-de-comptes\/<\/strong><\/a>).<\/p>\n

De fet, reclama que s’articuli una f\u00f3rmula no contractual per a donar cobertura jur\u00eddica a la sanitat concertada (https:\/\/cercledesalut.cat\/bloc\/posicionament-del-cercle-de-salut-davant-la-memoria-preliminar-de-lavantprojecte-de-llei-daccio-concertada-en-lambit-sanitari\/<\/a>)<\/p>\n

Seria aix\u00f2\u00a0 possible?<\/p>\n

– La segona q\u00fcesti\u00f3 \u00e9s\u00a0 tamb\u00e9 esfere\u00efdora: les fundacions que presten serveis p\u00fablics han de desapar\u00e8ixer perqu\u00e8 ja no compleixen els seus objectius fundacionals. La finalitat de les fundacions era, amb el seu patrimoni, prestar assist\u00e8ncia sanit\u00e0ria amb car\u00e0cter de benefic\u00e8ncia. Ara el que fan \u00e9s prestar serveis sanitaris a canvi d’una retribuci\u00f3 del CatSalut a persones que, per dret, accedeixen al sistema sanitari p\u00fablic. Fem-nos una pregunta:\u00a0 si no rebessin els diners del CatSalut prestarien els serveis que fan? S\u00f3n els diners p\u00fablics els que els\u00a0 permeten continuar. Si no poden dur a terme el seu objectiu inicial, haurien de desapar\u00e8ixer. La legislaci\u00f3 catalana aix\u00ed ho estableix.<\/p>\n

Per si no n\u2019hi havia prou,\u00a0 m\u00e9s endavant va ser el torn de la Sindicatura de Comptes amb l’informe 5\/2025 sobre \u201c<\/em><\/strong>Sistema de contraprestaci\u00f3 dels serveis d’atenci\u00f3 hospital\u00e0ria i especialitzada d’aguts prestats pels centres del SISCAT per compte del CatSalut, exercici 2022\u201d<\/em><\/strong>.\u00a0 Plantegen \u00a0revisar si els incentius establerts en la contraprestaci\u00f3 de l\u2019atenci\u00f3 hospital\u00e0ria s\u00f3n coherents amb la planificaci\u00f3 estrat\u00e8gica del Govern; que la facturaci\u00f3 de l\u2019activitat es faci per cada centre hospitalari del SISCAT, no per agrupacions de centres; que cal\u00a0 un sistema de contraprestaci\u00f3 que retribueixi el tipus d\u2019activitat que fa l\u2019hospital m\u00e9s que no pas les seves caracter\u00edstiques estructurals; que cal un sistema de comptabilitat anal\u00edtica que permeti retribuir l\u2019alta hospital\u00e0ria segons unes ponderacions basades en costos hospitalaris catalans i que la contraprestaci\u00f3 dels hospitals gestionats per l\u2019ICS inclogui incentius financers an\u00e0legs als del sector concertat.<\/p>\n

El mateix Cercle de Salut considera que:\u00a0 \u201c<\/strong>1) Les tarifes per a cadascuna de les l\u00ednies assistencials s\u2019haurien d\u2019aprovar en funci\u00f3 dels costos reals i haurien de cobrir les estructures de costos inherents als serveis prestats pels prove\u00efdors. 2) <\/strong>L\u2019aplicaci\u00f3 del sistema de pagament dels serveis d\u2019atenci\u00f3 hospital\u00e0ria i especialitzada d\u2019aguts no ha estat efica\u00e7 a l\u2019hora de dotar a les entitats prove\u00efdores de finan\u00e7ament adequat en temps i quantia. 3) El sistema de preus hauria de cobrir els costos est\u00e0ndard, directes i indirectes, entre ells, el cost d\u2019amortitzaci\u00f3 dels equipaments sanitaris i dels aparells m\u00e8dics, perqu\u00e8 les entitats prove\u00efdores puguin reposar-los\u201d<\/strong><\/p>\n

(<\/strong>https:\/\/cercledesalut.cat\/bloc\/un-informe-demolidor-de-la-sindicatura-de-comptes\/<\/strong><\/a>)<\/strong><\/p>\n

Toca doncs una reforma de dalt a baix, des de la gesti\u00f3 fins al finan\u00e7ament.<\/p>\n

Cap conseller o consellera de Salut\u00a0 anteriors va afrontar el repte de donar cobertura jur\u00eddica a la sanitat concertada. La consellera Olga Pan\u00e9 ha entomat el repte. Un repte per a intentar all\u00f2 tant lampedusi\u00e0 com que tot canvi\u00ef perqu\u00e8 tot continu\u00ef igual. \u00c9s normal que ho faci, ja que ha estat presidenta del Consell Assessor del Cercle de Salut, entitat que agrupa el lobby sanitari privat catal\u00e0, la socioverg\u00e8ncia de l\u2019\u00e8poca Pujol i les elits del business friendly sanitari catal\u00e0. L\u2019objectiu de la Consellera no \u00e9s el Cairos, els CSIR… sin\u00f3 mantenir per a trenta o quaranta anys m\u00e9s el model catal\u00e0, el sanitari concertat.<\/p>\n

Per aix\u00f2 est\u00e0 en marxa la redacci\u00f3\u00a0 l\u2019\u201d<\/strong>Avantprojecte de llei dels instruments de provisi\u00f3 del sistema p\u00fablic de serveis sanitaris\u201d<\/strong>, que ben al contrari del que fa refer\u00e8ncia a drets socials, on ja ha arribat una proposta legislativa, pel que fa a la sanitat concertada est\u00e0 entre boires. “S\u2019est\u00e0 treballant” et comenten.<\/p>\n

Per qu\u00e8 aquesta incertesa? Perqu\u00e8 la normativa comunit\u00e0ria no dona tant de marge com voldrien. No n\u2019hi ha prou amb canviar el nom o disfressar-lo. Hi ha un vell principi de dret, tamb\u00e9 recollit pel TJUE, que sost\u00e9 que els contractes s\u00f3n el que s\u00f3n i no el que diuen que s\u00f3n.<\/p>\n

Hi ha possibilitat de f\u00f3rmules no contractuals per a prestar serveis p\u00fablics… s\u00ed, clar que s\u00ed, per\u00f2 amb uns marges marcats per la Directiva 2014\/24\/UE del Parlamento Europeo y del Consejo, de 26 de febrero de 2014, sobre contrataci\u00f3n p\u00fablica, que \u00e9s la norma que la Generalitat hauria d’implementar.<\/h3>\n

\u00c9s possible que ens proposin una normativa que se salti el que diuen les directrius comunit\u00e0ries i la\u00a0 mateixa jurisprud\u00e8ncia del TJUE? \u00c9s possible, per\u00f2 no gaudir\u00e0 d’una exist\u00e8ncia llarga. Seria un text normatiu vulnerable, i el lobby sanitari espanyol s’hi llen\u00e7aria al damunt reclamant que es declari nul\u00b7la i que s’opti, tal com diu la normativa europea, b\u00e9 per la gesti\u00f3 directa o b\u00e9 pel concurs p\u00fablic.<\/h3>\n

Les conseq\u00fc\u00e8ncies d’obrir la sanitat p\u00fablica catalana a concurs p\u00fablic suposar\u00e0 que les decisions sobre el nostre servei de salut no es prendran al Departament de Salut, ni a la Pla\u00e7a Sant Jaume o al Parlament. Tampoc al Congreso de los Diputados\u00a0 ni al Parlament Europeu. Es prendran en juntes d’accionistes de corporacions i fons voltor. Quina mena de servei sanitari p\u00fablic tindr\u00edem llavors? Mirem cap als Estats Units.<\/h3>\n

\nPer aix\u00f2, aquest any 2026, \u00e9s un moment hist\u00f2ric. Des de la transfer\u00e8ncia de compet\u00e8ncies, el moment m\u00e9s important. Com a societat, pa\u00eds, poble, comunitat aut\u00f2noma o naci\u00f3, ha arribat el moment d’obrir un debat honest i plural sobre com volem que es gestioni el nostre servei nacional de salut.<\/h3>\n","protected":false},"excerpt":{"rendered":"

L’any 2025, pel que fa al servei nacional de salut de Catalunya, va ser l’any de dues sacsejades documentals que ennuvolen el seu present i futur. Al mes de febrer, la CUP va fer p\u00fablic l\u2019informe \u201cAn\u00e0lisi negocis jur\u00eddics del…<\/p>\n","protected":false},"author":1122,"featured_media":2676487,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35528,35524,35526],"tags":[38092,119831],"class_list":["post-2676486","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-opinions-ca","category-politica-ca","category-salut-ca","tag-salut","tag-serveis-publics"],"yoast_head":"\n2026, una oportunitat hist\u00f2rica per al sistema sanitari p\u00fablic catal\u00e0<\/title>\n<meta name=\"description\" content=\"L'any 2025, pel que fa al servei nacional de salut de Catalunya, va ser l'any de dues sacsejades documentals que ennuvolen el seu present i futur. 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