Alzira Model

Alzira Model I: 1999/2003

Granting for 10 years, extendable to 15 for the management of the Specialist Medical Care of a Health Area (AS 10).
Capitation fee: 204 euros + CPI (1999).
Building of a new hospital: Hospital de La Ribera. Private original investment of 61 M €.

Alzira Model II: 2003/2018

Granting for 15 years, extendable to 20, for the management of Hospital and Primary Care in Department 11.
Capitation fee: 379 (494 as of 1/1/2006) euros + % yearly increase in the health budget. 68 MM € investment during the concession.

New granting: Torrevieja and Denia (Valencia) and Valdemoro (Madrid); Up coming tenders: Manises and Crevillente; Valencian Population covered by granting: 20-25%

The private public partnership framework is an attempt to break the cycle of budget deficits faced by most local authorities. The contract with the Hospital de La Ribera explicitly sets out the costs the government pays for the hospital’s services for the region it covers.

After seven years, the management model has proved profitable for all the “agents” involved in the public health service:

• The users.
• The Government of the Autonomous Community of Valencia.
• The company running the health department.
• The professionals working in the health department.

PRINCIPLE OF SUBSIDIARITY

Lightening the burden of public expenditure in social services

• Public Administration deficit.
• Nation’s budget stability as a must.

Private responsibility

• Efficiency and efficacy.
• Entrepreneur patrimonial responsibility.

Public Control

• Limited contract period. Duration and possible extensions clearly set out in the contract.
• Administrative granting for a private contractor to manage a public service.

The company serves a catchment department of 245.000 inhabitants, who had been denied access to local hospital facilities until the new hospital opened its doors in January 1999. In the past, locals seeking hospital treatment often had to travel more than 40 km to Valencia. To close this gap in its provision of health services, the regional government of Valencia looked at novel approaches to financing hospital services using private capital. Finally it opted to put the contract to build and run a new public hospital out to tender.

Health Department number 11:

• 245.000 inhabitants.
  
• Lacked local public Hospital.
  
• Nearest public Hospital in Valencia, 40 km. away.
  
• Building a public hospital had been a political promise since 1982.
  
• 30 Health Centers.
  
• 2 Outpatients Clinics.