Dr Juan Abarca Cidón, president of HM Hospitales, one of Spain’s leading private health groups, gives insight into the private health sector of the country, its relation to the public system, and the opportunities that exist to interact. Dr Abarca goes on to discuss the R&D capabilities of the group as a top performer of clinical trials.


What are the strengths of the Spanish private healthcare sector?

Spain has a public health system that, when compared to other countries, is very strong. One of the key advantages of the Spanish private healthcare sector is that, historically, it is not regulated. Of course, there are approvals needed from the health authorities, however, the absence of control has allowed the private health sector to develop very quickly.

In Spain, a quarter of the population has private health insurance as a supplement to the universal coverage. The private sector has been socialized, making coverage affordable and reachable by the general population. Taking this into account, it can be said that Spain has one of the best private health systems in Europe.


What service offering can HM Hospitales deliver to patients that the public sector cannot?

As a private entity, we have different objectives than the public sector. The universal health system must work to meet a massive need while delivering consistent service across a greater number of patients. On the other hand, there is less pressure on the private sector which allows HM Hospitales to have a greater capability of meeting patient-specific needs.

The humanization of healthcare is a term that is currently very popular within the public health system. In contrast, HM Hospitales has moved beyond just humanization and is focusing on a deeper level; personalized medicine. For example, a patient with cancer who comes to our hospitals will have a dedicated patient navigator to guide them through their entire treatment at the hospital. Within the group, we are creating not only a better patient experience but simultaneously enhancing treatment methods to offer an advanced degree of care.


How would you describe the collaboration that exists between the public and private healthcare systems?

The concept of a public health system was not introduced in Spain until 1963 and up to that point, hospitals were managed by the church or privately. When the Spanish Constitution of 1978 created universal health access, many autonomous communities did not have a developed network of public hospitals. Therefore, private hospitals were incorporated into public health networks which is why, for example, Catalonia has double the amount of private hospitals than public. The private sector is fundamental to patient access because many of the private institutions help to make up the public health system through single agreement management structures.


How can the private sector contribute to the sustainability of the Spanish healthcare system?

I believe in the ideology that the public hospitals should not necessarily be managed privately, but rather in the most efficient way – however that may be. Nevertheless, it is clear that the private sector operates more effectively. The public health system in Spain was created, conceptually, to be competitive rather than effectual. The professional management of public hospitals is imperative as a solution to the challenge of sustainability.


How do you see the private and public systems in Spain evolving together?

I am very proud of the public system my country has created. However, I believe there is still room for improvement in how the public and private sectors interact. I hope to see a much more integrated model in which patient needs and access can be better addressed. There are many trends and challenges which are becoming increasingly relevant in today’s health ecosystem; innovative technologies, an ageing population, chronic disease, etc. In order to keep up, both sides must come together to ensure the high level of quality in Spanish healthcare.

In the same sense, the public sector faces a greater challenge of innovation. During the crisis years, the sector was harshly impacted, and investments in the area have suffered. Over the last 12 years, technological innovation has been coming from the private sector. I believe there needs to be an agreement between the government and private sector to better facilitate innovation collaboration in order to allow more patients access to the latest technologies which can only be found in private health centres.


What are your priorities as the President of HM Hospitales?

As a family company, our priority is to have the best practices across all angles of the operation, especially when it comes to patients. I am in charge of 15 hospitals, and any time there is a problem, I am aware of it. There are many private players who will say the same, but actions speak louder than words. As a company, we invest in R&D because we want our professionals to be fully equipped with the resources necessary to best serve patients.


What importance does HM Hospitales place on its R&D activities?

Above all, HM Hospitales is strongly dedicated to the role we can play in the development of new technologies and products which have a direct impact on patients and society. Neuroscience, oncology, and cardiology are our three biggest areas for trials currently. Last year, we conducted 63 research projects of which 30 were funded on our own directly through our research foundation. We have conducted 223 clinical trials which involved over 1,000 patients and have the fourth highest number of Phase I clinical trials for oncology in Europe. Moreover, HM Hospitales is within the top ten organizations in Spain in terms of the number of clinical trials executed.


What makes HM Hospitales the partner of choice for conducting clinical trials?

Of course, the level of quality we can provide makes us a partner of choice of the pharmaceutical industry. Additionally, we have a high number of patients in many areas along with top-tier medical professionals who work with us. HM Hospitales is the only university hospital group in Madrid and has over 300 professors throughout our ranks.

One key factor which sets HM Hospitales apart from other groups such as Quiron Salud or Vithas is our management system. Our managers not only work on a hospital by hospital basis but on a transversal level as well. The group has a planning structure at the national level while still giving each individual hospital autonomous flexibility. For example, HM Hospitales has a cancer initiative where we hold regular meetings with oncologists from throughout all of the group’s hospitals to discuss research and best treatment practices.

Clinical trials have stringent obligations and require a certain level of professionalism. HM Hospitales is able to guarantee the industry both efficiency and quality.


HM Hospitales recently took its first step into the region of Catalonia. What was the motivation behind this decision?

We entered in Catalonia in January by taking over the management of Delfos Hospital (renamed HM Delfos), in Barcelona. As a region with over two million privately insured patients, we saw the opportunity that exists in Catalonia and elected to extend the group geographically. As we are a family business, we must make our decisions strategically and grow in a steady trajectory. Currently, all our objectives are in Catalonia while continuing to maintain and reinforce our other operational regions of Madrid, Galicia, and León.


Looking at the future, what is your vision for HM Hospitales as the reference group within the Spanish health system?

Our focus is to continue the integration of all the institutions within our group and involve all players in a common project. The success of HM Hospitales has been our professional’s ability to give up a protagonist attitude to work together as a community to change society. As a group, we aim to enhance private healthcare; something we believe we have already done. In Madrid, where our presence is the strongest, we have seen the growth in private health and we want to replicate this in Barcelona as well.

In the future, we aim to be one of the top five global institutions with the highest impact factor of medical publications. This is why we strive for such consistently throughout all our hospitals, as a sign of quality to have a high patient number and medical professionals.