Announcement

**estacion** · January 3, 2010, 01:52 AM

Re: Pandemic Flu. Spain remained last with 13.5 million vaccinations, according to health

Espa?a cancela la compra de 24 millones de vacunas de la gripe A
? La Administraci?n central y las auton?micas se quedar?n solo con 13 millones de los 37 reservados
? Gobierno y laboratorios previeron la reducci?n si el tratamiento funcionaba con una dosis en vez de dos

Un hombre incluido en un grupo de riesgo recibe la vacuna el d?a
del inicio de la campa?a, en Barcelona. Foto: ALBERT BERTRAN

Una enfermera muestra una dosis de la vacuna,
en Valencia. Foto: MIGUEL LORENZO

RAFA JULVE
BARCELONA
Una cl?usula firmada por el Ministerio de Sanidad con los laboratorios fabricantes de la vacuna de la gripe A, seg?n la cual pod?an modificarse las cifras de abastecimiento si cambiaban ciertas circunstancias, ha permitido a Espa?a renunciar sin ning?n coste a 24 millones de dosis de los 37 que encarg? inicialmente para combatir la enfermedad.

De los 13 millones de unidades adquiridas finalmente, m?s de dos ya se han aplicado a los grupos de riesgo. Es un n?mero muy bajo de vacunaciones: solo el 22% de los nueve millones de ciudadanos en situaci?n de riesgo.
En Catalunya, han recibido el preventivo unas 250.000 personas, un 20% de aquellas a las que se recomienda la inoculaci?n. La consellera de Salut, Marina Geli, neg? ayer que la campa?a de vacunaci?n haya sido un fracaso y argument? que la gripe A lleg? con fuerza antes de disponer de las vacunas y que cuando estas estuvieron listas ya se sab?a que la gravedad de la epidemia era baja.

?De los 265 millones de euros que el Gobierno destin? inicialmente a la adquisici?n de vacunas, finalmente solo se gastar?n 92 millones?, explic? a EL PERI?DICO Jos? Mart?nez Olmos, secretario general del Ministerio de Sanidad. La circunstancia en la que se ha amparado Espa?a para rehusar la provisi?n de otros 24 millones de vacunas, agreg? Olmos, es que, ?en un principio, la Organizaci?n Mundial de la Salud (OMS) consider? que las dosis que se deb?an administrar eran dos, pero finalmente ha bastado con una sola aplicaci?n?.

OTROS MERCADOS / ?Significa esta decisi?n que los laboratorios deber?n quedarse con un enorme excedente de vacunas? Mart?nez Olmos argument? que no. ?Espa?a cerr? la compra de 37 millones de vacunas en junio, cuando estaban indicadas dos dosis por persona y se preve?a administrarlas al 40% de la poblaci?n?. Sin embargo, cuando en octubre se ratific? que una dosis era suficiente, el Gobierno comunic? ?r?pidamente? a las farmac?uticas que no necesitaba 24 millones de unidades. Los fabricantes ?que empezaron a suministrar partidas tambi?n a principios de octubre? tuvieron tiempo as? de detener la elaboraci?n de la mayor?a de millones de preventivos que a?n no estaban preparados.
En cuanto a las unidades que ya estaban listas para su aplicaci?n y que Sanidad ha rechazado, el secretario general del departamento record? que los laboratorios tienen dos posibilidades: la primera es comercializarlas en el mercado privado, es decir, las farmacias. Y la segunda es venderlas a otros pa?ses que no hicieron o no pudieron hacer un acopio inicial suficiente. Otros gobiernos, al contrario, no firmaron ninguna cl?usula de rescisi?n como la que rubric? Espa?a y se han tenido que quedar con todo el encargo.
La misma cautela con que negoci? las condiciones del suministro emplea el ministerio para analizar la situaci?n actual de la gripe A. Por este motivo, Mart?nez Olmos insisti? en la ?eficacia? del preventivo y en recordar que la campa?a de vacunaci?n contin?a.

EL REMANENTE / Sanidad ha decidido mantener un abundante remanente de 10 millones de dosis. ?No hay que olvidar que la OMS mantiene intacta la alerta de pandemia en nivel 6 y que el invierno no ha hecho m?s que empezar?, agreg? Olmos. Adem?s, los expertos pronostican que a finales de enero podr?a darse un nuevo repunte del virus H1N1 y, por tanto, no ser?a descartable un aumento de la demanda de vacunas.
Si aun as? sobraran f?rmacos, el Gobierno se reserva la posibilidad de destinarlos a los pa?ses en desarrollo, pero siempre a trav?s de una iniciativa de cooperaci?n que est? refrendada conjuntamente con la OMS o la Uni?n Europea.

Fuente: El Peri?dico

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http://www.elperiodico.com/default.asp?idpublicacio_PK=46&idioma=CAS&idnoticia_PK=675042&idseccio_PK=1474

Spain cancels purchase of 24 million vaccines for influenza A
? The central and regional administration will be left with only 13 million of the 37 reserved
? Government and labs foresaw the reduction if the treatment works with one dose instead of two

[PHOTO]
A man included in a risk group being vaccinated
for the launching of the campaign in Barcelona.
Photo: ALBERT BERTRAN

[PHOTO]
A nurse holds a dose of the vaccine,
in Valencia. Photo: MIGUEL LORENZO

RAFA JULVE
BARCELONA
A clause signed by the Ministry of Health laboratories with manufacturers of influenza vaccine, which could be modified according to the figures of supply if they changed certain circumstances, has allowed Spain to give up without any cost to 24 million doses of the 37 initially commissioned to combat the disease.

Of the 13 million units last acquired, more than two have already been applied to risk groups. It is a very low number of vaccinations: only 22% of nine million people at risk.
In Catalonia, have received preventive 250,000, 20% of those which are recommended inoculation. The consellera de Salut, Marina Geli, denied yesterday that the vaccination campaign was a failure and argued that influenza A was tightly before disposing of vaccines and when these were ready it was already known that the severity of the epidemic was low.

"Of the 265 million that the Government initially allocated to the purchase of vaccines, then only 92 million will be spent, 'he told the journalist Jose Martinez Olmos, general secretary of the Ministry of Health. The circumstances in which it has covered Spain for refusing to supply another 24 million vaccines, Olmos said, is that "at first, the World Health Organization (WHO) considered that the doses were administered as two but finally has enough with one application.

OTHER MARKETS / Does this decision that the laboratory will be staying with a huge surplus of vaccine? Mart?nez Olmos argued that there. "Spain closed the purchase of 37 million vaccines in June, when they were given two doses per person were expected to manage 40% of the population". However, when in October it was confirmed that a dose was sufficient, the Government informed "promptly" to the drug did not need 24 million units. The manufacturers, who also began to supply items in early October, and had time to stop making most preventive million still were not ready.

As for the units were ready for implementation and Health has rejected, the secretary general of the department recalled that laboratories have two possibilities: the first is sold in the private market, ie pharmacies. And the second is sold to other countries that did not or could not make a sufficient initial collection. Other governments, in contrast, did not sign any clause like the one initialed Spain and have had to keep all the commission.
The same caution with which negotiated the conditions of supply using the ministry to discuss the current status of influenza A. For this reason, Martinez Olmos stressed the "effectiveness" of preventive and remember that the vaccination campaign continues.

THE REMNANT / Health has decided to maintain an abundant surplus of 10 million doses. "We must not forget that WHO pandemic alert level 6 keeps intact and that the winter has just begun," said Olmos. Furthermore, experts predict that by the end of January could be a new surge of the H1N1 virus and, therefore, not be ruled out an increase in demand for vaccines.
If still on drugs, the Government [I love Google Translator

] reserves the right to allocate them to developing countries, but always through a cooperative initiative is supported jointly with WHO and the European Union.

Source: El Peri?dico

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Attached Files

**Giuseppe** · January 3, 2010, 03:29 AM

Re: Pandemic Flu. Spain remained last with 13.5 million vaccinations, according to health

I think Spain is not at the end of the list: Italy has vaccinated so far less than 1 million of people, as reported by latest Ministry of health weekly update, http://www.flutrackers.com/forum/sho...d.php?t=137987

Excerpt:

Vaccination of the population

Data on the number of vaccine doses administered during the 52 weeks (21-27 December 2009) were reported from 10 regions and autonomous provinces. In the 52 weeks were administered doses of 6206 and 2802 first second doses. Start of the vaccination campaign, a total of 812,559 first doses were administered, and 26,418 second doses.

Health professionals, social and health that have vaccinated 159,093, equal to 15% of the total.

Women in the second and third trimester of pregnancy were administered 22,249 doses (12% of total), people aged between 6 months and 65 years with risk conditions were administered 510,726 doses (12%) while children 1497 born preterm doses (7%).

Some regions have already begun to vaccinate children and young adults between 6 months and 17 years without risk conditions (15,894 doses) and the holders of at least one of the conditions of risk over the age of 65 years (9,225 doses).

**estacion** · January 3, 2010, 03:47 AM

Re: Pandemic Flu. Spain remained last with 13.5 million vaccinations, according to health

ENTREVISTA: TRINIDAD JIM?NEZ Ministra de Sanidad y Pol?tica Social
"Quiero unanimidad parlamentaria sobre el tabaco"
MAR?A R. SAHUQUILLO / EMILIO DE BENITO - Madrid - 03/01/2010

Su llegada a Sanidad coincidi? con la irrupci?n del H1N1. Pero Trinidad Jim?nez no quiere ser la ministra de la gripe. Para este a?o tiene en cartera la ley antitabaco, la de salud p?blica y un pacto de Estado sanitario

La ministra de Sanidad y Pol?ticas Sociales, Trinidad Jim?nez, tiene la cartera que simboliza su cargo debajo de la mesa. "Pesa", advierte al cogerla, "aunque menos que el modelo de los hombres". La sujeta con las dos manos, representando todo lo que abarca, aunque para esta entrevista le va a bastar con un asa, la que tiene que ver con la parte sanitaria, que no es poco: desde la gripe al tabaco, para empezar.

La ministra de Sanidad, Trinidad Jim?nez,
en su despacho.- ULY MART?N

A FONDO
Nacimiento: 04-06-1962 Lugar: M?laga

"Volver?a a tomar las mismas decisiones sobre la nueva gripe"

"Compramos 13 millones de vacunas. Se han puesto dos millones"

"Prohibir fumar no ha tenido ning?n efecto negativo en los bares"

"Plantear subvenciones a los hosteleros no tiene sentido"

"La salud del siglo XXI va a estar centrada en la prevenci?n"

"Las listas de espera se han rebajado cuatro o cinco d?as. Es poco"

"La salud del siglo XXI va a estar centrada en la prevenci?n"

Pregunta. Ha habido comunidades que han decretado el fin de la alerta por la gripe A. ?Va a seguir su ejemplo?

Respuesta. Lo que hemos hecho en estos ?ltimos meses es seguir las indicaciones de las autoridades sanitarias internacionales, tanto de la OMS como de la UE. Aunque por el momento la gripe A es una enfermedad leve y tiene una mortalidad baja, queremos seguir manteniendo la vigilancia porque el invierno no ha concluido. Se trata de un virus nuevo y nuestra obligaci?n es controlar la evoluci?n futura.

P. ?Qu? se va a hacer con las vacunas que no se van a usar?

R. Con las vacunas tuvimos la precauci?n de acordar en los contratos con las empresas farmac?uticas que si necesit?bamos un menor n?mero de dosis les avisar?amos. Hab?amos pedido 37 millones cuando todo el mundo predec?a que har?an falta dos dosis, pero en cuanto supimos que hac?a falta s?lo una se lo comunicamos. Estimamos que la compra final puede llegar a ser de 13 millones, de las cuales nueve los hemos servido a las comunidades aut?nomas, y el resto va a la reserva estrat?gica.

P. ?Y cu?ntas se han usado?

R. Se han puesto alrededor de dos millones. No hemos llegado al 25% de los grupos prioritarios, pero pensamos que podemos llegar. Es una cifra baja, pero ligeramente superior a la media europea. Es cierto que desde la alarma inicial a la situaci?n actual los ciudadanos han bajado la percepci?n de riesgo y no acuden a la recomendaci?n de vacunaci?n.

P. ?Se podr?n vender vacunas en el canal privado?

R. Eso depende de las farmac?uticas. En este momento no han querido hacer la petici?n a la Agencia Espa?ola del Medicamento porque no hay demanda y las personas que la necesitan la tienen en el sistema p?blico.

P. ?Qu? se va a hacer con los siete millones que sobran?

R. A?n no ha concluido la campa?a de vacunaci?n ni el periodo necesario para saber c?mo se va a comportar el virus. Tambi?n nos hemos planteado, y lo hemos ofrecido en la UE, poner en una bolsa com?n las vacunas, pero ante el comportamiento del virus y el hecho de que existan enfermedades que causan m?s mortalidad, a?n no hay un dise?o de cooperaci?n internacional.

P. ?Dir?a ahora que se exager? con la pandemia?

R. Habr? que esperar. Es f?cil hacer ese an?lisis en este momento, pero lo cierto es que cuando las autoridades sanitarias alertaron de que aparec?a un nuevo virus, como lo desconoc?amos todo de ?l, tuvimos que poner en marcha un sistema de alerta y vigilancia. A m? me han preguntado si exager? en la toma de decisiones. Pero hoy volver?a a tomar las mismas, porque en todo momento actuamos con medidas proporcionadas a la situaci?n que viv?amos. De hecho, el comportamiento del virus y su reacci?n han sido leves porque ten?amos todo previsto para actuar. Evidentemente, despu?s de que pase el tiempo podemos hacer un an?lisis m?s sosegado y completo. Francamente, creo que en Espa?a actuamos con mucha proporcionalidad, no actuamos como otros pa?ses y no nos dejamos llevar por la angustia de otros.

P. ?C?mo va a ser la ley antitabaco?

R. Lo ?nico claro es que por razones de salud p?blica vamos a modificar la ley. Es importante que eso lo entienda la gente. La decisi?n est? tomada. El objetivo es que se deje de fumar en los espacios p?blicos cerrados. Cu?ndo y c?mo lo vamos a hacer depende del proceso de negociaci?n. El tabaquismo causa alrededor de 50.000 muertes al a?o entre los fumadores activos; y de 1.500 a 3.000, entre los pasivos. La gente tiene que saber que, como autoridad sanitaria, tenemos que tomar decisiones para proteger la salud de la poblaci?n. Adem?s, con la ley que aprobamos en 2005 se ha ido generando una cultura social en la que predomina que la gente acepte con normalidad que en los espacios cerrados no se debe fumar para no coartar la libertad de los dem?s. En las conversaciones que he tenido con los distintos grupos parlamentarios ninguno me ha mostrado rechazo a la medida. Pero no quisiera adelantar el contenido de la reforma hasta que llegue a un acuerdo. Quiero que la ley salga por unanimidad.

P. ?Y los hosteleros?

R. No quiero entrar en confrontaci?n con ellos, pero lo que yo les transmito es que pr?cticamente todas las legislaciones de la Uni?n Europea est?n avanzando en esta direcci?n, y que los datos que tenemos de los distintos pa?ses indican que esta medida no ha tenido ning?n efecto negativo. Y si no lo ha tenido en Italia, Irlanda y Reino Unido, ?por qu? lo va a tener en Espa?a? En Reino Unido han abierto m?s locales, porque hab?a una demanda de personas que no iban a ellos porque el ambiente era irrespirable.

P. ?Tendr?n subvenciones?

R. Plantear subvenciones porque hay una modificaci?n legal que tiene coste cero me parece que no tiene sentido. Vamos a ver. La ley de 2005 no planteaba que los locales de m?s de cien metros tuvieran que hacer una reforma. Se dej? a la libre elecci?n del empresario el que hicieran una separaci?n. La ley no le obligaba. Y, por cierto, lo hizo menos del 1% de los 350.000 locales.

P. ?Cu?ndo van a incluir im?genes disuasorias en las cajetillas de tabaco?

R. En breve. La decisi?n est? tomada y est? todo hecho.

P. ?No le molesta haberse quedado al margen en la ley del aborto?

R. No nos hemos quedado fuera. Es una ley de Gobierno. He compartido con la ministra de Igualdad reuniones, decisiones, protagonismo en todos los sentidos que hemos estimado conveniente. No entiendo la pol?tica como compartimentos estancos, trabajo con muchos ministerios y creo que hemos llegado a una muy buena ley.

P. ?Qu? va a pasar con los m?dicos objetores?

R. La objeci?n de conciencia para los m?dicos existe desde que una sentencia del Tribunal Constitucional la reconoci?. Son pocos los m?dicos que se acogen, y est? perfectamente establecido en qu? casos.

P. ?Qu? balance hace de la venta de la p?ldora del d?a siguiente sin receta?

R. Tenemos datos de las oficinas de farmacia y las empresas de que se ha podido multiplicar por tres la venta. Pero el aumento de las ventas no corresponde a un abuso, sino a una demanda no satisfecha que exist?a.

P. En abril anunci? que en tres meses iba a tener lista una ley de salud p?blica. ?Qu? ha pasado?

R. No me cuesta reconocer que no es lo mismo hacer planes cuando llevaba 10 o 12 d?as al frente del ministerio que llevando ocho meses, como ahora. Si hacemos una ley queremos hacerla con la complejidad que entra?a afrontar la salud en los pr?ximos a?os. A medida que hemos ido profundizando hemos visto que necesitamos un poco m?s de tiempo. Es una ley que estar? en el primer semestre de 2010, y que va a poner el acento en la prevenci?n como elemento fundamental para la salud. La salud del siglo XXI va a estar centrada en la prevenci?n. Prevenci?n de la obesidad, pr?ctica del ejercicio f?sico, lucha contra el tabaquismo, alimentaci?n. Hablar de los determinantes sociales en la salud y las inequidades sociales en la salud es una visi?n muy progresista que me gusta much?simo. Queremos introducir como novedad que todas las pol?ticas que se hagan en el futuro tengan un estudio de impacto para la salud.

P. ?No hay riesgo de que sean s?lo buenas intenciones?

R. Desde los poderes p?blicos no s?lo tenemos que introducir regulaciones en la vida de los ciudadanos, sino ir creando determinados h?bitos de vida.

P. ?Definir? la ley mejor la participaci?n de los pacientes en la toma de decisiones del sistema?

R. Un cap?tulo espec?fico va encaminado a la informaci?n y a la participaci?n. Yo no veo a los pacientes como adversarios, sino como elementos necesarios para introducir las mejoras y detectar las disfunciones del sistema que no somos capaces de apreciar desde este lado.

P. ?Habr? pacto por la sanidad?

R. Por el momento yo me he encontrado una total colaboraci?n con las comunidades aut?nomas. Y con el sentimiento que me expresan los consejeros y consejeras de que la salud p?blica debe quedar fuera del juego pol?tico. Es leg?timo que las diferencias pol?ticas est?n presentes, pero creo sinceramente que estamos en mejores condiciones que nunca para conseguir un pacto.

P. ?Cu?ndo?

R. Tambi?n en el primer semestre de 2010. Hay algunos elementos que est?n pr?cticamente ya acordados. Pero las comunidades me han pedido que incorpore algunos aspectos que tienen que ver con la sostenibilidad del sistema. Me he comprometido con ellas a hacer un consejo espec?fico.

P. ?No teme que se reabra el debate de la financiaci?n?

R. La aprobaci?n de la ley org?nica de financiaci?n de las comunidades aut?nomas es un paso extraordinario. Hay que recordar que hubo un consejo donde se abordaron esos temas que hizo unas recomendaciones que se han incorporado todas al pacto, empezando por la revisi?n anual de la financiaci?n. Y no olvidemos que se ha hecho una transferencia importante de impuestos (IVA, impuesto sobre la renta, impuestos especiales) que en cuanto nos recuperemos de la crisis, que nos vamos a recuperar, supondr? un aumento considerable de ingresos por parte de las comunidades.

P. Tambi?n dijo que iba a tener un compromiso sobre las listas de espera. ?C?mo va eso?

R. Se ha rebajado en cuatro o cinco d?as. S? que es poco, pero ha habido un esfuerzo por parte de las comunidades.

P. ?Y habr? m?s transparencia?

R. El hecho de que los datos se den agregados es porque alguna comunidad aut?noma [Madrid] se ha quedado fuera porque usa indicadores diferentes.

P. ?No se le puede convencer para que use los de los dem?s?

R. No hay mecanismos de obligatoriedad, pero creo que la manera en que estamos trabajando con esa comunidad nos va a permitir llegar a un acuerdo.

P. ?Va a modificar la ley que permite a las empresas privadas gestionar la sanidad p?blica?

R. El problema no est? en que los servicios p?blicos los gestione una empresa privada, porque hay empresas privadas muy buenas. La cuesti?n es que mantengamos el fin p?blico, el control de calidad y el control de seguridad. El argumento que se ha venido esgrimiendo es que permite un mayor control del gasto p?blico, pero yo no estoy tan segura. Si se me pregunta a m?, soy firme partidaria de la gesti?n p?blica de los servicios sanitarios, porque se ha demostrado en Espa?a que es de una extraordinaria calidad y eficiencia. Para seguir un tratamiento de una cierta complejidad o una cierta envergadura, los ciudadanos tienen asumido que donde m?s garant?as van a recibir es en el sistema p?blico.

P. Entonces, ?qu? le parece la apuesta de Madrid y Valencia por una mayor participaci?n de las empresas privadas?

R. Tienen que hacer sus c?lculos, porque habr?a que ver si realmente se consigue gestionar de una manera m?s eficiente y con menos gasto.

Fuente: El Pa?s

Página no encontrada o de acceso restringido - EL PAÍS

http://www.elpais.com/articulo/sociedad/Quiero/unanimidad/parlamentaria/tabaco/elpepisoc/20100103elpepisoc_2/Tes

INTERVIEW: TRINIDAD JIMENEZ Minister for Health and Social Policy
"I want parliament unanimously on smoking"
MAR?A R. MARY R. SAHUQUILLO / EMILIO DE BENITO - Madrid - 03/01/2010

Her arrival coincided with the emergence Health of H1N1. But Trinidad Jimenez did not want to be the minister of the flu. This year the portfolio has anti-smoking law, the public health and sanitary State pact

Minister for Health and Social Policy, Trinidad Jimenez, symbolizing the portfolio is responsible under the table. "It's heavy" take it warns, "although less than the model of men." She held it with both hands, representing all that it embraces, but for this interview is going to suffice with a handle, which is concerned with the care, which is no small: from the flu to snuff, for starters.

[PHOTO]
Health Minister, Trinidad Jim?nez, in her office.-
ULY MART?N
IN DEPTH
Birth: 04-06-1962 Location: M?laga

"I would take the same decisions about the new flu"

"We buy 13 million vaccines. Two million have been set"

"Banning smoking has had no adverse impact on bars"

"Raising caterers subsidies makes no sense"

"The health of the XXI century will be focused on prevention,"

"Waiting lists have been lowered four or five days. It is little"

"The health of the XXI century will be focused on prevention"

Question. There have been regions that have enacted the all-clear by influenza A. Will you follow suit?

Answer. What we have done in recent months is follow the international health authorities, both WHO and EU. Although so far the Influenza A is a mild disease and has a low death rate, we continue to maintain vigilance because winter is not over. This is a new virus, and our duty is to monitor future developments.

Q. What will be done with vaccines that are not going to use?

A. With the vaccines had the foresight to arrange for contracts with pharmaceutical companies that if we needed fewer doses alerted. We had asked for 37 million when everyone was predicting it would take two doses, but once we knew we needed only one we told them. We estimate that the final purchase can become 13 million, of which nine have served to the autonomous communities [regions] and the rest goes to the strategic reserve.

Q. And how many have been used?

A. We have innoculated around two million. We have not reached 25% of priority groups, but we think we can go. It is a low figure, but slightly above the European average. It is true that after the initial alarm to the current citizens have lowered the perceived risk and do not come with the recommendation of vaccination.

Q. Can sell vaccines in the private channel?

A. That depends on the pharmaceutical companies. At the moment did not wish to petition to the Spanish Medicines Agency because there isn't demand and people in need have them in the public system.

Q. What is going to do with the seven million left over?

A. We have not completed the vaccination campaign and the period needed to know how they will behave the virus. We have also raised, and we have offered in the EU, put in a common stock of vaccines, but given the behavior of the virus and the fact that there are more diseases that cause mortality, there isn't a design of international cooperation, yet.

Q. Would you say now that the pandemic exaggerated?

A. We'll have to wait. It's easy to make that analysis right now, but the fact is that when health officials warned that a new virus appeared, as they knew nothing of it, we had to put up a warning system and monitoring. I have wondered if exaggerated in making decisions. But now take the same again, because at all times act with measures proportionate to the situation which we lived. In fact, the virus behavior and their reaction has been mild because we were all expected to act. Obviously, after time goes on we can make a more calm and complete analysis. Frankly, I think that in Spain we act with great proportionality, we do not act like other countries and we do not get carried away by the anguish of others.

Q. What will be the anti-smoking law?

A. The only thing clear is that for public health reasons we will amend the law. It is important that people understand it. The decision is made. The objective is to stop smoking in enclosed public spaces. When and how are we going to do depends on the negotiation process. Smoking causes about 50,000 deaths a year among active smokers, and 1,500 to 3,000, between liabilities. People have to know that, as health authorities, have to make decisions to protect the health of the population. Furthermore, the law passed in 2005 has been building a social culture that prevails in the people accept as normal in enclosed spaces should not be smoking to not restrict the freedom of others. In the discussions I had with the different parliamentary groups has shown me any rejection of the measure. I do not wish to reveal the contents of the reform until we reach an agreement. I want the bill out unanimously.

Q. And caterers?

A. I do not want a confrontation with them, but what I convey is that virtually all legislation of the European Union are moving in that direction and that the data we have from different countries indicate that this measure has had no negative effect. And if you have not had in Italy, Ireland and the UK, why it will have on Spain? In the United Kingdom have opened more stores, because there was a demand for people who did not go to them because the atmosphere was stifling.

Q. Will subsidies?

A. Propose subsidies because there is a draft law that has zero cost seems to me that makes no sense. Let's see. The 2005 law that the premises posed no more than one hundred meters would have to do reform. It was left to the free choice of employer to make a separation. The law did not oblige him. And indeed, it did less than 1% of the 350,000 premises.

Q. When will include dissuasive images on packets of snuff?

A. In brief. The decision is made and all is done.

Q. You do not mind being left out in the law on abortion?

A. No we are left out. It is an act of government. I've shared with the Equality Minister meetings, decisions, leadership in every way that we considered appropriate. I do not understand politics as compartments, working with many ministries and I believe we have reached a very good law.

Q. What will happen to doctors objectors?

A. conscientious objection for doctors exist since a Constitutional Court ruling recognized. There are few doctors who take in it and is well established in what cases.

Q. What is your assessment of the sale of morning-after pill without a prescription?

A. We have data from the pharmacies and firms that have been multiplied by three for sale. But the increase in sales is not for an abuse, but an unsatisfied demand existed.

Q. In April announced that three months would have a ready public health law. What happened?

A. I recognize that cost is not the same make plans while carrying 10 or 12 days ahead of the ministry taking eight months, like now. If we want to make it a law to address the complexity of health in the coming years. As we've gone deeper we saw that we need a little more time. It is a law that will be in the first half of 2010 and that will put the emphasis on prevention as key to health. The health of the XXI century will be focused on prevention. Prevention of obesity, physical exercise, tobacco control, food. Talking about the social determinants of health and social inequalities in health is a very progressive vision, which I love. We want to introduce as a novelty that all policies are made in the future have an impact study to health.

Q. No risk of being just good intentions?

A. From public authorities not only have to introduce regulations on the lives of citizens, but going by creating certain habits.

Q. Define the law better patient involvement in decision-making system?

A. A separate chapter is directed to the information and participation. I do not see patients as adversaries, but as necessary to make improvements and detect system failures that we are not able to appreciate from this side.

Q. Is there agreement on health?

A. At the moment I have found a total collaboration with the Autonomous Communities. And with the sentiment I expressed the counselors [female] and counselors [male] that public health should remain outside the political game. It is legitimate that political differences are present, but I sincerely believe that we are better able than ever to get a deal.

Q. When?

A. Also in the first half of 2010. There are some elements that are virtually agreed. But communities have asked me to incorporate some aspects that are related to system sustainability. I am committed to making them specific advice.

Q. Do you fear that reopening the debate on financing?

A. The adoption of the organic law of finance of the autonomous communities is an extraordinary step. Remember that there was a council where they discussed those issues that made some recommendations which have incorporated all of the pact, starting with the annual review of funding. And do not forget that it has made a significant transfer tax (VAT, income tax, excise duties) that once we recover from the crisis that we will recover, will be a substantial increase in revenue by the communities.

Q. Also said it would be a commitment on waiting lists. How goes it?

A. It has been lowered by four or five days. I know it's little, but there was an effort by the Autonomous Communities.

Q. And there will be more transparency?

A. The fact that aggregated data are given is because some regions [Madrid] has been left out because it uses different indicators.

Q. You can not be persuaded to use those of others?

A. There is no mandatory mechanisms, but I think the way we're working with that community will allow us to reach an agreement.

Q. Are you going to change the law that allows private companies to manage public health?

A. The problem is not that public services are managed by a private company because there are very good private companies. The point is to maintain public order, quality control and security control. The argument has been brandishing is that it allows greater control of public spending, but I'm not so sure. If you ask me, I am a strong advocate of public management of health services, because it has been shown in Spain that is of extraordinary quality and efficiency. For treatment of a certain complexity or a certain size, people have assumed that where more safeguards will receive is in the public system.

Q. So do you think the bet of Madrid and Valencia for a greater involvement of private companies?

A. They must do their calculations, because there would have to see if it gets really manage more efficiently and with less expense.

Source: El Pa?s

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