The Community of Madrid took advantage of the Government’s weekly press conference this Wednesday to directly attack the surgeon who reported the manipulation of waiting lists at the Ramón y Cajal hospital. “This case is very simple: the same complainant is the one who manipulated the waiting lists. He is a worker at the Ramón y Cajal hospital who irregularly manipulated the severity of 57 patients for his own benefit, to work less and operate on less complex cases. The center’s managers detected it and this irregularity was formally warned in writing for him to correct it,” said the Health Minister, Fátima Matute, who appeared expressly because of this case. The complaint of this surgeon was joined by those of three other specialists with whom this newspaper spoke, who supported his complaints.
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The government of Isabel Díaz Ayuso wants to reduce the case revealed by EL PAÍS to a conflict between the surgeon and his head of service. Matute announced on Tuesday that she will investigate whether the managers of that hospital lowered the priority of surgeries for patients on the waiting list behind the backs of the doctors who had evaluated those patients. But that investigation is flawed from the start because Matute herself questioned the credibility of the complainant, the surgeon Luis Alberto Martos, and anticipated the outcome: everything is correct, she said.
Now it has gone further. Matute has said that the surgeon has been accused of “slashing the tires of the car and scratching the car of his head of service.” Martos told this newspaper that this incident was investigated and closed due to lack of evidence, that the case was opened “for defamatory purposes.” The pressure from the Community of Madrid on him, at this moment, is brutal.
The reported events occurred between February 28 and March 14 of last year, when 57 patients on the surgical waiting list of the Orthopedic Surgery and Traumatology service at Ramón y Cajal went from preferential priority (those who must be operated on within 90 days) to normal (operation within 180 days). In this way, the managers gained time to achieve the expected result: that patients were operated on within the deadline.
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EL PAÍS has accessed documents and emails showing that the alteration was ordered by these two managers and has spoken with four doctors from the service who say they were not consulted. The surgeon who provided this evidence, Luis Alberto Martos, reported what happened to management without getting a response. Weeks later, the hospital opened disciplinary proceedings against him.
The manipulation of waiting lists is a widespread suspicion in Spanish healthcare because there are electoral incentives (administrations publish this metric monthly on the internet) and also economic ones (doctors with responsibilities receive productivity bonuses if they meet objectives). In Madrid, the case is well known that in 2005 led the region to be expelled for 10 years from the national system of surgical waiting list computation, when it was discovered that the delay for an operation was counted from the anesthetist visit, instead of the previous moment when the doctor prescribes the operation. That is, the timer was activated later than it should have been to improve the figures.
