TOLEDO.—Less than four weeks and it will be time for citizens to have a say in elections and choose who will lead regional and municipal governments for the next four years, the management model and what their priorities should be.
Thus, a legislature for the governments of the twelve autonomous communities now ceases to exist, without any agreement on what has been done – allowing for the health crisis posed by the pandemic and the economic crisis caused by the war in Ukraine – some of which One of the workhorses of the executives: the regional financing,
Governments, including Castilla-La Mancha, who have been demanding proper funding for years Allows for effective compliance with equal opportunities established in Article 14 of the Spanish Constitution, in particular with regard to access to public services such as health or education,
and he is Managing healthcare in big cities is not the same with hundreds of thousands of inhabitants, to do so in sparsely populated areasaccess to which citizens must also be guaranteed, which means very high costs.
For example, managing the provision of public services in a region like Castilla-La Mancha with a population of 2,058,049 inhabitants (according to the latest figures published by INE, as of July 2022) is not the same. Spread over an area of 79,461 km in 919 municipalities2, To do so in the neighboring Community of Madrid, which has a population (6,825,005 inhabitants) three times that of Castilian-La Mancha, although it is concentrated in an area almost 10 times smaller (8,028 km).2), in 179 municipalities.
Thus, while in the first the population density is barely close to 26 inhabitants per square kilometer, together with Extremadura and Castilla y León which present less data; The second has the highest population density in the entire national territory, with 850 inhabitants per square kilometer.
differences that translate Higher cost of maintaining the centers or hiring staff To serve them, eg.
Therefore, one of the claims of territories such as Castilian-Manchego, characterized by the wide dispersal of its inhabitants, is that Incorporating depopulation criteria while distributing funds With which these basic services can be guaranteed without additional effort for the regional treasury.
Matters pending resolution at the state level, but whose inequities continue to face autonomy, whose characteristics are in the face of the expenditure necessary to provide these services.
Thus, for example, while in the Community of Madrid, which has extended its budget this year to 2022, out of a total of 23,032 million euros, the expenditure planned for health does not reach 8,784 million (about 38 percent). Castilla-La Mancha, 36 percent of its budget’s non-fiscal expenditure is allocated to health, representing a little over 3,620 million (900 million more than in 2015) out of a total of 12,438 million budget for this year does.
Expenditure in the same percentage, which however Does not represent equal effort for one area and another, since if the percentage of GDP and expenditure per inhabitant is considered, according to the latest data published by the Ministry of Health, with regard to public health spending in the 2021 fiscal year, the Community of Madrid allocated 10,353 million euros, which is 4.4 represents a percentage of its GDP with a per capita cost of 1,536 euros; while Castilla-La Mancha with 3,670 million, which represents 8.7 percent of GDP, had Expenditure of 1,793 Euros per inhabitant,
With regard to the number of centres, as per the latest data published by the Ministry, also relating to 2021, whereas There were 1,314 centers in Castilla-La Mancha.of which 1,111 local clinics and 203 health centers, In the Community of Madrid, the total number of public centers to serve a large population was 424.Of which 262 are health centers and 162 are local clinics.
Primary care, to which 28 percent of the total health budget was allocated in Castilla-La Mancha last year, more than doubled in 2015, when it was barely 13 percent.
data from a public domain that contradicts Each community has a load of private health sectorWhich represents half of the total in the Community of Madrid.
Thus, for example, while the number of public hospitals in this autonomous community was 37 in 2021, the number of privately owned hospitals was 48 (33 with partial concussions) with 14,519 and 6,701 beds, respectively. For its part, in the case of Castilla-La Mancha, along with 18 public hospitals, there were 7 private centers (six of them with partial conservancy) with 5,256 and 334 beds, respectively.
The difference in terms of access to public health is also marked by another law in Castilla-La Mancha from the same year, which guarantees against economic, social and tax measures and for the development of the rural environment. Health resources are less than 30 minutes away in populated areas or at-risk areas of the population.
guaranteed by law
A law to deal with the population that also guarantees the provision of other types of services in rural areas, such as education, Guaranteed opening of rural schools with at least four students,
This is very different from what happened between 2011 and 2015, when 70 rural schools were closed in Castilla-La Mancha under the PP government of María Dolores de Cospedal. However, in this course, in this area are 256 population centers with rural schools74 of which have eleven or fewer students.
The budget item for education, to which the region dedicates about 2,300 million euros in its 2023 budget, costs about 5.5 percent of regional GDP. an exercise in Planned expenditure per student exceeds 7,200 EuroWhile the total expenditure for personnel is 1,586 million.
An item that exceeds the 400 million euros that the neighboring community of Madrid will allocate this year organized education (1,164,550,095 Euros), compared to 810 million Euros agreed by the Government of Castilla-La Mancha for six academic years.
difference, an autonomous community and a load of solid education in the other. While in Castilla-La Mancha they’re around 140 privately owned centers with educational music programs (including special education), In the neighboring area this figure is beyond 500.Compared to 812 public schools for early childhood and primary education and 358 existing institutions in the Community of Madrid. In Castilla-La Mancha, there are more than 1,200 publicly owned centers in these educational phases.
Two models of addressing the provision of health and education services that are separated by an administrative boundary, whose priorities and budgets are also influenced by demographic factors and region.
