As manager of communication of the University of Navarra, I would like to contribute some reflections to a discussion that will foreseeably become more intense as the date of the budget vote approaches. In these lines, I would like to offer two considerations and three suggestions.

The first consideration refers to the Navarra Health Service. Osasunbidea has the reputation of being one of the best health services in Europe and the most highly valued in Spain, as shown by a recent national user satisfaction survey survey . In this sense, living in Navarra is a privilege.

It is logical to ask: why do these 7,200 people not want to be cared for in such a qualified service? We have always answered that it is not at all because we do not want to be cared for in the SNS, but because the relationship with a specific doctor or nurse creates links that recommend stability and continuity, both in public and private centers. On December 30 last year, 7,200 people learned from the press that the current agreement was due to expire the following day. How can we not understand their concern?

Secondly, it should be emphasized that agreement is not a right, but the fruit of a agreement. There are reasons for and against. Personally, I consider some of the arguments against it to be correct: organization of the public health system, economies of scale, etc. But the discussion is not about principles, but about the possibility of finding an even better formula in Navarra, bearing in mind that the current one has proved to be efficient since the early 1980s. The question would be: is it possible to look for solutions that do not contradict the principle of equity and are economically favorable for the SNS?

With these starting points, I think it would be appropriate to continue this discussion with transparency, respect and spirit of partnership. This has been expressed by both the President of the Government and the President of the University of Navarra.

Transparency. Numbers are not dogmas. They provide a measure of reality, but they can be partial. That is why they must be clarified, contrasted, adjusted and compared. In any case, transparency is today a requirement of political and social life. 

The Clinic has provided data on the activity and costs of attendance to these 7,200 individuals. They come from the report of management that is sent annually to the Department, are result from an analytical accounting system and are audited. I recall some numbers. Fixed costs plus variable costs total 8,972,487 euros. Of this total, 2,403,335 correspond to purchases made for patient care (medicines, medical supplies, etc.). According to these data, the agreement represents a saving for Navarra.

At the moment the reports of the Regional Ministry of Health are not public, but they will surely be known in the next few days. There is agreement in that now it is time to put the numbers on the table and study them objectively.

Respect. The agreement poses a relative discussion entity: the current 5.1 million represent about 0.6% of the budget of the SNS. But at purpose of this topic latent currents of opinion have surfaced, which have ancient and deep roots and easily lead to a predominance of heatedness over lucidity. That is why I think it is important to maintain respect and serenity.

In a long-term relationship, blaming each other is useless. Rather, we must remember that throughout life, we all get it right and we all make mistakes, sometimes we explain ourselves well and sometimes we explain ourselves badly. At the University we are aware of this reality and we are convinced that we have to change some ways of doing things and some ways of communicating. Moreover, taken with respect and serenity, this discussion of agreement can become an occasion that helps to improve, or even a turning point. In this context, it is coherent that we ask that the reasons of the 7,200 people affected by agreement be listened to with respect.

partnership. The University of Navarra is an institution that deals with long periods of time. That is why we are not comfortable with polemics. At present, there are numerous forms of cooperation with all subject of institutions in the Comunidad Foral. Many more may be proposed in the future. In the health field, it would be worthwhile to evaluate, for example, the willingness of partnership in the complicated management of the waiting lists.

The University needs Navarra to carry out its educational and welfare work. At the same time, the University wishes to serve Navarre in whatever way it can. With its work, the 4,000 professionals of the University contribute a great deal to the region and are often ambassadors of Navarre throughout the world.

With these instructions of transparency, respect and partnership concrete solutions to the particular issue under discussion can be sought and future issues can be approached in a constructive manner.