The President of the Independent Authority for Fiscal Responsibility (AIReF), Cristina Herrero, took part today in the latest edition of Spain Investors Day, participating in the round table discussion “Healthcare, a driver of growth and innovation”, alongside the Minister of Health, Mónica García; the President of Novartis Spain, Amaya Echevarría; and the Director of the Department of Public Health and Environment at the World Health Organisation (WHO), María Neira.
In her remarks, she analysed the relationship between health, the healthcare system, and the competitiveness of the economy, and examined the case of temporary disability, a welfare system benefit with a clear impact on effective labour supply, productivity, and the organisation of companies. She announced that the evaluation recently completed by AIReF identifies room for improvement in the institutional design and governance of the benefit that would increase its effectiveness and efficiency without altering the level of protection. AIReF plans to publish this evaluation in early February.
The President pointed out that the separation between clinical decision-making and the assumption of economic costs, together with the existence of 17 regional health services and the limited coordination capacity of the National Social Security Institute (INSS), hinder the efficient management of temporary disability. From a competitiveness perspective, she noted that improved coordination between the health and labour sectors, better information, and closer monitoring of cases would contribute to better functioning.
Improving spending efficiency and employment
On the challenges of improving healthcare spending efficiency, Cristina Herrero noted that, based on experience gained from AIReF’s healthcare evaluations, the main room for improvement lies in system management. Specifically, this relates to how decisions are made, investments are planned, goods and services are purchased, and prescribing takes place—all of which involve key aspects of governance, incentives, information, and planning. Among other elements, she cited strengthening value-based decision-making, promoting the use of biosimilars and generics, improving the planning of high-technology investments, and making better use of information and data.
On healthcare employment efficiency, she stressed that analysis cannot be limited to the number of professionals or personnel spending, but must focus on how human resources are planned, organised, and managed. Although healthcare employment has significant strengths, AIReF’s evaluations identify significant room for improvement through better planning, a reduction in temporary contracts, more strategic use of incentives, and greater management autonomy in healthcare centres.
The AIReF President stressed the need to integrate evaluation into the decision-making process and the budget cycle, in line with OECD recommendations. She noted that AIReF systematically applies combined quantitative and qualitative approaches, enabling analysis of impacts, costs, governance, and incentives, as well as territorial and international comparisons, with particular relevance in the health sector.
