José Reyes
Director General
Institute of Safety and Social Services for State Workers (ISSSTE)
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Expanding Public Hospital Network Through PPP Schemes

Wed, 11/01/2017 - 11:45

Q: What are the advantages of building hospitals through PPP schemes?

A: ISSSTE has an internal infrastructure program as well as its own fiscal resources but due to budget adjustments we have had to vary our financing sources. We needed to migrate to a new scheme involving the private sector to continue building and expanding our network of hospitals and clinics. In 2016, ISSSTE invested over MX$4 billion to build and/or expand a number of clinics and hospitals throughout the country. We estimate that remaining investments from PPP schemes during the current federal administration could total about MX$14 billion

Q: What criteria helps ISSSTE decide where a new hospital or clinic will be built?

A: The concentration of beneficiaries and the existing public health infrastructure in a region are the key criteria. The Ministry of Health, ISSSTE and IMSS have developed a strategy that prevents duplication through mutual subrogation. If there is an IMSS hospital in a community with an ISSSTE clinic and a patient at the latter needs surgery, hemodynamics or cardiovascular services, the procedure will be performed at the IMSS hospital whenever possible. Services will also be subrogated from IMSS to ISSSTE, which does not mean implementing a universalization program but exchanging services and prioritizing cities and states according to the demand for services and the existing public infrastructure. All publicsector agencies need to maintain a close relationship and exchange services before allocating them to the private sector. Of course, cooperation between public institutions does not prevent the subrogation of services to private hospitals. We have contracts for integral services like hemodialysis and some minimally invasive surgeries. We also have collaboration and service-exchange schemes between both public and private entities.

ISSSTE is analyzing several new hospital projects in Tampico, Acapulco, Oaxaca and Mexico City. We have also received requests for new hospitals in San Luis Potosi and Sonora. There is a PPP hospital being built in Merida and three others to be tendered: Mexico City-Tlahuac, Villahermosa and Tepic.

Q: What are ISSSTE’s main priorities for the remainder of 2017 and beyond?

A: First, we want to continue modernizing ISSSTE through several measures: building new facilities, installing new equipment, hiring better-qualified health technicians, reducing processing times for home loans and retirement payments, reducing surgery wait times, accelerating emergency services, consolidating our hemodynamics areas and developing the triage protocol at emergency departments. Secondly, we aim to humanize the institution. If we do not create a warm, more caring ISSSTE, then we are failing. The Trato para un buen trato program is an agreement between ISSSTE and its labor union to make the hospital personnel more patientfriendly.

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