AMONG 25 BEST LATAM HOSPITALS

Ecuador 2019 | HEALTH & EDUCATION | VIP INTERVIEW

TBY talks to Javier Contreras Cevallos, Executive President of Grupo Conclina, on Ecuador's healthcare system, public private sector interaction, and expectations for the year ahead.

How have you positioned your hospital group within the healthcare landscape in the country?

We are one of the largest hospitals in the private sector in Ecuador. At the time of our establishment, there were mostly smaller clinics in the country. When we opened, we attracted many healthcare professional who studied abroad and wanted to utilize their experience in a large-scale hospital. This led to a scaling up of other healthcare facilities as well, so in that sense we were pioneers in improving the standards. As the first and only hospital in Ecuador, we have JCI accreditation, while we rank within the 25 best hospitals in Latin America, by America Economia. Still, we keep working on improving our standards: being the best in Ecuador is not enough for us. To be able to provide people with the best level of care, we invested in a medical prepaid company called Humana, which functions like an insurance company and gives wider access to healthcare. Still the healthcare environment in Ecuador is not that patient-friendly yet, with confusion over the role of the private sector and the public sector, in terms of financing this access. Our constitution states that the country—the government—will guarantee access to everybody, but sometimes the authorities, then, state that part of this responsibility comes to the private sector. Through the social security institutions, people make their obligatory payments to be eligible to healthcare. The rest of population has access provided by the Ministry of Health. The private sector does not get funding from that and self finance our operations is a must.

How should the synergies between the public and private sector be enhanced?

Three years ago, therefore, we had to close down our transplant facilities—the only such facilities in the country—because due to the system in place, our bills could not be paid. As a private institution, we should be able to invest in our healthcare, and provide it in return for sufficient financing. Shutting down our transplant unit was not good for the country – public and private healthcare should complement each other. Currently, the way the public and private sector interact put financial pressure on the private healthcare providers, which has even led to bankruptcy of some. Fortunately, in 2012, we managed to open up our agreements with the social security institute to put a limitation on our exposure under that payment structure. There is a new law under review, the “Código Orgánico de la Salud", and although people need the best possible care, but proper financing is just as important for sustainability of the sector. In the private healthcare sector, there will always be a corporate view so you can sustain your operations. That does mean, you cannot accept all patients for free, obviously. That said, we have a strong CSR program in place, and we do receive around 9,000 patients almost for free for medical consultations, in addition to 650 complex surgeries for those who cannot afford it. It is our vision to be conscious, to provide affordable care, while maintaining operations as an enterprise. The Ministry of Health should take care of the rest, one way or another. Currently, there is a great opportunity to improve healthcare, and we are happy to collaborate with the ministry and the other healthcare facilities to make this happen and to complement one another.

What are the ambitions for the coming year?

We would like to further advance in tertiary and specialize care, as we have the expertise in-house. In the short and mid-term, the road ahead is quite challenging but I do believe that in the long term, we can achieve our goals for Grupo Conclina, while also moving towards a better healthcare environment in general. The public sector is focusing on preventive healthcare, as they should be, but they are diverting some of their responsibilities to us. As a listed company with 2,000 shareholders, we have to maintain an enterprising perspective and be rational. The general occupation in the private sector is 65%, so there is unused capacity that should be allocated for the greater good.