The growth of healthcare expenditure actually executed in Catalonia last year was the lowest since 2016. It increased by 2.9%, up to 14,056.2 million. It is a figure of increase below the 4.3% estimated by the previous team of the Department of Economy led by Jaume Giró when it presented the 2022 budgets in the fall of 2021.
The slowdown in the growth of real expenditure (accrued) is a consequence of the low impact of covid on the system. In fact, if you analyze the evolution of ordinary health expenditure without taking into account everything related to the pandemic after the two years, the growth is much greater: of 9.7% year-on-year between 2021 and 2022.
Sources from the Department of Economy, which is currently headed by Natà lia Mas, explain that the growth in non-covid health expenditure is fundamentally a consequence of the recovery of the rhythm of diagnostic tests and ordinary activity once the impact of the pandemic has been decreasing .
The Health area is the only one in the Generalitat that has unlimited spending. For this reason, the forecast set by the budgets is never fulfilled in this department. In the accounts of 2022, for example, it was expected to spend more than 11,000 million and in the end the bill exceeded 14,000 million. The expected growth is also very different from the actual one, because the year before was also greater. Giró’s budgets estimated a 15% rise in healthcare expenditure and the aforementioned 4.3% increase in entitlements. The accrued expense is the one that has actually been executed. Not the expected one. This is also why it is very difficult to make estimates.
The Department of the Economy defines the accrued expenditure as that “actual for the budgeted year as a result of the activity carried out regardless of the moment in which it is carried out”. In this way, it is possible to assess “the volume of services that are being provided at each moment”.
The bill paid last year is the largest in the historical series, as can be seen in the graph. It’s always like this, that every year is a record. Only during the financial crisis was this rule not met and in several years less was spent than the previous year. Those were the years of cuts. The impact of the crisis on public accounts was so remarkable that it took the Generalitat a decade to recover the level of health spending prior to those cuts. Last year’s 14,056 million is more than double what was running in 2003 and 2004, when the series begins.
As a result of the civil war, the health sector was particularly strained in the years 2020, 2021 and 2022. This extraordinary situation led to increases never seen before. During the first financial year, growth was 19.5%; in 2021, of 4% and in 2022, of the aforementioned 2.9%. The increases are very different if you take into account only the “normal” healthcare expenditure without the specific one due to covid. In this case, spending increased by 1.9% in 2020, 7.4% in 2021 and 9.7% last year. This strong increase in spending (without covid) last year, however, remains below the increase in the years before the bubble (between 2006 and 2008) when they were more than 10% .
Last year covid cost 848.1 million, and that means 6 out of every 100 euros spent last year. For this year, the budgets have a health allocation of 11,636 million, which means 9.6% more. The item is below what was spent last year. For this reason, it is expected that the real expenditure (accrued), one more year, will be above what was approved in the budgets. During the presentation of the public accounts for this year, the Natà lia Mas team declined to make an estimate of the increase in accrued expenses.
