Covid hits the medical transport business

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Perhaps the answer to the question of how much a van can be squeezed is given by the flames that devoured an Iveco Daily on October 14 on the A5 motorway near Navalmoral de la Mata (Cáceres). It was an ambulance en route to Madrid. The paramedic who was driving her managed to lower the patient and remove the oxygen cylinder before it exploded.

It is not an isolated case. A succession of fires has destroyed vans of the same company, Tenorio ambulances, in Casar de Cáceres in August, and in the same A5 on January 12, this with several passengers among patients and companions. In Malaga, on August 23, an ambulance that the same firm intended for service on the Costa del Sol also caught fire while running.

Those burning ambulances are a metaphor for the state of the business of medical transport in the pandemic, a sector plagued by conflicts: strike and complaints in Catalonia, protests by users and workers in Andalusia, Madrid, La Rioja and Extremadura, parliamentary investigation in Cantabria, sanctions from the Labor Inspectorate in Aragon, and strike and termination of the contract in Castilla-La Mancha.

European alert

Ambulances Tenorio does not comment to EL PERIÓDICO what happens to his vans. The firm, one of the leaders in the sector throughout Spain, He has not filed a complaint for sabotage, report sources from the Civil Guard. The armed institute observes the phenomenon through a preventive informative diligence in case any criminal relevance is derived from the facts.

On October 15, the company announced legal measures against Iveco, considering that the fires are caused by “a problem foreign to this company.” 90% of the 1,000 ambulances that Tenorio has are Iveco.

Perhaps an alert from the Consumer Safety Portal of the European Commission explains the fires. Last May it issued the notice A12 / 00674/20, on “serious risks” in 16 models of the Iveco Daily van: “A high temperature in your particle filter it can set the vehicle on fire, “says the alert.

Inspection approved

Iveco, through its communication department, says it is unaware of the case. Among the most striking details of these fires is the one that all the ambulances had passed technical and health inspections.

CCOO of Andalusia blamed the Malaga fire on the old age of medical transport vehicles in Spain, and how on the Costa del Sol the ambulance contract has been automatically renewed since 2014, with the same specifications.

To the north, in La Rioja, the sanitary technician Adrián Zaldívar, UGT delegate in the contract that Ferrovial has in the region, is surprised to see some vans on the road: “I’ve always wondered how they managed to pass inspection. But the fact is, they pass it.”.

“Pass the inspection, go back to the workshop and they take everything away for the next ambulance that needs it …”, account Victor Arnelas

Victor Arnelas, Head of Sanitary Transport at USO Extremadura, and JF, a veteran of Aragon’s ambulances without union activism who asks for anonymity, speak directly of picaresque in the sector. “Many times we witness how an ambulance comes bare, on the same morning that it has to pass the inspection He goes through the workshop, all the things he needs are filled in, or the things that they know the inspectors will ask for. He passes the inspection, returns to the workshop and they take everything from him for the next ambulance that needs it. We are sick of seeing this, “he says.

And JF tells: “In twelve years that I have been in the sector I’ve seen all kinds of tricks: from going to a friendly ITV who is not interested in losing you as a customer, until change the wheels to pass the ITV and then put the old ones back on, or lighten weight so that the ITV does not give the excess that all medical vehicles carry “.

Unstable hires

He that inspections are always dated It is one of the details that companies are taking advantage of to reduce expenses.

The pandemic is stressing public contracts thought for other times. The expenses overwhelm the benefits: more Epis, more masks, more trips and more disinfections. That is why companies are beginning to think about their continuity.

In Extremadura, Tenorio has expressed his desire not to continue in the current conditions. In Madrid, the government of Isabel Diaz Ayuso automatically renewed la contract with Ferrovial for 42.5 million euros until 2022. It was last August 28, but the construction company is still waiting to renegotiate the terms of the contract, according to Madrid health sources, as it is not comfortable. The firm does not comment on the matter.

Reduce expenses

In this situation of hardening of the business, their unwritten standards are deteriorating service … and opening a flank to the virus.

An internal email from the Extremadura Health Service that EL PERIÓDICO has had access to describes the situation. On April 7, masks and PPE were in short supply in Spain, but not bleach. However, at the Health Assistance Directorate, the doctor complained Ana Morano: “In the facilities of the company (Tenorio) in Badajoz cleaning products and materials are scarce and in poor condition. “

On March 30, an ambulance base coordinator in Cáceres also complained in another email: “In this base no cleaning and disinfection product has been received for de side of the company”.

Due to very similar details, the Government of Castilla-La Mancha decided on October 7 terminate the ambulance contract with the Andalusian company Servicios Sanitarios Generales, another of the biggest in the sector.

Javier Abella spokesman for the Sanitary Technicians area of ​​the Spanish Society of Emergency and Emergency Medicine, ruling: “The pandemic has hit the waterline of these companies, displacing the presumed expenses of the contracts. Many times it has been public services that have provided PPE to companies, and they have been waiting, considering that they have a closed contract and that it is not their responsibility to take charge of what comes to the elderly “.

Today, says Abella, the ambulance technicians “are not well equipped. There are still shortages in many services, and procedural changes to save on PPE, without following objective, proven and scientific criteria.”

The precedent is in March. In that month, in Logroño, “a large number of Epis have been reused by order of those responsible, stacked on hangers without being thrown away “, relates a public complaint from UGT about the Ferrovial contract.

Money

A sector that interested large construction companies for important contracts such as Madrid and La Rioja (Ferrovial) or Zaragoza (Acciona), and in which Venture capital funds had already entered, as in nursing homes.

This is the case of one of the main contracts in the country, Transports Sanitaris de Catalunya, which belongs to the Health Transportation Group, in turn the result of the merger of Ambuibérica and Emeru.

“The pandemic has hit the waterline of these companies”, explains Adrián Zaldívar

Ambuiberica was owned by the Proa Capital fund, which it has sold to the British Glendower fund. Proa Capital’s relationship with healthcare is shared with interests as diverse as military avionics or Gallo pasta. Glendower, for its part, also has money in truck and bicycle component factories. Emeru is from the Investindustrial fund, which belongs to the Bonomi family. His interests range from the chocolate business to the making of PVC to the making of hot tubs.

Against this and other contracts, CCOO, UGT, USOC and SINDI.Cat have summoned in Catalonia strike since October 9. Extensive minimal services are making it barely noticeable.

Reckless cuts

For all the health technicians consulted, poor prevention in ambulances is due to the outsourcing of health processes.

“Even before the pandemic, these contract documents were not profitable,” says Zaldívar from Logroño. And from Badajoz Víctor Arnelas says: “The Administration does not even know what the service is worth and takes out tenders with poorly calculated prices,companies pull down to win the contest. Then they have no choice but to default contracts to be able to do business, because what they are not going to do is lose money. “

In Extremadura, the service went up for auction in 2017. A tender of 139.6 million euros and four years duration was at stake, for 432 vehicles and 842 workers. Tenorio won by promising a cost of 122.4 million, 17 less than what was set. A local consortium was wrong thinking that it was going to win by lowering the bidding by eight million. He lost, like the other two contestants, Ferrovial and SSG, who had only offered discounts of 100,000 and 600,000 euros.

Today in Extremadura there are circulating “more than 100 ambulances without defibrillator”Arnelas laments. There are even in malls and buses, but not in those vans.

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