IHF Bulletin: Featuring La Unió Catalana d’Hospitals

Date:  30 October 2020

IHF Bulletin: Featuring La Unió Catalana d’Hospitals

The Catalan health system is based on inclusive, quality social care.

  • With universal access, a system considered one of the best in the world.
  • With a stable, inclusive, professional and socially responsible network for the provision of care.
  • Backed up by positive results as regards people’s health and welfare:
    • More years of life in good health.
    • Longer life expectancy
    • Lower mortality



  • It is a model based on our country idiosyncrasy
  • Ruled and run by the Catalan government and Health administrations (after health competencies were transferred by Central Government in 1986)
  • With a Network of healthcare providers of different ownership, public and private, all working for the public healthcare system.


In 1986, the Spanish Health Act that recognized the UHC as a right, and created the National Health System, that was decentralized to the regions.

In 1990 Catalonia approved its Health Act (LLOSC) and begin to manage its own healthcare system.  That law recognizes and consolidates the singularities of the Catalan healthcare model, based on:

  • The coexistence of a public healthcare system and privately-funded health care, in a country where one in four people freely choose to have double health coverage (public and private).
  • A public healthcare system, with a management model based on the split of the functions: financing (health administration) and provision of services (the network of providers). The Health Administration is responsible for accreditation, planning, contracting and evaluating public healthcare system services. The Health services delivery depends on a network of public healthcare providers, some public in ownership (and run by the Health administration directly), some private that have a contract with the health administration. This network is integrated by a diversity of institutions (hospitals, PC, long term care), with different ownership (Foundations, Consortia, Trusts, Religious orders, mutualities, …), that contribute with its facilities, resources and professionalized management to the public healthcare system.
  • A decentralized model in the territory that brings resources closer to the population. We have a network of tertiary hospitals that are a reference for the entire population and a network of county hospitals, near the population. Also, a widespread PC network that covers all the population.

The contract model contributes to the public health system: putting its resources at the public system service, improving access, increasing knowledge, guaranteeing professional management and addressing innovation, regardless of ownership.


La Unió is the Catalan Hospital, Health and Social Services Association.

The commitment to improving people’s quality of life has made La Unió a reference association for organisations engaged in the health and social care system.

La Unió is an association of health and social care organizations, a referral for the transformation of the system, that work to improve the health and quality of life of people.

As a privileged agent in this context, La Unió, which has more than 40 years of existence, stands out for serving its members, defending their interests, being a reference partner and influencing the improvement of the Catalan health and social model to benefit our society.

A leading player in this system, La Unió engages in various lines of action:

  • Mediation with government
  • Collective bargaining over working conditions
  • Promotion of professional development
  • Lobbying, creating opinion
  • Generating knowledge and innovation
  • Helping to design the strategic vision that guides the health and social care system
  • Promoting good practice in the sector



  • We are all organisations formed by people who serve people.
  • We promote health and social care systems that encourage public-private cooperation at the service of public policy.
  • Our philosophy of health and social services is that these should foster people’s health, well-being and autonomy.
  • We adopt professional, results-oriented management standards, conducting evaluation processes and sharing best practices.
  • We are committed to sustainability, transformation and social responsibility.
  • We support research and innovation focused on clinical practice.
  • We look to the future from a perspective that is open to the world.





Those challenges would be very difficult to face if we not move side by side with the international community. For learning, exchanging knowledge and contribution to worldwide challenges, we have developed an International area from whom we collaborate with the main international organizations of the world related to health and social care: WHO, IHF, worldwide hospital associations, professional and management associations, to put our grain of sand to make larger and better the beach of health and humans well-being.



Foreseeing the challenges health and social systems are facing, La Unió has developed the Project + Future (acting to anticipate future), a collective project with our members to be positioned in advance in the future scenario for evolving health services delivery and organizations, as well as promoting the necessary transformations to meet those challenges and improve care for people.


Social Responsibility

We are one of the 4,000 non-profit organizations at the international level that have adopted the commitment to the principles of the United Nations Global Compact since 2009, and we are active in contributing to the 17 Development Goals. Sustainable Development (SDGs) that guide the steps of the SD Agenda 2030.


What are the key challenges and accomplishments for service delivery in your country?

  • Commit to health systems that drive action on the set of determinants of health, promoting health in all policies.
  • To value and promote stable consensus around the strengths of the health and social system in Catalonia, to help to make it the best possible.
  • Bet on Improvement of financing of the health and social system, to adapt it to the growing needs associated with aging and chronicity, technologies, access new treatments with proven effectiveness, among others. Underfunding of the public healthcare system cannot be transferred to organizations, jeopardizing their sustainability, reducing professional’s remuneration, increasing waiting lists, resulting in the obsolescence of the facilities.
  • Health and social services integration, putting the patient at the center of our activities, is essential and unavoidable. Addressing health care in nursing homes with dependent people is a strategic priority for the country that goes beyond the debate on competencies. It requires a deep and professional knowledge of the change in the health needs profile of people and families, the complexity and challenges associated with long-living societies, and how the health system and the social system must respond, in an integrated way.
  • Commit to the good governance of public policies by setting priorities, facilitating regulatory frameworks that allow effective management of public health resources and services, demanding good results and making them accountable for society.
  • Value health professionals and their capacity to contribute to improving the system, by incorporating them into decision-making organs to transform the health system and health organizations, to improve working conditions, access to quality and effective training, retain and attract talent, accompany generational change and new leadership, adapt to the new values ​​of professionalism and guarantee a right work-personal life balance.
  • Incorporate learnings continuously, to be able to do things differently and better by driving and encouraging transformational change.


What are the key challenges and perspectives in healthcare at the international level?

Currently, work with coordinated and internationally tested management protocols, in face of the global pandemic due to COVID-19. Focus on COVID-19 nowadays is a priority, but we have to be prepared, at the same too, for the near future and the changes need to face it.

Before this crisis, but also during this crisis and for the after-crisis period, when arrives, the WHO pointed out several aspects that we agree with. We would like to highlight:

  • Rethinking, avoiding demagogy, how we want to be cared for now and tomorrow and what resources we devote to it,
  • Above all, which is the social contract we sign with those who take care of us both in the health and social field;
  • Stand for promotion and primary and community health, as well as prevention, addressing the determinants of health, considering what we think that health is in this new context.
  • More promotion and prevention means more resources to reinvest in care.
  • How to take advantage of the possibilities of science and technology
  • Save lives in conflict zones
  • Make good use of medicines.

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