The Spanish Constitutional Tribunal (CT) has issued a verdict confirming the ministry of finance's authority to limit healthcare spending at the regional level, dismissing a constitutional challenge presented by Andalusia against the amendment of the Organic Law on Financing of the Autonomous Communities in 2015.
Implications | The CT stated that Ansalusia did not present any valid arguments that the finance ministry's power contravened the current legal and constitutional system in Spain. |
Outlook | Following the CT's decision, the government will be even more focused on adhering to the amendment in 2015 to limit regional healthcare spending. Regions that exceed GDP-linked spending caps risk losing their healthcare competiveness. |
The Spanish Constitutional Tribunal (CT) has issued a ruling ratifying the Ministry of Finance and Public Administrations' authority to limit healthcare spending at the regional level. With this judgment, the CT has dismissed the constitutional challenge presented by Andalusia against the amendment of the Organic Law on Financing of the Autonomous Communities, which has imposed expenditure ceilings on public investment in medicines and medical devices. The CT's verdict can be accessed here, in Spanish.
The Spanish autonomous region of Andalusia had decided to challenge legally the ministry of finance's power to limit healthcare spending at the regional level, claiming that this infringed upon the final provision added last year to the General Health Law (Articles 107 to 110) allowing regional health authorities to control their healthcare expenditure. According to the Andalusian healthcare authorities, the ministry's power violated the principles of hierarchy, legal certainty, and regional autonomy.
However, the finance ministry had advocated the new rule, arguing that the power also allowed the central government to control pharmaceutical expenditure, in line with the recommendation by the European Council to Spain to introduce measures to achieve this.
The CT has therefore ruled in favour of the finance ministry and decided to declare the legality of its power to limit healthcare spending at the regional level. The CT stated that Ansalusia had not presented any valid arguments that the finance ministry's power transgressed the current legal and constitutional system in Spain.
Outlook and implications
The Spanish government has focused on enforcing the new healthcare policy of linking pharmaceutical regional expenditure with Spain's gross domestic product (GDP) across the autonomous regions, capping any increase in spending to the rate of GDP growth, which under the Organic Law on Budgetary Stability and Financial Sustainability is 1.8% for 2016 (see Spain: 5 May 2016: Spain enforces ruling linking pharmaceutical expenditure with GDP across regions).
In fact, in June, the finance ministry reported that the vast majority of the Spanish autonomous communities – 14 in total – had already enforced the pharmaceutical spending measures introduced last year by the Spanish government and the national pharmaceutical industry association (Farmaindustria; see Spain: 15 June 2016: Ministry of Finance reports 14 autonomous communities have capped pharmaceutical spending and incorporated Farmaindustria's protocol in Spain).
Some autonomous communities, such as Andalusia, Castilla-Leon, Navarra, and the Basque Country, have opposed the measures. However, regions that fail to implement these GDP-linked caps risk losing their healthcare competiveness, such as approvals of portfolios of complementary services and access to central government budgets.