The provinces, one of the oldest territorial divisions in Spain that is still in force, will have a prominent role in the stages of lack of confidence designed by the Pedro Sánchez government. Except for exceptions, the Ministry of Health will decide by provinces and islands the rate at which each territory can return to normal in the coming months, according to the plan approved by the Minister's Council this Tuesday and which must be validated by Congress at the extension of the alarm state. But the chosen provincial structure has disturbed and raised blisters in several autonomous communities, which do not organize their hospital systems around the province, but according to basic health areas and health regions.
This Wednesday, Catalonia, the Valencian Community, the Basque Country and Galicia have shown their reservations that the basic units for unconfinement are the provinces. The governments of the four autonomous regions, all of them of different colors, have shown their catalog of arguments to be reluctant to a plan of confinement piloted by the government delegations. After the inter-territorial health meeting, in which several communities have made their complaints known, the Minister of Health, Salvador Illa, has ended up opening the door for unconfinement to occur through territorial units other than the province.
In the case of the Valencian Community, the Minister of Health, Ana Barceló, has demanded that the de-escalation in its territory be carried out by health departments, which is the way in which the Valencian system is organized. Barceló noted that the document approved by the Government gives the communities “propositional capacity” to transfer their preferences, and that the Consell has already submitted the reports epidemiological and technical in which it is based to bet a territorial lack of confidence that goes beyond the provinces.
It is not the only community with a socialist government that has been reluctant to apply the provincial template proposed by the Ministry of Health. The President of Aragon, Javier Lambán, has repeatedly expressed his reluctance at the possibility that the city of Zaragoza, where there have been 65% of cases in the community, be treated in the same way as the whole of its province , the fourth Spanish by extension. The Lambán government considers that normalization should begin in municipalities with less than 5,000 inhabitants and, starting from the rural world, extend it to the larger population centers.
Neither in Catalonia has it been a good idea that the area chosen by Sánchez is the provincial one, a division that has already been deliberately forgotten by the Generalitat since the time of the first Pujol. “This plan has been drawn up without taking into account the opinions of Catalonia or the rest of the territories,” said the Government spokeswoman, Meritxell Budó. From the Catalan Executive they use the plan presented by Sánchez as new proof that coordination between administrations is not working, since this document was not discussed at the meeting of regional presidents held last Sunday.
“The Government is wrong to use the province as a basic territorial unit,” has supported the Catalan Minister of the Interior, Miquel Buch. “The Generalitat will not enter to discuss how other Autonomous Communities should be divided, but we do know how we work here and how to better organize ourselves territorially. The province is not the best system because it has many shortcomings,” he insisted.
Feijoo: “The focus should be the sanitary areas”
In a similar sense, its president, Alberto Nuñez Feijoo, has spoken from the Xunta de Galicia, who has denounced that the Government's plan reduces communities to a “testimonial role”. For Feijoo, the central government's road map presents “some lights and many shadows”, so “Galicia cannot guarantee it”. “The focus should be the sanitary areas, and the zoom should be comarcas or sanitary districts,” said Feijoo.
The Servizo Galego de Saúde is divided into seven sanitary areas, which do not correspond to the provincial boundaries. For example, the city of Vigo and its metropolitan area has its own sanitary area, which covers the south of the province of Pontevedra, while the province of A Coruña is divided into up to three sanitary areas. Despite the fact that in Galicia the provincial council is an administrative level with strong roots, the Galician health division, whose last update is in 2017, does not take them into account.
“It does not make sense that from a neighboring council it is not possible to pass to the neighboring council, from the other province when they have the same epidemiological situation,” said Feijoo, who assured that he cannot share “the sanitary philosophy of the document in that refers to mobility. ” In addition, like the Generalitat, the Galician president has considered that the central government is acting unilaterally when addressing the health crisis. “It has not been negotiated, much less consensual with the autonomous communities,” added the autonomous president of the PP.
“Centralizing backward movement” for the PNV
The Lehendakari, Iñigo Urkullu, considers that the lack of confinement by provinces is a “centralizing setback and an incomprehensible anomaly”. As the nationalist leader has expressed, the government's plan follows a model that “does not respect or recognize multinationality or the autonomous state, let alone” the capacity of the Basque “singular self-government”.
The Basque leader expressed himself after the meeting of the institutional coordination body to deal with the health emergency in the Basque Country, LABI, after which he opined that, in the current situation of the coronavirus epidemic, “there is no need to extend plus the exceptional situation “, so it should return to” the full capacity of ordinary legislation “to manage the crisis from now on.
Josu Erkoreka, the spokesman for the Basque Government shared by PNV and the Socialists, has been more restrained in his criticism of the central government's plans. Erkoreka has ensured that they must carefully study the central government's plan and this time they have saved the darts that they have once thrown at Sánchez's measures. However, the language has again shown the distance that the PNV maintains with respect to the territorial management that the Government is doing during this health crisis, with which they have collided since the first alarm decree.
The spokesman for the Government of Iñigo Urkullu, Josu Erkoreka, has ironized in the press conference this Wednesday, assuring that Sánchez has gone from “plurinationality” to “pluriprovinciality” by putting the provincial territories as the basis for de-escalation. The jeltzale has also indicated that the “provinces” are not areas contemplated in the Basque Statute, which refers to Alava, Gipuzkoa and Bizkaia as “historical territories”. Some entities that, although they have a lot of economic weight, since they are the owners of the provincial haciendas, in the health field do not play “any role” or have competences, said the spokesman.
Illa opens the door to other territorial units
With this panorama, the Minister of Health, Salvador Illa, has again brought together the inter-territorial Health Department in which several regional councilors have once again demanded greater clarity in the indicators that will establish the passage from one phase to another and also a criterion different from the provinces to carry it out. At the end of the meeting, Illa explained this Wednesday that the Government's phased de-escalation plan “is flexible and allows for introducing specific considerations.” Asked about the requests of some autonomous leaders to establish territorial units other than the province to move from one phase to another, Illa has indicated that “we set the province or the island as the reference unit, but we are open to another type of approach” .
This is the case of Castilla-La Mancha, where they maintain that in provinces such as Guadalajara there are areas with a high population density – the Henares corridor that borders the Community of Madrid – compared to the area that goes to the Sierra that is unpopulated. Castilla y León is also betting that the geographical unit to be taken into account for de-escalation is “below the province” and thus “misinterpret from bottom to top”.
Several autonomous governments are hopeful that Health ends up changing their criteria and accepting that the territorial unit be different health districts than the province. For now, Illa has assured that the communities will have to send them the proposals and they will be studied on a case-by-case basis.
The autonomous governments complain that they have little information regarding the standards that will guide them to the different phases as well as the conditions for phase 0 in which they will allow, from May 2, walks or individual physical activity in the Exterior. Illa has informed them that a ministerial order will be issued in this regard this Thursday. Most communities trust that some of their proposals will be followed, such as the separation of exits by age groups to avoid crowds and, above all, the coincidence of children with the older population.
Provinces with exceptions
Epidemiology experts believe that lack of confinement should be territorialized. That is the spirit that the Government's plan has when using the province and also opening up to the possibility that, at the proposal of the Communities, there may be other territorial divisions that enter different phases of de-escalation. This is how Joan Ramón Villalbí, from the Spanish Society of Public Health and Health Administration (Sespas) interprets it.
According to Dr. Villalbí, the province is useful in most territories of Spain, especially considering that several communities are uniprovincial. However, the expert considers that in some places it would be desirable for deconfusion to be adapted to the health areas on which the autonomous systems are based. “I understand what the plan is proposing, which aims to adapt to the reality of the epidemic that is taking place in different areas, even within the same province,” explains the expert in Public Health.
The director of the Institute of Regional and Metropolitan Studies of Barcelona, Ricard Gomà, considers that the province is a particularly problematic area in large urban areas. “I think that in the proposal of the Government there are two problems that add up. The first is to consider that there must be a single territorial area of de-escalation, whatever this area is. The second is that this area is the province, which today it does not express the most relevant socio-spatial dynamics, neither from an economic point of view, nor mobility nor social relations, “says the professor in Political Science.
Also the head of Epidemiology at the Hospital Clínic de Barcelona and member of the government's advisory expert committee, Antoni Trilla, defends that the de-escalation plan can be adapted to different realities. “If everything went well and it could be argued that there is a certain health region or a region that has a very different situation, I believe that this can be put on the table with data. Later we will see how the political part is ventilated,” insured this Wednesday in Catalunya Ràdio. Trilla has also indicated that the reason for proposing the province as a basic unit of lack of confinement responds to reasons of mobility.