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Management and Construction of the Spanish hospital system from the perspective of economic history: between public and private sectors

Jerònia Pons-Pons (Universidad de Sevilla) and Margarita Vilar-Rodriguez (Universidad de A Coruña)

This paper aims to analyze the historical construction of the network of health infrastructures in Spain during the Franco dictatorship (1939-1975) from very different areas both public and private. The first part provides a first statistical progress of the major infrastructure before approving the compulsory insurance. The second part of the paper analyzes the implementation of compulsory insurance in a context where the state lacked a basic network of public health infrastructure. Within this context, concerts with the private sector were essential.

Later, the Plan Nacional de Instalaciones Sanitarias was approved. It was an ambitious and expensive project launched in a country with serious economic problems. From here, two main questions arise: How did the dictatorship manage to fund and build the plan?; What role did private health infrastructure play after the approval of this plan? The paper ends with some conclusions and a future research agenda.