The historical roots of the creation of the Catalan private-public hospital model: c. 1870-1935

Abstract

This paper analyses the roots of the creation of the Catalan hospital model, based on a preponderance of privately owned hospitals and beds over those of public provision. In particular, on the basis of new statistical and documentary sources and a review of the existing historiography, this study reinterprets the keys that shaped this historical model during what is considered to be a strategic period of the process, 1870-1935. In the late nineteenth century, hospitals dependent on provincial authorities became private charity institutions in the provincial capitals, under the control of the medical and economic elites (a decisive process in the case of the city of Barcelona). Later, during the dictatorship of Primo de Rivera and the Second Republic, institutional impetus helped foster a system of district hospitals intended to meet the public demand for a network of public utility hospitals. This network was made up the few publicly owned hospitals and numerous privately owned ones. The philosophy of this model was taken up again during the transition to democracy after responsibility for healthcare was devolved to the Government of Catalonia 1981.