Internal documents show that instructions to reject non-profitable patients at Torrejón Hospital were issued in writing, confirming recordings from a management meeting. Madrid's president Isabel Díaz Ayuso downplays the scandal as internal disputes and announces further inspections. Ribera Salud's CEO defends the audios as decontextualized.
On September 25, Pablo Gallart, CEO of Ribera Salud—the company managing Torrejón University Hospital—met with about 20 executives. In audios from that meeting, published by EL PAÍS, Gallart ordered reversing the waiting list reductions from 2022 and 2023 to achieve an EBITDA of 'four or five million' euros, selecting profitable procedures and reusing single-use sanitary products up to 10 times, such as catheters costing over 2,000 euros.
Written documents confirm these directives. Two weeks later, an executive emailed: 'As discussed in the meeting, NO NON-CÁPITA PATIENTS (sic) SHOULD BE INCLUDED in peritoneal dialysis, and apparently this instruction was clear.' 'Non-cápita patients' are those outside the hospital's health area, selected by profitability. Gallart justified the measures claiming the hospital loses nine million euros annually in amortizations and financial costs.
Four executives were fired for reporting these practices in the internal ethics channel, warning of 'violation of patient rights.' Gallart, who requested removal from Torrejón management but remains group head, sent a letter and additional audio stating the published excerpts are 'out of context' and that he is willing to continue 'even if profitability is zero,' always with shorter waiting lists than public ones.
On Saturday, Madrid President Isabel Díaz Ayuso described the audios as 'taken out of context' in an 'executive dispute' and denied economic patient prioritization, stating there are no complaints and lists are 'excellent.' She announced a new inspection, added to the 40 annual ones, and denied material reuse, attributing it to possible negligence if it happened. A Madrid Community internal inspection concluded no evidence of irregularities.
The central government criticized the model: Pedro Sánchez defended Constitution Article 43 on public health, and Minister Mónica García called it a 'flow from public to private,' with millions to firms like Ribera.