The following article was translated by Dennis Beach from the Friday, November 15 issue of the Prensa Gráfica, one of the major Salvadoran daily newspapers.



El Salvador, C.A., Friday, 15 November 2002

All Concession of ISSS Services Prohibited

Assembly Defeats Francisco Flores

Yesterday the opposition ratified Decree 1024 as it had been approved on the October 17, rejecting recommendations for revision that President Flores had made. The doctors, however, announced that the strike will continue.

Carlos Ramos/José Luis Sanz
Roberto Alas/Ena Rivas/Amadeo Cabrera

The legislative opposition culminated yesterday its negotiations with the executive agency on the subject of health, by ratifying the "antiprivatization” decree of the ISSS [Salvadoran Institute for Social Security]. Also yesterday, at 5:30 p.m., this decree was sent to president Francisco Flores for his approval and for publication in the Official Daily Legal Register.

With 55 votes, the recommendations that President Francisco Flores had made to Decree 1024 as it had been approved on October 17, were ignored and, instead, it was decided that all concessions, subcontracting, and privatization of the services offered by the ISSS and the state centers of health are prohibited.

The ARENA bloc, that only Wednesday entertained the possibility that the modifications made by Flores could be included, remained alone yesterday.

The Strike Continues

The doctors on strike, although they celebrated the parliamentary resolution, announced that the strike will nevertheless continue and set new conditions for it (see page 8).

A group of doctors who were present as the plenary session unfolded, burst into applause when the legislators raised their hands. The deputies, in contrast to the usual practice, did not vote by voice.

The president of the Assembly, the PCN Deputy Ciro Cruz Zepeda, even suspended the session for 10 minutes so that the deputies could take part in the celebration.

Last September 30 SIMETRISSS [the doctor’s union] presented to the Assembly a projected decree for the “state guarantee health and social security” that was given the bill number 1024, which has as its aim to assure that public institutions cannot transfer to private organizations contracts for health services.

After the ratification of the decree, the president of the Medical School, Guillermo Mata, clarified that the strike which they have maintained since September 18 will not be suspended while the rehiring of the dismissed workers is not guaranteed.

“The strike cannot be suspended until we have the legal guarantee of the return of all the workers,” he declared.

Flores is Resigned

The President of the Republic announced yesterday at noon his decision to accept what the Assembly established and its provision to send Decree 1024 for publication in the Official Legal Daily Register.

Flores explained why, although he thinks the decree is unconstitutional, he did not veto it, but returned it to the legislature with written recommendations for change: “I was interested in ending the strike,” he argued.

The Vice-Minister of Health, Herberth Betancourt, also indicated that they will respect the parliamentary decision. However, he also expressed his concern with the legal implications that could ensue if the government fails to fulfill contracts with suppliers of services.

COMING TOGETHER. The doctors of the tripartite group meet with the legislative faction of the PCN before the plenary session began.
AGAINST OBSERVATIONS. The deputies of the Commission for the Protection of the Environment and Public Health vote unfavorably on the Executive recommendations to decree 1024.
JOY. Ricardo Alfaro celebrates together with his colleagues of SIMETRISS the ratification of decree 1024 without the recommendations of President Flores.

The Legislative Path of Decree 1024

In the Commission

Formal Position

At 11:05 a.m. the Commission of Health initiated the meeting to know the position the different fractions on decree 1024. Nine opposition deputies raised their hand indicating an unfavorable vote to the observations made by the Executive Branch to Decree 1024.

Doctors and PCN Deputies

The Meeting

At the same time, the doctors met with deputies of the PCN fraction. In this meeting, the PCN deputies reiterated to the physicians that they will give their votes for the ratification of Decree 1024. A large number of doctors are assembled in a march near the Legislative Assembly.

The Plenary Session

The Votes

The minority parties that a day before had been counted on to vote for the new redaction of the decree, adapting the suggestions of the president, change their opinion and commit their votes to overturn the recommendations made by the Chief of State Francisco Flores to “the anti-privatization” decree.

Decree 1024

The legislative decision approved October 17 has provisions that prevent the privatization of health services.

It guarantees that public organizations cannot transfer to private institutions in any way whatsoever the provision of health services.
It prohibits the privatization, sale and purchase of services or any means that might transfer to private organizations the benefits of health services.
The provisions contemplated in the initiative revoke all arrangements promulgated previously that contradict the text of the decree.
The clauses of the decree constitute norms for public order and have retroactive applicability in reference to those matters that they regulate.
It authorizes the purchase of health services only in cases of national emergency caused by epidemic, for the purchase of laboratory and imaging diagnostic services which the institution does not possess, and by diseases whose treatment cannot be offered by the institutions of the national system of health, and for illnesses whose treatment cannot be offered by the institutions of the national health system.

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