From 2019 to 2024, Madrid’s government under Isabel Díaz Ayuso transferred more than 5 billion euros to the Quirón group. This private healthcare group manages four hospitals that are part of the region’s public health system. Over five years, the administration’s debt to Quirón dropped from one billion euros to 455 million, though the process was far from straightforward.
The payments covered not only current obligations but also old debts dating back to 2016. Some of these were incurred during the previous government, led by Cristina Cifuentes, who headed the region from 2015 to 2018. Settlement was delayed by lengthy audits and legal proceedings, leading to late payments.
Old debt
In recent years, Madrid authorities have had to close debts from previous periods. In 2023, the region was forced to pay 56 million euros following court decisions. Opposition figures have repeatedly questioned the transparency of financial flows and criticized delays in settlements with private operators.
Quirón itself notes that funding allocated for hospital operations remains among the lowest within its network. According to the company, service rates have not been updated for over a decade, despite rising costs and inflation. Management says this makes it even more difficult to operate efficiently.
Public-private partnership
Quirón operates four public hospitals in Madrid under various cooperation agreements with the administration. This public-private partnership model was introduced in the region nearly two decades ago and has sparked ongoing debate among politicians and experts.
The funding of these institutions is a regular topic at regional government meetings. In recent years, Madrid authorities have taken unprecedented steps to reduce debt owed to private operators. Since 2022, overdue payments totaling more than one billion euros have been settled within six months.
The remaining amount
Despite the significant reduction in debt, some obligations to Quirón remain outstanding—the exact figure depends on the results of new audits and court rulings. The timeliness and transparency of payments continue to be a source of dispute among regional authorities, the opposition, and private sector representatives.
The financing system for private healthcare operators in Madrid remains one of the most discussed topics in regional politics. In the coming years, the region will have to determine how to ensure the sustainability and transparency of this model to prevent similar debt situations from recurring.
