Realising the dream of a tenacious visionary

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11.10.2018

Realising the dream of a tenacious visionary

The co-operative healthcare model created by Dr Josep Espriu is, a little over 15 years since his death, more alive than ever. The edifice that he began to build in 1957, armed with nothing more than abundant ingenuity and tenacity, and his ability to forge a shared sense of intent, has become an international service provision model based fundamentally on constant dialogue between doctors and patients.

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When the young Dr Josep Espriu set up his medical practice in the Gràcia district of Barcelona, the social or collective medicine available to the vast majority of people was, in his own words, “shoestring medicine”.

For the patients, the care they received left much to be desired, but nor were the doctors themselves happy, as working for insurers or mutual schemes was scarcely any better given the precarious working conditions, which Dr Espriu experienced at first hand when he was elected as the representative of the young doctors belonging to the Professional Medical Association in Barcelona. Determined to change this pitiful situation, in which the public sector, in the form of the mandatory sickness insurance that had been launched in Spain a few years earlier, was also failing to provide satisfactory social medicine, Dr Espriu focused on a successful formula implemented in the form of the “medical mutuals” of the province of Vizcaya. He took them as his inspiration to lay the foundations of what would ultimately become his own co-operative healthcare model: free choice of doctor; professional fees paid per professional act, which made doctors owners and employees at the same time, and lastly, the elimination of dividends.

“Fair and very simple ideas”

We are talking of the dignity of medicine that cures people and the dignity that a sick person always deserves, and that cannot be sullied by any pursuit of profit”. Dr Espriu was entirely clear on that and was as wary of the “power of money” as he was intrigued by the possibility of direct contact between doctor and patient, an idea that captivated him from the very outset, and became his primary goal. “I have striven,” he told Ramon Rius, the author of Conversations with Josep Espriu, “to serve ideas that are both fair and also very simple: that patients should have a dialogue of trust with their doctor, that doctors should hold their patients in esteem, and that nothing and no one should come between them, no intermediaries, which give rise to interference and misunderstanding”.

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