Changes

The graphs on Evolution in the number of Conferences of Presidents and the Evolution in number of Health Sector Conferences show the scant relevance of these mechanisms prior to the pandemic, and highlight a relevant institutional and political deficit. These mechanisms did not have for decades the prominence that would have been necessary to provide good internal governance, as evidenced by the fact that more Conferences of Presidents were held in the few months that the first wave of the pandemic lasted than since this mechanism was founded back in October 2004. Moreover, the way these mechanisms are put into action is far from desirable, they have only had muted results, and the Spanish sharp political polarisation makes difficult to forge crucial agreements. Proof of this institutional deficit is that the Conference of Presidents ceased to convene short after the end of the first wave of the pandemic, in October 2020, whilst it should have continued to operate with the frequency required by the exceptional situation of the whole pandemic. By contrast, the Health Sector Conference, the Social Service Sector Conference as well as some other sector conferences have continued to operate regularly showing good results.

Governance initiatives at different levels throughout the first year of pandemic went above and beyond the amount of Conferences held and exceeded the powers of each level of administration. At times, contradictions, shortcomings, improvidence, disagreements and even bringing debates before the Courts of justice took place, following the trend of the rest of the European Union. The emergency situation explained much of this. Nevertheless, the four levels of administration (the European Union, the national administration, the regions and the local authorities) deployed on other occasions very important measures on different fields, such as health, education, social services, economy, finance and employment, with the shared aim of saving lives, launching economy by implementing recovery and reconstruction plans, providing ample liquidity to households and companies, and meeting the demands of the most vulnerable citizens.

Some lessons have been learned so far from how the pandemic was managed: a) it has tested the ‘autonomous state’, which has emerged stronger, using the instruments of internal governance as never before. A more polycentric, more horizontal, more decentralised Spain has taken root in the collective imagination, and all levels of administration have been seen to act as such; b) there are different ways of organising the public health service in each region, as highlighted by the map on Primary healthcare areas. However, this is compatible with sending aggregated information to the national administration; c) it has served to highlight the deficit in multilevel internal governance and the shortcomings in basic pillars of the welfare state. Nevertheless, serious issues caused by COVID-19 have been solved and collective learning has taken place; d) the importance of public services as a pillar of the welfare state and a basic responsibility of the regional authorities has been perceived by the population; e) it has opened a new stage of dialogue in drafting agreements and strategic alliances between different regions to address common issues and challenges that may entail relevant political symbolism as they are promoted bearing in mind the whole country; f) the agenda for the immediate future has been made clear, i.e. Spain shall improve the funding mechanisms for the welfare state so that territorial equity is provided and welfare standards may catch up with northern and central Europe, a regularity in celebrating the Conference of Presidents and the Sector Conferences shall be introduced, and founding a national Health Office would be praiseworthy.