The Health Anti-Tobacco Plan only gets the support of five CCAA

The Ministry of Health will give the green light tomorrow to the Comprehensive Plan for the Prevention and Control of Smoking (PIT) 2024-2027 in the plenary session of the Interterritorial Council of the SNS (CISNS), without the support of the majority of the autonomous communities. Only five (including Catalonia, the Canary Islands and Navarra) have joined, while the rest have decided “not to cast a vote” because they believe that the procedure “is not appropriate.” This same morning the minister, Mónica García, alleged that the last two meetings of the Public Health Commission (held in the last two weeks) were held to seek “consensus” and so that the CCAA could make their contributions.

A consensus that has not been obtained and contributions that the regions complain of not having even had time to evaluate (more than 200 were presented, of which 150 have been included). Knowing that he would not find the desired support, The ministry decided to “innovate” both in the procedure for regional executives to support or not support the PIT and in the way of getting a response. Thus, at the meeting of the Public Health Commission on April 3 proposed the approval of the document through a “collaboration agreement” to which the regional executives could adhere (or not), specifying its red lines. The information arrived by email this morning (so the vote was “delayed), causing surprise and discomfort in the majority of the regional Public Health DGs. An unexpected and unprecedented move, since Health had never before used a similar procedure.

The tension escalated even more when the Secretary of State for Health, Javier Padilla, published on the social network 'X', that “this week will be left to decide who, once again, is placed in a place where the years will show that there was no point in being there.” In the same publication, he assured that the Plan “will move forward even if the PP does not support it.”

Doubts about legality

Although the ministry blames the lack of agreement on the political sign of the communities that have opposed it, they give compelling reasons to oppose the form – and substance – of the PIT. They deny that Health has sought consensus, but only avoided the way to achieve it in order to be ableapprove it at all costs without giving them time to reflect or obtain a response to their complaints.

Thus, the director of Public Health of the Madrid's communityElena Andradas, has sent a formal letter to the ministry in whichexplains the reasons for the “no” of the region he represents. “Approval must be by consensus and the competence of the Public Health Commission is essentially preparatory to the matters to be discussed later in the Plenary of the CISNS in matters of Public Health, so at this headquarters (that of the Commission) there is no “should vote on whether or not to join a cooperation agreement, which is what they request in their email, as it exceeds the functions attributed by regulation to this body.”

Likewise, since Galicia have criticized that“a cooperation agreement is voted on, which does not appear within the operating procedures of the Public Health Commission, nor was it even on the agenda of the meeting.”

The Public Health representative of Balearics, Elena Esteban, recalledyesterday along these lines that the agreements of the Public Health Commission “must be taken by consensus, not by vote”, and that “the document should return to the Commissionto achieve the consensus that has always characterized this body”.

The Minister of Health, César Pascual, has indicated that the action of Health “does not seem serious to us.” “We believe that if a plan is made it has to be with all the consequences and with the consensus of the communities and not quickly and running and modifying the documents as they are being modified, permanently.” The president of the Executive, María José Sáenz de Buruaga, for her part, believes that the Plan is not the instrument to establish prohibitions; and she has criticized that it is the result of an “imposition”, in which “unilaterality” has prevailed, according to Ep. Even so, from the region they have assured that they will abide by it if the Ministry of Health approves it because they are not going to “confront” or act “in rebellion.”

Last-hour changes

Complaints of “improvisation” have not prevented Health from continuing to do last minute changes to the draft text. One of the most relevant is that, as Ep has reported, the document no longer includes the prohibition of smoking in private spaces, thus clearing up the existing doubt about whether tobacco could be legally banned in cars. On the other hand also will ban single-use tobacco-related devices, a measure that was not contemplated in the previous draft either. The objective here, beyond public health, is to reduce the ecological footprint, as they argue.