Catalan Comuns Demands Probe into Unequal SEM-SAAS Medical Transfer Deal with Andorra

The Catalan parliamentary group Comuns has requested the appearance of Anna Vives, the Generalitat's delegate in Andorra, and Anna Fontquerni, director of the Sistema d’Emergències Mèdiques (SEM), to explain the terms of a new agreement between the SEM and Andorra's Servei Andorrà d’Atenció Sanitària (SAAS).

The deal regulates interhospital transfers of critical patients using ground and air medicalized vehicles. It replaces previous agreements renewed since 2012 and, for the first time, allows the SEM to request support from SAAS helicopters and ground units during contingencies or cross-border accidents.

Comuns, at the request of its Alt Pirineu i Aran branch, questions the lack of reciprocity in the accord. Spokesperson David Cid highlighted that no clear written clause secures the single medicalized helicopter in the Alt Pirineu for all local residents. The group contends that the SAAS can choose whether to deploy its two helicopters, while the SEM faces an obligation to assist.

Comuns also noted that Andorra has paid amounts below the actual service costs for years and called for public scrutiny of the agreement's conditions. Coordinators Txell Teruel and Mario Mata warned against deals that cede resources without mutual benefits, potentially harming access to healthcare in Alt Pirineu, Aran, and beyond. They referenced past struggles to restore helicopter coverage lost in Tremp.

Vives's office responded that the delegation's role is limited to coordinating and energizing cooperation through seven working groups between Generalitat departments and the Andorran government. It does not set thematic priorities or negotiate sectoral agreements. The delegation aligns with Generalitat positions but lacks authority over such pacts. A recent press release marking three years of the office made no mention of negotiation powers.

Vives clarified that patient transfers from Andorra to Catalan hospitals typically use Andorran air and ground resources. The SEM handles only complex critical adult cases, pediatric, or neonatal transports requiring specialized equipment, such as its incubator-equipped aircraft. Since 2022, the SEM has conducted just 20 such helicopter transfers from Andorra—one adult critical patient and 19 pediatric. This figure contrasts with SEM reports citing around 50 annual infant transfers to Catalan hospitals, including ground ambulances covered by the deal. In 2020 alone, the SEM's night-adapted helicopter made 20 flights from Andorra's Meritxell hospital.

The delegation expressed surprise at Comuns's summons, attributing it to confusion, as Vives neither signed the agreement nor joined negotiations, which involved only SEM and SAAS officials. Questions persist over why the new text omits equivalent conditions for SEM resources as those granted to SAAS.