The Mexican Social Security Institute (IMSS) spent 427 million pesos on land that includes a half-built building, which was to become a new hospital for Puebla, but which proved to be a work that was useless and can only be used in the future for offices .
The new hospital would replace the San Alejandro de Puebla General Hospital, the main service for 60% of the state’s rightholders that resulted in severe structural damage following the tremor of September 19, 2017.
Two years later, not only is there no hospital, nor can progress be made in the construction of any work on that land because the award is in dispute. In 2018 the tender was made for the project, but the companies that were disqualified in the process reported irregularities and challenged the procedure.
The administration of the new government in the state decided to replenish the process in which the Spanish firm Sacyr was the winner, which resulted in a dissatisfaction of the company before courts and that the IMSS can not do anything on the ground until it has a resolution Judicial.
Read: 180 hospital works in Mexico are suspended for corruption or lack of money: Health
While a solution is being found, the people suffer the consequences with a collapsed health system that has forced hospitals of the entity such as La Margarita, in the southeast of the capital, to operate with overcharge and over-demand of up to 300% to care for general San Alejandro, as recognized by IMSS itself.
And although the new hospital should already be performing 188,000 hospitalizations, 23 thousand surgeries, 7 thousand deliveries and 200 transplants each year, according to the investment project, everything is still in the role.
Why after two years there’s still no hospital? What decisions led to this situation?
Buying a problem
On October 5, 2017, two weeks after the 7.1-magnitude earthquake that left hundreds of people affected, then-Health Secretary José Narro Robles and IMSS Director Mikel Arriola toured the damaged structure of San Alejandro Hospital.
That day, they confirmed that the property would not be able to continue operating and Mikel Arriola announced that, by presidential order, 1.4 billion pesos would go for the recovery of IMSS services in the entity, and that 90% of the resources would be exclusively for the new San Alejandro.
From that moment on, the IMSS board began the search for land for a hospital with 415 beds, the number that San Alejandro had.
Find out: What do people think of IMSS services? More than 60% say drug supply is «very bad»
Political Animal He sought out Mikel Arriola to know his version of buying the land to build the new hospital, the former director of the IMSS said that Patricio Caso, former director of administration of the Institute, would be in charge of responding.
«Finding 6 hectares in Puebla was not easy, especially because certain characteristics had to be met: that the terrain was flat, that it could be used in an agile way and that it had good channels of communication,» Case said in interview.
The former official explained that they eventually found a plot of 62 thousand square meters in which entrepreneurs began the construction of a private hospital known as the International Medicine Center (CIMA), located in the Atlixcayotl territorial reserve of the cholula city, but that after 20 years of construction began, it was not finished.
Photo: Ernesto Aroche
The firm Medicus, S.A. De C. V., made up of Texan health entrepreneurs headed by Gary Brent Woods, president of International Hospital Corporation Holding NV; Poblano entrepreneurs, led by Luis Regordosa Valenciana, and medical specialists led by urologist Enrique Macip Nieto, bought the land between 1995 and 1998.
In the following years they began to build a building that was intended to be a luxury hospital, but only got 14 thousand meters of construction with advance slam slams and floors, because of lack of capital, the work was stopped in 2012.
For IMSS, the work was an ideal place for the new hospital because «it was the only property that had in Puebla with these characteristics», according to the former official Patricio Caso.
Photo: Ernesto Aroche
The negotiation for the purchase of the land took place between the IMSS and the Texan entrepreneurs, who held the majority of The shares of Medicus, says the urban entrepreneur Luis Regordosa Valenciana.
In November 2017, Regordosa Valenciana intervened to allow the minor partners to intervene in the sale, but was rejected by the then director of IMSS, Mikel Arriola, on the grounds that they were in a hurry to start the work.
«He told me that they had an emergency and they wanted our hospital, that with that they were going to buy a lot of time in rebuilding the new San Alejandro, because they already had a breakthrough, and that they wanted Peña Nieto to inaugurate it by closing his six-year apartment,» Regordosa explained in an interview.
The proposal by Mikel Arriola was also based on the minutes of the IMSS Technical Council where the purchase of the IMSS property was approved «in accordance with the proposal submitted by the Director General, through the Holder of the Directorate of Administration , by means of trades 466 and 476 of dates 9 and 10 October 2017», cites the document signed on 11 October 2017.
Among the Council’s requirements was that the land should be at least 50 thousand square meters and be «technically suitable for the construction and commissioning of a hospital or hospitals covering the 415 censible houses of the Regional Hospital 36 San Alejandro».
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The Technical Council of the IMSS, the highest governing body of the Institute, also received a study analyzing the cost and benefit of the «Emergency Program for the Replacement of the 36 San Alejandro General Hospital», which set out two options for address the emergency: subrogate private services or build a new hospital.
The first would be a more expensive and less viable option in the future. Therefore, it was better to build a new one and since then it was apparent the intention to buy the land of the private hospital CIMA, because it had «an area in gray construction that was not affected by the earthquake and that will be used for the construction of one of the units of the conjun To. The purchase of the land will allow to reduce construction times by 40%», read in the cost-benefit analysis.
Photo: Ernesto Aroche
Progress had also been made in the requirement to secure the valuation of property by the Institute of National Property Assessments and Management (INDAABIN), which determined a maximum price of 710 million pesos, of which 89 million were construction breakthrough that CIMA already had.
The sale of land took place on 6 December 2017, almost two months after IMSS approved the transaction for 427.6 million pesos, which meant 60% less of the budget ceiling, according to the contract of sale recorded in the 248th of the Mexico City, whose headline is Eduardo Francisco García Villegas Sánchez Cordero.
According to the poblano entrepreneurs, there was a real estate broker from which they did not remember the name, but it was the one who brought the property to the IMSS and, for which, the privates paid a commission of 7%, that is 29.7 million pesos.
«From what was sold, we had to pay commissions to the one who sold it, to the broker. Commission which also made me elevated. It was, if I remember correctly, of the 7%, that for operation of this type a commission of this size is not stythed, but that was what agreed with the Texans,» said Luis Regordosa.
Read: Only three out of a thousand domestic workers have enrolled in the IMSS
Patricio Caso, for his part, denied the existence of a broker. «We negotiated with the company that owned the property, strictly with the legal representatives. We pay the representatives for the land, we don’t pay any middleman.»
In the file of the Public Registry of the Property of Puebla consulted by Political Animal, where the purchase and sale of the property is located, the government documentation is included as the minutes of the Technical Council of the IMSS and with the company, but there is no reference to the real estate broker.
The problem building
Patricio Caso said IMSS negotiated well enough and paid «cheap» the land because the hospital in gray work was not relevant. «The negotiation was that: I bought you the land, after that studies would be done for the preliminary study to see if the property served us.»
However, in the IMSS cost-benefit study it was considered as an advantage that the land had a property because it meant a 40% progress of the total work and thus, the new hospital would finish building in 2019.
In fact, the contract of sale specifies that of the 427.6 million pesos paid, 52.2 million corresponded to the price of the half-built building. But this, far from being a quick solution to address the emergency in the health system in Puebla, was a problem: the building in gray works cannot be hospital.
Photo: Ernesto Aroche
It does not comply with medical standards or current building regulations, since it is a work of more than 15 years, Juan Manuel Delgado, current coordinator of Real Estate Infrastructure of IMSS, said in interview.
«We are in a dilemma, we want to make the most of it because we don’t want that that one that cost to be lost, but we can’t marry an idea that we’re going to give something that it’s not going to meet,» we don’t want to get the most out of it.»
Although it is not yet decided, one of the proposals to use the building is to reinforce it and adapt it for officiaNas. «Our responsibility is to use those public resources. It would be easier to adapt these office spaces for the IMSS delegation in Puebla,» Delgado explained.
In the rest of the land if it is sought to build a new hospital, but it will be only 210 beds, that is, half the capacity of the old hospital San Alejandro, because the project of the new administration consists of making a «hospital network» and not a pharaonic work , to «do not repeat the error».
In addition to this, the hospital network planned by the new administration would include the construction of another 260-bed hospital in Amozoc; another with 180 beds on the ground where the old San Alejandro will be demolished and a building for obnoobstetric of la Margarita Hospital.
Read: No infrastructure or budget: this is how you’ll have to hand out thousands of medicines
So far, 512 million have been spent in the CIMA field between 2017 and 2018, of which 427 million were in the purchase of the land, and so far this year only 2.4% progress is reported, according to budget transparency reports of the Ministry of Finance.
In addition, the budget is expected to be increased. In 2017 an expenditure of 2 thousand 996 million pesos was estimated, according to the Public Account of that year, but in the following years the projection has increased to remain at 3.223 million pesos in the work, which means 7% more than at the beginning , as noted in the draft budget for egress for 2020.
Still, there is still no date to start construction because there is a court proceeding pending.
On April 3, 2018, four months after the purchase of the land, IMSS launched the public tender for the «Integral Project Concerning the Emergency Program for the Replacement of the Regional General Hospital No. 36 of 415 Beds in San Alejandro, Puebla, by the Hospital PaediatricS of 210 beds and the Regional General Hospital of 205 beds».
Two months later, the work’s failure that would cost 911 million pesos was released, resulting as the winner of the Spanish company Sacyr, which was to start work on July 11, 2018 and complete the project in 22 months.
But three of the eight participating companies rejected the ruling arguing lack of transparency and fairness, according to the record published on the Compranet page.
Photo: Ernesto Aroche
Jesús Flores Lagos, partner of CV’s SA Engineering and Project Control, explained to Political Animal that the argument for scraping his proposal was «lack of experience, even though we have 35 years and more than 110 hospitals built. Right now we’re building four super hospitals that are 250 beds, three 250 and one out of 150, and still disqualify us from leaving Sacyr the way free.»
At that time, the IMSS decided to remove walls, windows and floors that were already installed, and even, to say of the former partners of CIMA, the pipe for the air conditioning system to review the structure and be able to make adaptations to the work.
As a result of the complaint, the Internal Control Body (ICO) «found that nonconformity was appropriate» and ordered IMSS to replace the procedure. «We found that (the work) is not for the discontent, nor for the one who had been awarded,» explained Juan Manuel Delgado, now in charge of the project as head of Infrastructure at IMSS. Therefore, on 20 February 2019, the IMSS declared the tender «deserted».
In March, Sacyr brought an appeal against the decision of the ICO before the Ninth Court in Administrative Matters. The firm confirmed Political Animal that in the face of the deserted tender statement, «through the legal means we are inconforming against this resolution and we maintain a dispute that aims to keep the contract in force to continue executing the works of the project».
Meanwhile, the IMSS cannot do any work within the terrain because «if we do anything, the judge can say that we are violating the rights of the worker. We’re tied hands» until there’s a resolution, Delgado explained.
The official added that while the emergency has tidyed up decisions, it is ultimately apparent that with the purchase of the CIMA land «someone stopped having a problem and someone had a problem.»
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