THE "MARQUÉS DE VALDECILLA" FOUNDATION

The Santander Council had been giving free assistance to the poor in the San Rafael Hospital, a solid XVIII-century building with 350 beds. Plenty of them, initially, but hardly enough more than one century after, as the flu epidemic of 1918 had proved. The high bourgeoisie of the local industry and commerce decided to build up a new and bigger hospital, but the necessary funds could not be collected, perhaps due to the bad times of the European post-war period. Then, the "Marqués de Valdecilla" ―whose generosity was known from rural schools to Central Madrid University― took on the project on his sole account, which he reoriented in 1927 into two directions. The first was social class mixing, so that the poor and the disabled from all over the region ―the target group of his deeds― would receive health care assistance, but also sick people in general, whether covered by insurance companies or not; and the second to provide technical and scientific assistance of the highest quality. This amounted to the background origin of an authentic medical and surgical school. According to these aims, Gonzalo Bringas, who agreed with the Marquis ideas, started his architectural design.

PRIVATE CHARITY FOUNDATION

Family trust
By means Spanish Royal Decree of April 1928, mixed private Charity Foundation was appointed in charge of the project, legally independent from official organisms and managed by a Trust of Directors, most of them directly designated by the Marquis. In the first Trust meeting, the hospital centre was named “Casa de Salud Valdecilla” (CSV), and the neuropsychiatrist Wenceslao López Albo was appointed Director Manager and Head of the Department of Psychiatry.

López Albo organised the CSV in four basic sections after the modern hospitals of the time. Assistance was divided into clinical and surgical departments, with fully developed central services ―several laboratories, radiological imaging, blood bank, and others sections; teaching, focused at first on the Medical Postgraduate Institute and the Nursing School, but aiming to become a University College; research, both clinical and basic, which was provided with laboratories, a library with subscriptions to the most relevant foreign and national journals, and research grants and scholarships for other hospitals; and, finally prevention, by means of health education, childcare, occupational health, and drug addiction campaigns among others, to be developed in all Cantabria. Other relevant decisions in these beginnings were the appointments of Department Heads (selected exclusively for their merits by an experts committee including personalities like Ramón y Cajal and Gregorio Marañón) and hiring professional secular nurses provided, if necessary, by its Nursing School. After two years of office work, López Albo resigned when the Trust ―that had supported and respected his decisions so far― imposed the presence of the nuns “Hijas de la Caridad”, and entrusted them with functions and attributions that Albo judged inappropriate.

From its beginnings, the CSV had to face several adversities, like the Marquis’s death in 1932, the Spanish Civil War and post-war period, and above all, the almost ever-permanent economic difficulties that have later been attributed to the Government’s mean attitude, the lack of insurance agreements and the social enemies of the Santander physician class.

Official trust
The Marquise of Pelayo, niece and heir of the Marquis, succeeded him in charge of the trust. When she died in 1951, she already had reduced considerably an economic contribution to the institution that had been very important in its beginnings. The difficulties to cope with the economic situation led the trust to resign its management in December 1951. The Cantabria Government took then the responsibility, in accordance with the Foundation statutes.As a result, and after several administrative vicissitudes, the Foundation, with the same name and functions, became managed by an official trust (or cabinet meeting) composed of several Ministries, Town Council and Cantabria Government members. This trust was actively involved, especially since the presidency of Pedro de Escalante, in the CSV growth, while at the same time there was an expansion of the social security services to provide health assistance to wider sectors of the population. The hospital’s Eighth wing was then adapted to allocating the growing number of patients, until the Social Security inaugurated its own hospital, named “Cantabria”, in 1969.

In spite of these difficulties, the Foundation continued the post-academic training of nurses and physicians, as well as the essentials of the initial project related to its clinics, conferences, doctoral theses, summer university courses, journals and publications ―especially the CSV records― thanks, in general, to the political support and to a certain “spirit” that, for some, is the only explanation for its prestige during those dire times.

PUBLIC ASSISTANCE FOUNDATION

The plan of modernizing the CSV, promoted by the Cantabria Government, was finally stated by the Spanish Ministerial Decree of April 1969, concerning the termination of the Private Charity Foundation and the transfer of all its funds to the regional government. In order to manage the project, the Cantabria Government created the Foundation of Public Health Care and Assistance “Marqués de Valdecilla”, ruled by an Executive Committee and a Manager, Dr. López Vélez, who also was the Head of Physicians of the CSV. Therefore, the directive model of the López Albo years was recovered in some sense. The new Foundation included now a Regional Maternity ward, and the services of Kindergarten, Psychiatry, Geriatrics, and Special Needs Education.

Between 1970 and 1973, the Foundation developed three fundamental initiatives: the architectural and functional renovation of the CSV, including the Nursing School, the designation of the hospital as the site of the new Faculty of Medicine for clinical courses, and an agreement with the Social Security in order to unify the medical assistance provided by the Cantabria Hospital and the CSV. The result of this merging is the creation of the “Centro Médico Nacional Marqués de Valdecilla”, equipped with new Departments and Services, and larger medical staff and resources. The new entity is being ruled by a Management and Executive committee, composed of both Cantabria Government and Social Security members, and by a Managing Director, Dr. López Vélez, who continued to be the Manager of the Foundation until 1983, when both positions were separated.

The Foundation has been active in all of its assistance services, including the Nursing School that become a University Faculty in 1980 and the creation of a Study Centre for Emergency Care. Its connection with the hospital has been effective in the support of doctoral theses, educational trips and research projects, albeit with small periodical interruptions.

At the end of 2002, the Cantabria Government redefined the functions of the Foundation, stressing the importance of both the biomedical research and the collaboration between the Foundation and the Faculty of Medicine, creating to this end the “Instituto de Formación e Investigación Marqués de Valdecilla”.