Leaders have to be giraffes. Yes, you read that right: people with a long gaze and attention, good relationships with everyone, who don't sleep too much, and who have a very big heart. The leadership of giraffes, which reminds us so much of Hospital Sant Joan de Déu, also has a lot to do with the letter C, and this means cause, knowledge, compassion, commitment, and collaboration. "Giraffe leaders have to inspire and build narratives that generate commitment with the team and society. I still have more dreams than memories," assures Manel del Castillo, managing director of Hospital Sant Joan de Déu and president of the Cairos expert committee for reforming the healthcare system, in a new session of the True Leaders cycle, organized by The New Barcelona Post and EY to learn firsthand about different business leaders and their success stories in an exclusive environment with entrepreneurs, senior executives, and founders.
Manel del Castillo is a medical specialist in family and community medicine, and he completed a master's degree in public company management at Esade. "I am a manager, but I have never stopped being a doctor," he recalls after having held different management positions and received all kinds of recognitions. He was also president of the Fundació Factor Humà, from where he continues to advocate for the importance of conscious organization, the full person, and the best possible world.
The director of Sant Joan de Déu is passionate about history, management, and humanism. His raison d'être is hospitality, while his purpose is to humanistically care for vulnerable people (families or sick children) to contribute to creating a more just society. "We are not here to accept what cannot be changed, but to change what cannot be accepted," he insists. To give you just a first piece of data for hope, at Sant Joan de Déu, more than 80% of children with cancer are cured, and from the hospital, they fight, night and day, to get closer and closer to the 100% goal.
The history of Hospital Sant Joan de Déu is reminiscent of the phoenix that knows how to rise from its own ashes. Its transformation model as a private center that is part of the public utilization network is studied as a success story at IESE, and since the late 19th century, it has had to face challenges of viability and identity, as well as the 2008 economic crisis which, according to Manel del Castillo, was "the perfect storm," with cuts, fewer staff, fewer beds, and fewer patients, also accompanied by a continuous decline in birth rates in Catalonia. However, giraffe leadership implies having a long-term vision, which is why, a decade ago, it made the decision to become an international hospital despite the complex economic situation, and thus explore new sources of income instead of merely reducing expenses.
In fact, the first international trip they made from the hospital was to the Emirates in February 2013. Years later, they were invited to participate in a public tender which they won to receive international patients. The director of Sant Joan de Déu remembers as if it were yesterday the words the Undersecretary of the Emirates told him at the Madrid embassy in 2018: "You didn't win because you are the best, but because of the dignity with which you treat families."
Hospital Sant Joan de Déu performs half of Catalonia's pediatric activity, is the largest center in Spain, and is in the top 3 in Europe, only surpassed by Bambino Gesú in Rome and Necker in Paris. They say that numbers in pediatrics are key and that, to have expertise, many numbers are needed. To add just a few current figures, Sant Joan de Déu has more than 370 beds, 3,500 professionals, more than 55,000 care records, and a budget of around 400 million euros, of which 10% corresponds to non-public billing. On a normal day like today, it has up to 140 international patients in treatment, from almost a hundred different countries. "We are a herbivorous organization. Our way of competing and differentiating ourselves is humanism and patient satisfaction," he insists.
Paraphrasing Nelson Mandela, the best way to reach the soul of a society is surely to see how it treats its children. At Sant Joan de Déu, they are very clear that children must always be with their parents, they must be able to play and, as far as possible, not feel pain, while also creating spaces that adapt to children and managing to personalize all their needs. Manel del Castillo explains that "children never forget a hospitalization; we have to try to make it a positive and learning experience within what is possible."
Sant Joan de Déu's latest crisis is that of complexity. "The gods punish humans by granting their wishes: we wanted to be a complex hospital, and we have achieved it," explains Manel del Castillo. So much so that they have gone from 6,000 to more than 33,000 children with rare and highly complex diseases through precision medicine. "We have to work on cancer or rare diseases in a different way. Precision medicine is not about treating tumors, but about treating patients better," he assures. From this emerge projects such as the Pediatric Cancer Center Barcelona or Únicas, with a space of 13,300 square meters and a budget of 59 million euros, with a donation from the Amancio Ortega Foundation.
The best societies are those that best care for their vulnerable. Jim Collins and Jerry Porras's book titled Built to Last analyzes the importance of habits for the success and legacy of visionary companies that endure over time thanks to their professionals and their values. Thus, Hospital Sant Joan de Déu cannot be understood without its corporate culture with highly committed and compassionate professionals, also known as "empathy in action." "Surely when I retire, they will give me a plaque, and I hope it says: He didn't mess it up," explains Manel del Castillo amidst laughter from the audience.
Let's go back to the origins: what is the key to the success, resilience, and survival of Sant Joan de Déu, which had its first seed in a charity hospital born in 1867 for children with polio and tuberculosis? Simply and plainly: "Good professionals and being faithful to values. Everything must be changed, except what is nuclear." In this sense, this hospital has grown to improve the what without forgetting the how, and it has done so by offering innovative therapies and treatments oriented to rare diseases without ever ceasing to think of children as the center of everything, because "there is nothing more vulnerable than a family with a seriously ill child."
Some say that learning from difficulties is a great art and that when you try many things, you have to be able to rectify. In fact, Manel del Castillo assures that this is one of the great qualities that Amancio Ortega has valued most, recalling again that the giraffe is born falling and gets up very quickly. As an example, the director of Hospital Sant Joan de Déu recalls the mistake they made with the fundraising campaign for the Pediatric Cancer Center. "We wanted to raise 30 million euros, Leo Messi gave us his support, and a theoretical expert told us that with the millions of followers he had, we only had to think about what to dedicate the leftover money to," he recalls. Nothing could be further from the truth. The campaign was presented at Camp Nou, with Leo Messi, and media from all over the world disseminated it, but on the first night, only 28,000 euros were raised. "We set up a campaign based on micro-donations and we were wrong. Likes are not euros. We had to go look for the big donors. This mistake could have cost me my position and international prestige," he adds. Fortunately, they spoke with different senior executives and managed to raise 30 million euros in a year and a half. It's not about never falling, but about getting up as quickly as possible.
A perhaps lesser-known facet of Manel del Castillo is his presidency of the Cairos committee, created by the Ministry of Health to reform the healthcare system. In Greek mythology, Kairos is the god of opportunity, and in current Catalan affairs, it stands for the Committee for Evaluation, Innovation, Operational Reform, and Sustainability of the Health System. In a conversation we had years ago with Manel del Castillo, he warned that we often fear losing what we already have, and that we had lost the reformist spirit of the 80s, just as we feared reforming the healthcare system. Coincidence or not, destiny has given him the opportunity to lead this reform, at least from the perspective of a new committee, and the truth is that the Generalitat has already approved an agreement to provide formal coverage for the reform of primary care.
Even so, Manel del Castillo warns that "the healthcare system, which is a pillar of the welfare model, is at risk of losing legitimacy, trust, and social sustainability. It does not compete and has a serious accessibility problem." There are a couple of facts that should make more than one person reflect: 49.9% of Barcelona's citizens have double insurance or the almost seven years of surgical waiting list in Mallorca. In the case of Catalonia, the diagnosis points mainly to excessive bureaucracy and the lack of productivity of the healthcare system. "51 reports and reform proposals have been made in the last 30 years. From Cairos, we will not make number 52, but we will try to recycle everything that has already been done and execute it. We are managing to generate this sense of urgency," he points out. Vivir es urgente (Living is urgent), as Pau Donés sang.
"The welfare state is a great invention, but it can disappear and if it does, we would become a much more individualistic society"
Also, pay attention to these two facts: the poverty rate for those over 65 is double the average population rate, and 50% of healthcare spending occurs during the last six months of life. Healthcare, like the welfare state, is above all a matter of trust. Manel del Castillo delves into the problem of Javier Miley's or Elon Musk's chainsaw as a degradation of what is public, and that old thought typical of the "victims of the system" who argue that the best place for money is in one's own pocket. "The welfare state is a great invention, but it can disappear and, if it does, we would become a much more individualistic society. The system must be reformed," he snaps.
The conclusion of this new session of the True Leaders cycle was given by the businessman Antoni Esteve, founder of Adsalutem Instituto del Sueño and president of the Fundació Factor Humà: "Manel makes what is very difficult easy. He has the ability to envision, inspire, and attract other people. You will leave Sant Joan de Déu in the best possible situation for those who have to continue it. You are successfully creating the future."
For now, however, Manel del Castillo continues to have more dreams than memories.