The main objective of this study is to analyse the process of integration of health care implemented in the public health system (Osakidetza) of the Autonomous Community of the Basque Country (CAPV), and assess whether the steps taken to date have helped or hindered the work of health personnel in times of COVID-19. Based on a case study, an assessment is made of the way in which certain tools of the integration process have been applied, if they have worked well and if they have led to better management of the pandemic.

For the purpose of this study, a qualitative methodology is chosen consisting of a case study and in-depth interviews with health personnel at the front line of the integration process and the fight against COVID-19.

This study makes two fundamental contributions. First, it analyses the health integration process in recent years in the public health system of the Basque Country. Second, it gathers the perceptions of different agents related to the Basque Health System of the way in which the tools of the integration process implemented in recent years have worked during the pandemic, detailing the positive and negative perceptions in this regard.

Our conclusions offer a series of strategic recommendations linked to comprehensive patient care and the use of tools related to teleconsulting: the unified medical record, electronic prescription, and non-face-to-face care channels.

Federal agencies perform many important tasks, from guarding against terrorist plots to mailing social security checks. A key question is whether Congress can effectively manage such a large and influential bureaucracy. We argue that Congress, in using oversight to ensure agency responsiveness to legislative preferences, risks harming agency morale, which could have negative long-run effects on performance and the implementation of public policy. More specifically, we argue that oversight’s effects on agency morale are conditional on whether oversight is adversarial or friendly. We assess our claims using a novel data set of the frequency and tone of hearings in which federal agencies are called to testify before Congress from 1999 to 2011 and merge it with data on agency autonomy and job satisfaction. Our findings suggest that agency morale is sensitive to congressional oversight attention, and thus speak to questions regarding democratic accountability, congressional policymaking and the implementation of public policy.