The WAR DRUMS sound in the Catalan healthcare. At the dawn of the doctors’ strike in Madrid and the demonstration in defense of public health on Sunday (which brought together 200,000 people), the sanitary facilities in Catalonia are also studying mobilization. Right now, although nothing is closed, a strike is not ruled out. Because the “background” problem in Catalonia (and the rest of Spain), they say, is the same as that of Madrid: overloaded care (especially in primary care), poor working conditions and a great concern about the next batch of retirements of baby boomers that cannot be covered because there are no doctors. This is also the case in other European countries, such as France and Germany, where many Spanish physicians are going to work because the conditions are better.
The syndicate Metges de Catalunya (MC) is carrying out, between this month and next, a series of assemblies in which they are consulting physicians about their concerns. Union sources assume that there will be mobilizations, although for the moment it is not known format (they don’t know whether they will be demonstrations, rallies or directly a strike) and the date of the same (January or February). Right now, according to these sources, there is a 50% chance of a strike in January. But, despite this ‘run run’, nothing is closed. The union met this Monday for the first time with the new ‘conseller’ of Salut, Manel Balcells. “Among the toilets there are unease, indignation and a sense of mistreatment.” MC assures.
Anger over longitudinality
Balcells has not entered with good foot in the ‘conselleria’. Last Thursday, in the Catalan Parliament, he said that longitudinality had become “old”. The primary care was thrown at him via social networks. Longitudinality is the stable relationship maintained over time. between the same doctor or nurse and his or her patients. It is characteristic of the first level of health care, that is, primary health care, and has proven to have direct benefits on patients’ health. Longitudinality is lost if the health care providers are constantly rotating because they cover sick leave, as often happens, and do not stay long in the same health center. Balcells will appear again in the Parliament this Thursday and the health workers have already demanded a rectification.
The vice-president of the Col.legi Oficial de Metges de Barcelona (Barcelona Medical Association) (COMB), Jaume Sellarès, acknowledges that he would not be surprised if there was a strike among healthcare workers, especially in primary care, which already experienced a five-day strike in November 2018. MC agreed then with the Institut Català de la Salut (ICS) to fix a maximum of 28 visits per patient and 12 minutes minimum. But things have not improved, or not enough.
“The situation is very hard. I am a family physician. The situation of some CAPs in Barcelona and in the outskirts of the city is very complicated”, Sellarès assures. An example: the president of En Comú Podem in the Parliament, Jèssica Albiach, denounced this Tuesday that she herself had made an appointment with her family doctor and the CAP was unable to schedule her for the next 30 days. He showed a screenshot of La Meva Salut with the notice.
Divendres vaig demanar hora pel metge de família. La resposta de @salutcat: I can’t schedule an in-person visit in the next 30 days.
Aquesta és la situació de la Sanitat Pública catalana. pic.twitter.com/4U7MrdHG85
– Jéssica Albiach (@jessicaalbiach). November 15, 2022
The average waiting time to access the family doctor in Catalonia is not 30 days (it is 5.36 according to Salut, although the medical societies recommend a maximum of 48 hours), but the situation described by Albiach illustrates the situation experienced by some CAPs, especially in Barcelona. As you go out of the city, “accessibility improves”, admit from Metges de Catalunya.
Different, but not so different
“The situation of Madrid is not the same as that of Catalonia. But there are commonalities.” Sellarès points out from COMB. For example, historically there has been a “certain mistreatment” of primary care (with a “suffocating level of bureaucracy), to which budgets, he says, “never go hand in hand”. The World Health Organization (WHO) recommends allocating to it a 25% of the budget, but in Catalonia it receives 16,7% of the total received by Salut (5% more than in 2019).
“On this breeding ground, in Madrid more things have been done. [reabrir las urgencias extrahospitalarias, tras dos años cerradas, sin el personal suficiente] -Sellarès continues. And there is something you have to know how to read: when things in healthcare are not done with care, citizens take to the streets. Because that demonstration was of citizens.” The vice-president of the COMB, who nevertheless calls on “not to politicize” healthcare, also calls for health care workers “more autonomy” when making decisions.