The first wave of covid-19 pandemic closed some local primary health care centers (PHCs) in order to be able to centralize resources. According to the Conselleria de Salut, 100% of the CAPs in Catalonia and 93% of the local clinics are currently open. But some of the local clinics that have reopened have done it with cut back schedules.
This is the case, for example, of the three local clinics in Dosrius (Maresme) and El Bruc (Anoia). “In Dosrius they have cut hours of attention”, he denounces. Rafa Torres, member of Marea Blanca and the Coordinadora en Defensa de la Sanitat Pública de Mataró i el Maresme. “The problems in the CAP El Bruc started in 2017, but with the covid. we have lost doctors and health coverage.” notes for his part Roser Castellet, neighbor of El Bruc.
With covid-19, two local consultories closed in Dosrius (the one in Canyamars and the one in Can Massuet) and only one (Dosrius Centre Consultori) was functioning. The municipality has 5,000 inhabitants and its reference CAP is that of Argentona. “Until last year, we all had to go to the office downtown or to Argentona. With protests we were able to get the other two opened,” says Torres. The “problem,” he relates, is that “they have cut back on hours of care.” Before the closure, there were six hours of health care at Canyamars. Now, there are four. “There are fewer staff,” he notes.
Dosrius, without a pediatrician
Torres points out another problem related to the service of pediatrics: “The children are being attended by general practitioners. In Argentona there used to be three pediatricians and one of them came here three days a week. Now we have no pediatrician. The 970 children of Dosrius have to go to Argentona,” says Torres.
In Dosrius, she complains, there is only one pediatric nurse to give vaccines. That is why the citizens demand a pediatrician for those thousand children. “We’d like Monday through Friday, but we understand that’s a slam in the face, so we’re asking for one. Two or three days a week.” Torres notes.
“Pediatric care is guaranteed throughout the territory and is organized according to the needs of each population,” assures Salut.
In many European countries, According to the Societat Catalana de Medicina Familiar i Comunitària (Camfic), in primary care, children are cared for by the physicians and family nurses, while pediatricians act as consultants from the hospitals when there is a need for their action, derived from primary care. “Currently in Catalonia this model, which works in the most advanced Europe, is not feasible, essentially because we do not have the number of family doctors that we would need”, says Antoni Sisó, president of Camfic.
The case of El Bruc
At the El Bruc practice, the problems began in April 2017, when. schedules began to be reduced. The center went from opening Monday through Friday mornings and afternoons to opening three mornings and two afternoons. As Castellet explains, the same thing happened with pediatrics: from having a pediatrician from Monday to Thursday (two days in the morning and two in the afternoon) to having one in the morning and one in the afternoon. Behind this situation lies a reduction in staffing: Salut and city council eliminated a family team. “Once past covid-19, the consultancy, which was closed for six months, reopened with more cutbacks and today there is a medical team one afternoon and four mornings, and a medical team one afternoon,” says Castellet.
This neighbor of the municipality, which is home to some 2,100 inhabitants, also criticizes the “deficiencies” of this office, because, according to her, wheelchairs “cannot pass through the doors”, the elevator “is not suitable” for them either and “there is not enough space for patients to wait their turn or their consultation”. The neighborhood demands reverse the situation and make the necessary improvements to this health center.