The Medical Union has been demanding for years from the Ministry of Health to make a major effort to retain doctors who have completed the MIR in Andalusia. However, the measures taken so far for this purpose are not yielding results.
The SAS has returned this year to instruct centers to offer jobs to recently terminated residents. The results have once again been pathetic. Of the 55 family doctors who finished their specialty this year in the province of Seville, only 16 have been appointed, as well as those from the other two provinces. In hospital care, the failure has been even greater, as 265 doctors who finished the specialty have only been offered a total of 6 places.
There are many reasons for this shameful incident. In primary care, job insecurity and pay discrimination discourage doctors from entering public health. These conditions are particularly worse in the summer and are particularly bad in Andalusia. In hospital care, the lack of updating recruitment pool lists and the scourge of platforms through which appointments are offered has blocked the possibility of hiring recently terminated specialists, as earlier in the process. Associates with seniority above 30 years are required to be offered appointments. , In fact, the time frame for completing the entire process is so short that even when it was possible due to paucity of time, proposals were not made.
The SAS, halfway between hypocrisy and incompetence, announces triumphant and promotionally-sounding juicy proposals of “long-term” contracts to retain doctors (as Jesús Aguirre did in March 2022), while in practice, it Refuses to eliminate uncertainty and to implement agile hiring processes. In fact, it looks like the board has given up on trying to stop the decline of public medicine.
The Minister of Health, Catalina García, has openly acknowledged this in an interview with Consalad TV in January this year, in which she affirms that “today, in the whole national health system, we have the impossibility and inefficiency to change pensions, doctors due to the current shortage of sick leave, holidays or permission”. Affirming that there is no solution to the problem of shortage of doctors, our consultants avoid any responsibility for the disaster and refuse to mitigate it, while paving the way for its strategy based on putting public health in the hands of the nursing staff. Thus, in an interview with the online channel Enfermeríatv, Catalina García said: “In 4 years we included 7,590 nurses in the SAS. done, it is said too soon. Enough? No, we will include more”.
Public medicine faces great challenges in the near future. The 2008 crisis meant a sudden deterioration in our working conditions from which we had barely recovered when the pandemic dealt us a brutal blow, particularly in primary care. The current administration has perpetrated the grievances we’ve been decrying for decades, such as eliminating exclusivity, increasing the price of on-call or enforcing continuity of care in primary care. However, they do not seem ready to go further than this.
Implementation of the agreement to limit schedules in primary care is being hindered by the same SAS team that signed it, which also refuses to end doctors’ intolerable pay discrimination in the sector. The condition of Sadar Hospital is also not much better. The massive inconvenience caused by the offering of destinations in OPE 18-21 has been only a preview of the conflict that is expected in the region in the immediate future as well.
Administrations across the country, regardless of their political affiliation, must urgently address the improvement of the working conditions of the medical community. The current labor and remuneration model, which applies to a specialist doctor in the same way as an orderly or administrative assistant, has failed. Our group needs its own regulatory and negotiation framework, which establishes specific professional selection and promotion systems and a remuneration model and incentive system appropriate to our responsibilities and qualifications. Otherwise, it will be impossible to retain doctors in public health in the near future, as the data we just provided shows.
If the administration continues to opt for a progressive reduction in public medicine based on the replacement of doctors by nursing staff, then in a few years they will be unable to attract doctors to the public health system. In fact, the average age of doctors in the private sector is already lower than that in the public sector (see report here).
This year’s triggering of the resident loyalty scheme, not much different from what happened in previous years, is not only a result of administration incompetence, it is also an alarm sign of what is to come. If the administration continues to ignore this problem, quality medical care will soon be available only to those who can afford it.