The serious epidemic produced by the man SHARS-Cov-2 revealed the shortcomings of our health system; all EU countries have suffered serious consequences that the virus has left us; that even the economically advanced would not have been able to manage the epidemic effectively. Only some of the Nordic countries have suffered a lower incidence, both in the number of infections and in deaths. Italy, on the other hand, where the coronavirus has wreaked the greatest havoc; He followed Spain.
In our country, the beginning of the epidemic was not effectively managed, considering the consequences that it could bring us. We ourselves have seen the matter go through Italy; but the Ministry of Health with its “experts” did not know what was coming to us; which led to overcrowding of both hospital and primary care cases, as well as extremely high hospital admissions and deaths.
However, the Government effectively managed vaccination in coordination with the Autonomous Communities and that reached more than 80% of the population by the end of 2022; coincides with the Omicron variant, until then the most contagious; then the pestilence became mild in most cases of respiratory infection, except in severe or persistent disease. The management of the vaccination schedule has been carried out (and this must be said) better than in most European countries; although the rest of the pestilential administration carried out by him is far away.
Because of all the aforesaid, Spain suffered a notable drop in the health of its citizens; We must consider that our country is less powerful than the European average; which in 2022 was 2,244 inhabitants. Spain is reported to have invested in the same year 1854, after France, Germany and Italy. Although this region of ours is considered the 25th in the number of 1912 of the largest regions: but it is not enough.
First, Spain needs to increase public health resources; especially in “primary care”, a basic and necessary filter to avoid the saturation of the system, especially the hospital. We have confirmed that increased investment in “primary care” will result in a substantial improvement in the health of citizens; especially the elderly, who suffer from the most frequent diseases.
Another important point to consider is waiting lists. Countries like France, Germany, Norway and Finland have shorter waiting limits than in our country; both in surgery and in other medicines; Let us give some examples: in Spain “primary care”, the percentage of patients who seem to have to wait more than a day has gone from 55.1% before the epidemic to 78.1% today; Similarly, in specialties, the percentage of patients with a delay of more than three months was seen from 25% before the arrival of the coronavirus to 37.8% in the last wave of studies. In surgery, the expectation of intervention has greatly increased, in large part due to the epidemic; reaching 148 days last year: the Community of Madrid has a waiting list much shorter than the national average, with 64 days for access to surgical intervention; the national average is less than half.
However, with regard to “primary care”, the Community of Madrid lacks sufficient resources to provide quality medical services. Since May last year, the Community of Madrid has suffered a blow to primary doctors and fewer hospitals; Fortunately, the Ministry of Health reached an agreement with the doctors and unions; they envisage increased medical fees of 350,000 for family doctors and paediatricians; and 500 coins for those who opt for the afternoon shift. It is also limited to 20 patients per day for family doctors and 30 for paediatrics. For the attack on the hospital, the unions reached provisional agreements with the Ministry; a few days ago they had begun to strike by calling; and they expect some great things to be accomplished in the next few days, perhaps after Easter.
If we want to significantly improve “primary care” in the Autonomous Communities, the following points must be considered. First: to limit the number of patients by doctors, both in the family doctor and in pediatrics (a convention reached in the Community of Madrid). Second: it increases the fees of both doctors and nursing staff. (Also paid to Madrid). And thirdly: to promote clinical sessions between doctors from outpatient clinics and hospitals; essential for the continuous training of the former, which is worth taking care of. A fourth reason is to increase the recruitment of doctors with training in family medicine. All this requires significant resources that are directed to health centers. The “welfare state” consists mainly of health, education and pensions; but, as I think, it is perhaps a health which, if the requisite services are to be obtained, requires greater care.
We must consider the five most common pathologies, and they are the ones that occupy more than 80% of people’s diseases. These are the following: diabetes, hypertension, COPD, rheumatic diseases and finally heart failure. These pathologies will be treated by doctors in the first instance through “primary care”, before referring the patient to a specialist. Therefore, as I mentioned above, it is important to provide the services of “health centers” with the human resources needed to adequately care for patients.
Investment in technology is not as necessary as in primary health services; The hospitals in Spain are the same as those in Europe with the best high-tech equipment; This is not a public health problem in Spain, but there is a great lack of services in the “health centers”.
Finally, I will refer briefly to the generosity of the offices: I believe that it is a great addition to the public safety; while, indeed, wisely The release that has been carried out in Britain since 2012 did not give the expected results; on the other hand: ‘The care of the doctors for the citizens is getting worse’ (1). I am in favor of reason, I am the same for common offices; but always with hospitals and centers of reference and excellence. He completes the public health and waits for the times; both in consultations and in complementary tests. In Spain, especially with this government, there is no good idea of traveling; it is believed to render all services to the public health; nor is that true at all.
After the worst “epidemic” known since 1918, it is essential to increase investment, especially in “health centers”. The “welfare state” cannot be covered unless we do it. It is needless to say that there is no place between those who decide the matter; As an economist with a background in healthcare management, I have limited myself to giving my impression: whatever it is worth.
(1) Aaron Reeves, Oxford Professor: Lancet.
(2) Doctor Gómez Catalán, formerly the managing director of the Hospital Ramón y Cajal.
