The president of the Spanish Federation of Medical Scientific Associations (FACME) states that “the excessive bureaucratization of health management fails or that it is time for the government to change the structure of the management”
An expert in Internal Medicine with more than 40 years of experience, Javier García Alegría governs the Federation of Spanish Medical Scientific Associations (FACME) from December 2022, an organization that encompasses 45 entities and represents more than 120,000 medical experts.
How You See the National Health System Now If the National Health System were sick, it would undoubtedly show signs and symptoms of concern. Before the pandemic, there was already information that showed us that the issues needed to be improved and the pandemic just revealed those deficiencies and structures that needed to be delivered. The system is overwhelmed, and the consequences of that are not only immediate, but also always drawn. We have prepared a document for the restoration and transformation of the health system, which has four basic aspects. It is necessary for the first patients to be admitted. It is also key to establishing better management and follow-up of chronically ill patients; greater proactivity and identification of risk factors and improvement of diagnostic processes; and regulation of the allocation of health resources. We have a public fund, this is 25% less than other countries in the European Union. But not only more efficient funding is needed, but the health system, which is built from the care of urgent pathologies, must be reorganized, when the truth is that today the prevalence of chronically ill patients is greater. The health system is not adapted to these requirements. We want to organize health care because it is also very rigid and many aspects can be improved. I do not hope that the system is in danger. The National Health System was a true source of national pride, an example for many nations and a balance of rights. We have built a great system and now the challenge is how to adapt and how to meet the challenges of the next years. I’m not so negative about this. I believe that needs to be introduced to solve the problems we have now. Recently in a speech you lamented that Health is not in the political agenda. I believe that citizens and professionals should take care of health as a priority in different political agendas. I believe that we need a national agreement, a national agreement for health to define how Health will be from now to the next 10 years. Many issues are discussed, in addition to the aforementioned, also important aspects related to technological innovation, the application of information systems, artificial intelligence, also the care of the mental structure… It is necessary to define at least what the health system is affected by. We want Spanish for the next 10 or 20 years. I believe that we all want to guarantee public accountability, because the weakness of public institutions promotes more inequality. An agreement must be reached, I am sure that there are more things that unite than divide. A few weeks ago, FACME requested from the Ministry of Health, together with other medical organizations, a greater link with their objectives. Are the health management professionals not being heard enough? technicians, professionals, have never had more participation in the planning of organizational centers than during the pandemic. We heard every day, when it was adapted to the centers, in the prediction that we were going to have patients, in the organization of rounds, etc. But that ended when the worst of the pandemic passed. It should have a system with the representation of experts in each science at all levels. For example, in the process of approval and financing of new drugs and therapeutics, it cooperates with other European countries. Now, scientific criteria do not have the weight of health in general management, or do they have more? Each individual’s own knowledge consists of professionals and representatives of scientific societies. It would also help with other problems associated with the national health system, such as the excessive bureaucratization of the administration or the fact that the administrative structures change every time the government changes. How do you see the situation of the teachers, what has happened with the management of human resources, with the contracts for one day, in poor conditions, the knife work has generated a lot of discontent among the teachers, it’s all for you. they make the papers read every day. You cannot see 60 patients in one morning, that is impossible. And then there is the official burden in the medical operation which is filled in the time of the doctors. There has been a lot of discussion about whether we need more doctors or not, but what needs to be done is to think about how the medical time should be spent, what tasks should be used. Working conditions must be improved and other aspects of management must also be improved. Doctors have constant attention for patients. I don’t like to go on a strike. Strikes only occur when there is an extreme lack of dialogue. Our country has come from very difficult circumstances. Now is the time to think and reach a national consensus and plan for health care in the coming years. that treaty can be made.
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