The autonomous communities and the Ministry of Health will address next Thursday in an Interterritorial Council that is expected to be tense the difficult summer that the health system faces due to the lack of doctors with which to reinforce vital services, such as Emergencies. The department he heads … Mónica García has called on the communities to present their plans in this regard, but the Minister of Health, Juan José Pedreño, has already responded that “it is not about sending a plan”, but rather about “the Ministry fulfilling its obligation and saying What solution does it provide so that we can have professionals this summer?
The origin of the conflict is the impossibility of hiring as attached doctors the MIR of Family Medicine who this course finish their specialized training period, since instead of ending in May, as usual, this year they will not do so until September . This represents a problem because Family Medicine is the specialty that supplies professionals to both Emergency Services and health centers. But it is not an unexpected event, as the Ministry itself recalled: “Everyone has known, for four years, the peculiar situation that was going to occur this summer.” Since 2020, when this promotion was incorporated late due to the pandemic, the administrations already knew what they would face in 2024. The moment has arrived without the Emergencies of the Region of Murcia being prepared to make up for the absence of new specialist doctors.
The Ministry of Health was counting on the Ministry to advance by decree the accreditation of these MIRs as associate doctors, but the central Government has ruled it out. For counselor Juan José Pedreño, this shows that Minister Mónica García “is involved in other things, in other tasks, and she does not fulfill her responsibility.”
The Ministry’s decision, however, has the support of the Murcia Society of Family and Community Medicine (Smumfyc). «We are not in favor of shortening the MIR training time. They are not labor, but rather personnel in training with a training program that must be followed,” warns its president, Jesús Abenza.
Discomfort grows
While Counseling and Ministry confront each other, unrest grows among Emergency doctors. The absence of MIRs available for hiring this summer is a temporary problem, but what underlies it is a structural deficit. The situation is “critical,” summarizes Pascual Piñera, head of the Reina Sofía Emergency Department and president of the Murcia Society of Emergency and Emergency Medicine (Semes).
The management of some health areas has begun to deny permits, reductions in working hours and vacation days to doctors in their Emergency Departments. The managing director of the Cartagena area, José Sedes, speaks openly in these resolutions of the “insufficiency of human resources to meet demand” during this summer. This is the execution of a measure already announced that has generated enormous unrest among the staff, and which has led to protests at both the Santa Lucía and the Reina Sofía and the Rafael Méndez de Lorca.
The problem is especially serious in Cartagena. In the resolutions in which he is denying permits and reductions in working hours, José Sedes recalls that “while demand is reduced in inland health centers” in summer, “on the coast and specifically in the hospitals of Cartagena, the opposite effect occurs.” » fruit of tourism. Specifically, healthcare pressure increases by 13% on average in the months of July and August in Santa Lucía, if the period 2017-2023 is taken as a reference. In Rosell, the increase is 4%. But, in addition, the forecasts for this summer call for an even greater increase, because in the first months of the year a rebound in demand has been detected. As of today, there are no reinforcements available for Cartagena or the rest of the hospitals. “The central services of the Murcian Health Service have informed us that the job boards for doctors are empty at this time,” says José Sedes. In the summer of 2023, 8 associate doctors could be hired “to cover requests for vacations and other permits during the summer period.” But this year “there are no doctors available to hire.”
The same happens at the Reina Sofía, where six contracts were closed last year. On this occasion, only two professionals who covered guards have been stabilized, and they have become full-time.
Exhaustion and discontent
There is, in short, less possibility of reinforcing staff that, in addition, are increasingly depleted by casualties due to exhaustion and discontent, and by leaks to other levels of care. “At the Reina Sofía we have seven unfilled gaps: three maternity leaves, two other sick leave, a professional who has gone to 061 and another who has gone to La Arrixaca,” says Pascual Piñera. In a statement, the Medical Union warned this week of the “serious risk of mass resignation” from jobs. For Juan Crevillen, from UGT, the situation “is becoming unsustainable.”
In addition to fitting in with the holidays, the Emergency Services will reduce the number of doctors on call during July and August. This will put more pressure on professionals.
health centers
Primary Care also faces a difficult summer. Smumfyc foresees “zero reinforcements in most centers.” “The general trend will be to double consultations, assuming quotas of unsubstituted professionals,” explains the president of this medical society, Jesús Abenza. There are also 85 unfilled Family Medicine and Pediatric places in health centers. These are positions created last year within the framework of the Primary Care Improvement Strategy (GEAP), but they remain vacant and, in many cases, have not even been offered yet. Salud explains that it is preparing an open and permanent transfer competition.
As in Emergencies, the problem in Primary is the lack of professionals available for hiring. A report from the Ministry of Health published on Friday warns that the deficit will worsen until 2029. From 2030, the trend will begin to be corrected thanks to the increase in MIR places.
Unions fear a cut in replacements
The unions are still waiting to know the summer plan of the Murcian Health Service (SMS). «There are problems and restrictions with vacations. Middle managers tell us that there is no money for replacements,” warns Juan Crevillen, secretary of the UGT Health sector. «The SMS has not yet offered information. We fear that everything will be done at the last minute and in a hurry,” says Antonio Martínez, general secretary of the Union of Health Professionals (SPS).
The Satse union, which already denounced last week a foreseeable “reduction” of contracts, has demanded the convening of the Sectoral Health Board and personnel meetings in the areas. “The summer plan is still not closed because the SMS wants to reduce Nursing contracts, but this does not suit management,” warns Pablo Fernández, general secretary of Satse. Workers’ Commissions also demand a Sectoral Table and regret the lack of information.
The Minister of Health, Juan José Pedreño, pointed out this week that “we are working in advance with the health areas, as every year, and will be informed in a timely manner, as has always been done.” The SMS “will provide all the necessary resources to guarantee health care,” he said.