There is a lack of doctors. Two words that have been said and repeated ad nauseam in recent times but that, for the first time, have come out of the mouths of Andalusian public health managers in the form of S.O.S.. The first to set off the alarm was the Minister of Health, Catalina García, who, after the Interterritorial Council of the monographic National Health System was held last Wednesday, explored the possibility of having to close health centers in summer due to the lack of doctors to maintain the adequate level of staff and give professionals a rest. Just a few hours later, he was the spokesperson for the Junta de Andalucía, Ramon Fernandez-Pacheco, who demanded help, especially from the central government, to close the necessary health contracts for the summer. He shortage of doctors affects several specialties, but suffocates the Primary Care. Currently, in the entire province of Seville, the Andalusian Health Service (SAS) has 67 empty family doctor positions, according to official data provided to this newspaper by the Health Administration. They are quotas that have been left vacancies due to the retirement or discharge of the owner and for those who cannot find professionals who can fill those positions, which end up being taken over by the rest of the doctors in the health centers affected by these vacancies. That is to say, there are 67 fewer doctors that the SAS has in the province to do the work that the preparation of the Summer Plan in health centers entails each year. There is free places in all health districtsbut in rural areas, where the staff is already shorter to cover a smaller population, the problem is much more accentuated than in the capital, where the number of doctors per outpatient clinic is much larger.
The consequences? Dramatic Primary Care for the summer. “It will be a very complicated period”, warns the Health Minister. “There are already autonomous communities that have announced that they will have to close health centers, such as the Basque Country or Catalonia. Andalusia wants to keep health centers open, maintain our attention, but we are in a very difficult situation“, Add.
Given this scenario, only the arrival of new professionals can alleviate the pressure on health centers, but doctors who join the health system to train as specialists do not choose Family Medicine and those who chose it four years ago, who did not begin their training MIR until September, instead of May, as a result of the outbreak of the coronavirus pandemic, they will not be able to serve this summer as a bargaining chip to combine the vacations of permanent staff since, just as they started late, they will also finish their training later. and it will not be until next September when they finish their residency and can join the workforce.
The unions, for their part, raise their tone and are already talking about a summer “catastrophic”. He Andalusian Medical Union He calls the SAS plan of trying to have the MIRs “prevent the collapse of Primary Care” as “ridiculous.” They also reply to the Minister of Health, Monica Garciato which they remind that “many of the doctors who work in Primary Care are graduates without a specialty and earn more and have less training than the resident doctors whom they theoretically must supervise, but, without them, Primary Care medicine would simply be disappeared in a good part of the national territory”.
As a solution, the union center is committed to “economic incentive” to the MIR to alleviate the lack of doctors this summer, although they insist that “the solution to the Primary Care crisis involves improving the working conditions and remuneration of their doctors.”
He too Andalusian Council of Medical Colleges (CACM) shows his stupor at his “ignorance” of the SAS summer plan to solve the lack of doctors. In a recent statement, the body headed by Jorge Fernández Parra, acknowledges that “months ago” they made themselves available to the SAS to make proposals and try to resolve this matter.” Since then we have held informal conversations with SAS officials but, until date, we are not aware of any proposal in this regard from the Ministry of Health,” the agency indicates.
With a broader view, the situation will get worse. The deficits that Primary Care now supports come, beyond the specific unforeseen event of the MIR of 2020 and their later end of residency, from the retirements of doctors of the generation of the baby boom, which has not been compensated with an incorporation of young residents, a consequence of a drastic cut in the number of places between 2010 and 2016. Since 2017 it has been increasing, but this does not completely solve the problem since, on the one hand, the MIR places Those offered today will not become professionals ready to join for another four years and, on the other hand, community and family medicine is also beginning to leave vacancies in Andalusia. Although Seville has escaped this trend and its 72 MIR places in Family Medicine have been filled, the truth is that, despite the fact that it is the specialty that offers the most places, it is also the one that more resignations havearound 30%, according to the union sources consulted.
But the future is not expected to be rosy, at least in the coming years since, according to the Medical Demography Report in Andalusia 2023 from the CACM, in the next ten years it is expected that the province of Seville will enter the age of retirement more than 1,600 doctors. The organization does not specify how many correspond to the Family specialty, but due to the high number, the percentage is presumed high.
In this line, retain doctors of retirement age It is another way that the SAS uses to alleviate the shortage of professionals. Thus, at the end of last year, there were 255 doctors in the province who were over 65 years old and who continue to work for the health of the people of Seville. It is another of the extremes that the SAS has had to go to to try to alleviate the lack of doctors for which it included in the Human Resources Management Plan in May 2019 the possibility that certain health personnel could prolong voluntarily to remain in active service until reaching 70 years of age.
With this panorama, the question is: Will there be enough family doctors this summer in Sevillian health centers? At the moment, from the Junta de Andalucía, the Ministry of Health has already reported that it is working on the Summer Plan, in which around 32,000 hires will be made (which include hospital and primary care), of which 2,000 would be in May and October and the other 30,000 in the summer months.
They will be contracts between one and three months and, with them, the objective is to be able to maintain a device similar to last year with the health centers open in the morning, and with closures in the afternoon depending on demand, which in Seville capital, the area with the largest population, In recent years, it has translated into an evening offer of nine available clinics and, in the rest of the province, with the concentration of care at strategic points due to the impossibility of being able to keep the health centers and clinics in each municipality active.