“Great medical demonstration” in May for the defense of Primary Care

The State Confederation of Medical Unions (CESM) launches in this month of March its campaign in Defense of Primary Carewhich will feature a series of mobilizations and reminders of the main demands of the first level of care distributed according to their urgency, all in an attempt to “alleviate the unsustainable situation that this health level is going through”.

As reported by CESM in a statement, this is a first step towards the Defense of Primary Care professionals “Which on its journey will unite the rest of the doctors to come together in a great demonstration of the entire profession next May in Madrid, thus recovering the concentrations restricted by the pandemic and which will aim to remember the demands that the Confederation has maintained for a long time. years, since so much later still none of them have been solved and it is necessary to value once more the doctors of the National Health System”.

“The social context in which we find ourselves today it is devastatingleaving the sixth wave pandemic by SARS-CoV2, with some professionals who feel exhausted, especially the medical community, following the assistance overloads to which it has been subjected to cover the needs of citizens who demanded assistance in the SNS; discouraged by the terrible working conditions and the shortage of templates, without the corresponding health authorities providing solutions beyond temporary patches, always at the expense of worsening the conditions of professional practice; tired of continuing with some Remuneration that does not respond to the responsibility required and that are increasingly distanced from those of the countries around us; Tired of the poor regulation of the working day in which the compulsory medical shifts, both in their physical presence and location modality, crush, like a great slab, health and the reconciliation of their work and family life; outraged at being systematically ignored in the participation and decision-making bodies in everything that affects their profession; exploited, with unworthy and highly precarious contracts that are already manifested from the MIR stage“, he stresses.

CESM measures for Primary Care

All these circumstances, adds CESM, “are manifesting themselves at this time especially raw and with great virulence in Primary Care of the SNS, which is why at CESM we demand the following measures, many of them identical to those of the other care areas of public health in our country, classifying them according to their urgency”.

1. A urgent economic investment finalist for AP destined to immediate measures that allow the economic and functional sustainability of the same.

2. An offer of stable and defined contracts for physicians specialized in FCM and paediatricians in PC.

3. One increase in templates with the creation of medical positions, necessary for them to develop all their skills and to cover ordinary and extraordinary absences, and fulfilling the quality criteria with 1,250 individual health cards (TSI) for family doctors and 900 for paediatricians, with a progressive creation in the next 3 years, the first year being at least 30%.

4. A clear leadership of the Primary doctor in the team management that allows decision-making on organization, structure and necessary human and material resources. It is necessary that the competencies of the doctor are no longer questioned, which is achieved by creating a regulation for Primary Care teams where the functions and competencies of each member of the team are clearly set out in accordance with current legislation.

5. A limit in the agendas of professionals with 30 patients maximum (Distributed between 25 face-to-face, telephone, home and 5 emergency requests).

6. The decrease in consultation bureaucracy unrelated to clinical care in order to reduce it to zero.

7. Delimit the time spent in the working day continuing Education already research.

8. Establish by law the limit of delays in Primary Care for the entire national territory.

9. A definition of management tools inside and outside the ordinary working day, voluntary and correctly remunerated, to alleviate the shortage of physicians while it exists and avoid delays in AP (with overtime at a higher price than ordinary time).

10. The involvement of Occupational Health Services in monitoring the health and working conditions of its professionals and the application of protective measures by those responsible.

11. One salary increase for PC doctors that allows their salary to be equal to the average salary of doctors in Europe, doubling the current salary by increasing the price of TSI, so that a salary is reached that is double the current salary in 5 years, being the first year of at least 25%, also reversing in this first year the cuts that have been supported since 2010 in three-year terms, extra payments, etc.

12. A improvement of working conditions and retributive of Continuous Care, which must be recognized as an ordinary day and therefore be paid as such, with recognition of the night shift and the reduction that this implies and with the corresponding breaks.

13. An acknowledgment of exemption from guards from 55 years and the corresponding compensatory modules.

14. The implementation of security systems in all Primary schools, with adequate plans and financing to be effective, with complaints to the Administration that does not put adequate measures to avoid risks to professionals in addition to those once morest aggressors, with exemplary sanctions.

15. The mileage credit for those doctors who have to travel to different towns.

In addition to those mentioned above, there is another series of CESM measures “that must be applied to medium term“, as they are;

1. The study of the real needs of the populationtaking into account the casuistry and the multiple factors that influence the demand for consultations, which must be accompanied by the appropriate registration of professionals.

2. Promote stability with creation of the precise vacancies for future generations of family doctors and pediatricians in the years to come.

3. Set up economic incentives for areas of difficult coverage.

4. Assume that the MIR vacancies they have to respond to the needs of the population and thus ensure generational change through the gradual increase in MIR positions for family doctors and paediatricians, together with the corresponding increase in Teaching Units.

5. Encourage the guardian figure, since if they do not have the necessary conditions to be teachers, they will not have the capacity to increase the MIR positions, and for this it is necessary to limit the consultations. On the other hand, if there are no incentives and recognition of the figure of the tutor there will be no tutors and therefore it will be impossible to continue training residents.

6. Set up contingency plans for the next few years that include economic incentives for doctors. In this way, it will be possible to make up for the deficit that primary care physicians are going to experience due to retirements and the loss of interest in the specialty due to working conditions.

“All these measures are necessary to reverse the current dramatic situation, but they must be framed within the final objective, which is to have a solid and healthy Primary Care that stops tottering due to the inaction of the Administration”, points out the confederation. For this, the long-term demands must not be forgotten, which go through:

1. Some Primary Teams equipped with resolution capacity and that they can increase the portfolio of services, something that is achieved by creating sufficient templates to allow new challenges to be addressed, in addition to covering incidents.

2. One prospective annual study of the needs of residents of Primary Care specialties.

3. Salaries for doctors in Spain that allow them to be competitive with those of surrounding countries.

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