Maria Luisa Carcedo.
Rethink the system Primary Care with a holistic view of diseases, multidisciplinary teams and ‘mandatory’ rotations that allow to know closely this level of care in a generalized way among the teams of doctors. This is the ’emergency plan’ proposed by Mary Louise Carcedo as former Minister of Health to clean up and strengthen the entrance door of the National Health System.
After having participated in the development of the Strategic Framework for Primary Care during her time at the helm of the health portfolio, the current president of the Commission for Territorial Policy and Public Function in the Congress of Deputies puts on the table in an interview with Medical Writing a battery of necessary measures, in his opinion, to improve the operation of health centers following in the footsteps of the ‘roadmap’ marked out by the Government.
What is the future that presents itself in Primary Care in this post-pandemic stage?
For now, the first plan has been approved, which aims to develop the strategic framework and deal with the situation. All the measures of this framework, which go beyond resources, will have to be implemented.
What is most urgently needed by this level of care?
A bit of everything. As for the Primary budget, it all depends on what you account for. Therefore, whether it is 25, 30 or 14 percent is relative because you can include the Pharmacy or not, the referrals… In any case, what Primary does need is consideration within the system, the assessment by the professionals themselves, both Medicine and Nursing, and start up multidisciplinary teams, which were already thought of from the beginning but I think we must continue to insist a lot on it. I am talking regarding Physiotherapy or Dentistry, which was reflected in the Oral Health Plan that we launched. It is one of the most painful issues and one of the most serious reasons for inequality in health, because the portfolio is very scarce.
What regarding mental health? Do you need a reinforcement especially following having passed a crisis of this caliber?
Yes. Coordination with mental health centers needs to be improved. With the support of a psychologist or not. That depends on how it is organized, but in any case reinforce the link with mental health and community centers.
What would be the guidelines to change the perspective and move in those directions?
It is necessary to exist from undergraduate training in the importance of Primary Care and prevention. Within health, it is necessary to know what the social and environmental determinants of health are. It is of no use to us to be at the end of the chain curing cancers when you have to avoid them. You have to prevent people from getting sick and generating all this expense for the system, which is not only a health cost but also an economic cost, it is a cost to society, of suffering, of pain… We have to change the look, reorient the system and for that it must be done from the undergraduate and postgraduate levels.
|
“Hospital doctors should know what is being done in health centers to prevent” |
We start from the fact that the Family and Community Medicine doctor is as specialized as the gastroenterologist or cardiologist. Therefore, just as the primary care doctor has to rotate through the hospitals to learn techniques, the hospital doctor also has to know what is being done in the health centers to prevent those diseases that finally reach him.
In other words, in your opinion, there should be mandatory rotations…
That’s what we put in the frame. The imbricate both levels with more force. Not only that there is a manager who coordinates and when the result comes out, he says that it must be put in the electronic medical record and the Primary doctor can see it.
Collaboration has to go beyond the management of hospitals and health centers. It has to go further through the co-responsibility of professionals. Especially with a more holistic view of the system as a whole. Where does the disease start and how to prevent it. Always complying with the mandate of the General Health Law, which tells us, since 1986, that priority must be oriented towards disease prevention and health protection. And in all of this, it is necessary to count on many administrations, not only the health sector, and many institutional levels.
There is a claim that doctors especially focus on and it is that difference that they find not only in terms of recognition but also in terms of salary compared to hospital care professionals… How can it be solved?
This measure is also contemplated in the framework. It can be approached like any other remuneration system. But that this redoubt has remained is a bit unfortunate. But there it is and you have to face it too.
Could we talk regarding deadlines for the implementation of all these measures?
I am not in day-to-day management either and therefore I am not in a position to give an opinion but yes, that should be the horizon, because of that maxim that they are equal specialists and with a very high importance in people’s health.
Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.
