Last June 21st The Virgen de Valme Hospital in Seville offered 140 care places to fill summer positions. Three weeks later, on July 13, he returned start the same offer for 60 jobswho remain vacant because there are no health professionals. During this period, and in order to shorten colleagues’ vacations, the Andalusian Health Service has invited workers to extend their work shifts and those with reduced working hours have been offered the opportunity to do so entirely during the summer period, as explained by Reyes Cavadas, Provincial Secretary of SATSE in Seville and assigned to this hospital.
What happens in the Virgen de Valme can be applied to almost any other hospital or health center in Spain. The shortage of health workers, particularly GPs, paediatricians and nurses, is a disease that is beginning to become chronic in the public health sector due to the lack of MIR positions – a shortage which the central government is trying to alleviate by offering greater public specialized health training throughout history (11,112 places) announced this Wednesday by the Ministry of Health― the increase in retirements from an aging workforce or victims increased by Covid infections and worsening in the summer due to the bank holidays .
The situation is also much more serious, as the unions denounce, due to the fierce competition between the municipalities, which try to keep the few doctors with incentives such as higher salaries, longer contracts or ever earlier offered toilet visits. . “This has caused a war between the territories, at the expense of other communities without doctors and other professionals, where not only do you have to be faster, but you also have to guarantee better working conditions, paid, that the duration is attractive…”, complains Rafa Carrasco, President of the Andalusian Doctors’ Union.
Rocío Jiménez, 22, graduated with a degree in nursing on June 22 and had barely three days to pay tuition and submit an application for one of the 337 summer positions on offer on June 21 from the Virgen del Rocío Hospital in Seville. “All of us who secured a place just finished the race,” explains Jiménez. He was lucky because at the last minute the board activated the hiring plan at the end of this month to replace the summer vacancies at the end of this month June. 18,000 places, of which 1,300 are for doctors and 7,700 for nurses. “I wanted to stay in Seville and work in public health, if the vacancies hadn’t come out I would have looked for another municipality or I would have had to stay in the private one,” he says.
Many of her classmates didn’t want to risk it and almost at the beginning more than fifty students in her course signed six-month contracts offered by the Catalan Ministry of Health. “Right at the beginning of our last course, the suggestion was made to start a six-month contract as soon as we finished our studies,” he says. His is only two months long. Cavadas criticizes the “terrible planning” for the summer of the Junta de Andalucía. “It was one of the last to offer positions, and many colleagues went to other communities that took the positions much earlier,” she explains.
The neighboring region of Murcia was one of the farsighted. During the months of February and March, a plan to recruit more than 5,000 summer care professionals, including 43 doctors, was activated and all recruitments were carried out. “We have pushed the process forward to prevent vacancies from going unfilled,” said a spokeswoman for Murcia’s health ministry, noting that an additional 210 contracts had previously also been offered to reinforce templates spanning the summer months. . “These are year-long appointments to keep the available specialists in the region,” the ministry said.
Apart from the obvious problems of filling the gaps in nursing in Andalusia, as illustrated by the case of the Virgen de Valme, the unions have unanimously ensured that the vacancies for doctors are not filled because there is no longer a skilled market, which has also been accepted by the Board, which has extended the offer to those recent medical school graduates who have not yet done the MIR, and extended the traditional duration from one month to three.
Basque branch minister Gotzone Sagarduy has also admitted that the posts for the summer will not be filled. “Yes, we have a deficit in certain job descriptions. There are no doctors in Euskadi, Cantabria or France,” he explained. Basque doctors claim that “medical staff have to work twice as hard to care for patients, they are under a lot of pressure and therefore have a higher risk of making mistakes”.
An excessive demand that his colleagues from Galicia also denounce. According to the majority trade union federation CIG-Daúde, there are 55 outpatient clinics with unoccupied medicine slots in this municipality. To mitigate this situation, the Xunta has increased the bonus GPs receive for extending their working hours and taking over the work of colleagues who are on vacation or sick. But from the doctors’ union CESM, they predict little success because the doctors are already exhausted. Andalusia has retained the opportunity for doctors to lengthen their days in the afternoon, even in summer. “That can’t be the solution, because it’s an insult to think that you can keep up with 50-60 patients in the morning, in the afternoon with the same quality. It is necessary to convey to society that the health centers are being dismantled, ”says Marta García Caballos, a general practitioner from Granada. She warns that the shortage of skilled workers in the summer is “a never-ending story”. “What happened is that there is no long-term personnel policy,” he laments. “Those who have completed their residency cannot be kept, they are not offered a minimum of stability, it is not so much that there are no doctors as that they are not loyal and do not just go to another community, it’s that they go to another specialty,” he says.
lack of loyalty
García Caballos warns that the situation will be very difficult this summer, with professionals who are already overstretched, bringing with them the saturation of two years of pandemic and who face new victims due to the seventh wave contagions. “It’s going to be very tough in the coastal regions, where the population is doubling and the staff isn’t skilled, but also inland, where they don’t go on vacation either because of less money,” he claims. “We know that we will not have a replacement,” he says himself.
The Valencian Community and the Balearic Islands are also two reference tourist destinations where the shortage of health professionals is currently a problem chronic. The Valencian Generalitat has planned the reinforcement of 56 health centers on the coast, either with the opening of summer clinics (21) or with the increase in staff in the 35 that already exist in coastal areas, as part of a reinforcement plan activated at the end of June , which calls for the recruitment of 7,357 professionals, of which more than 2,000 remain vacant as of July 15. As in the other municipalities, the Valencian Minister of Health, Miguel Mínguez, recognized “that the employment offices do not always have the staff to cover the holiday gaps of the health workers needed”. The health association CC OO in Valencia warns that fewer centers will be covered in primary care than in 2021.
In the Balearic Islands, the Doctors Union has liberalized 90% of its union delegates in primary care due to a lack of substitute doctors to cover holidays and sick leave for a union that is already overwhelmed for the rest of the year and is now seeing population growth. The islands have always had tremendous difficulty attracting doctors from the peninsula due to their insularity and the cost of housing, so in Ibiza the old Can Misses hospital has been converted into a residence to accommodate the doctors who come as reinforcements. Of the 37 rooms available for this summer, only eight are still available.
Aurora Bueno, Director of Department of Preventive Medicine and Public Health from the University of Granada, argues that the basis for this lack of planning by the administrations is the fact that “managers do not prioritize the patient’s health”. “In this country, a lot of time and money is invested in the training of a doctor, but then they are not paid or their needs are not well attended to, and for this it is necessary to increase the health care budget, and for this it is necessary giving it enough importance is not given to it,” he emphasizes. Bueno stresses that the lack of coordinated planning encourages a battle based on supply and demand. “A doctor must work and will take whatever position is offered beforehand or where it pays the most and which creates a skills vacuum where that offer later comes up.”
Jiménez’s contract ends on August 31. She is also looking for stability and is aware that in order to achieve it she will have to leave Andalucia and continue working in the public sector. Still, he’s looking for some comfort to hold on to. “Before you had to wait years for a contract, now we have them as soon as we leave the faculty,” he says.
assets and claims of the communities
The difficulties encountered in expanding the medical workforce have prompted the leaders of Galicia and the Basque Country to submit a manifesto to the Ministry of Health, which other municipalities have joined, containing a shock plan with urgent measures that can be exceptionally managed by requesting an MIR (internal resident doctor). for family medicine and pediatrics. In Andalusia there have been calls for some time to increase the MIR positions in Andalusia and to speed up the admission of non-EU doctors
In the battle for doctors, Castilla-La Mancha has chosen to deceive with the length of the contracts. Its President, Emiliano García Page, has announced that from 2023, all contracts for doctors signing the MIR will be extended from the current two to four. Immediate recruitment upon completion of primary care and paediatrics training is also an incentive from the Basque government, to which is added the salary: 3,000 euros per month.
With information from Virginia Vadillo, Sonia Vizoso, Mikel Ormazabal, Cristina Vazquez Y Lucy Bohorquez.
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