Just a month ago, Juan Manuel Vieites, the president of the Confederation of Businessmen of Galicia (CEG), took stock of 2024 in an informative breakfast from which, beyond his criticism of the “occurrences” of the Ministry of Labor, there was a very clear message: the “very serious problem” that Galicia suffers with “absenteeism from work.” To solve this, among other classic measures, he proposed strengthening medical inspection. Exactly thirty days later, at the first meeting of the year of the Galician Government, the Xunta presented the result of the special plan with which the inspectors discharged 13,000 of the 20,000 sick leave people that they interviewed between June and December. Vieites received it as “a necessary step that will benefit everyone.” “This is a luxury we cannot afford.” But not everyone sees it that way. Unions, primary doctors or psychologists believe that the Xunta joins the employers’ strategy, criminalizing doctors and patients instead of solving the underlying problems. And not only that: they detect much more concern about the economic losses of companies than about the suffering of people.
Vieites, in response to elDiario.es through a spokesperson, was very cautious when looking for culprits. As before, this Monday, both the president of the Xunta, Alfonso Rueda, and the Minister of Health, Antonio Gómez Caamaño. Both sides avoided focusing on patients at all times and pointed out the need to increase the efficiency of the system, streamline clinical trials and improve the training of doctors, especially with regard to regulations. In this regard, the president of the employer’s association limited himself to considering that “the data provided by the inspections and in particular the number of unjustified dismissals is very significant and needs to be analyzed in depth.”
He did remember that Galicia is the second community with the longest duration of casualties. Despite narrowing the difference during 2024, they are still 73.66 days compared to the 41.47 state average. This “has an impact on companies’ costs” and causes “a fundamental decrease in their competitiveness.” If absenteeism represents the loss of 6.7% of working hours in Spain, that derived from temporary disabilities reaches 5.2%.
Therefore, for the president of the businessmen, if these indicators are to be improved, control measures “are essential.” “We consider it necessary to maintain this monitoring and above all that the information collected during the inspection processes can be used to improve the functioning of the system and with it also the quality of care.”
The “damaged goods” of the employers
“The PP is buying the toxic and dangerous merchandise of the employers, which places work absenteeism in a lazy working class that abuses its rights.” Paulo Carril, general secretary of the CIG – the majority union in Galicia – is not surprised by this position on the part of an administration that is committed “to the privatization and commercialization of services.”
Carril believes that with this strategy, those who are on sick leave are “criminalized” “without first addressing issues that should be a priority.” “In Galicia we lead the figures for workplace accidents, with greater emphasis on the result of death.” Between December 2023 and November 2024, according to official data from the Ministry of Labor, 63 fatal accidents occurred in the community, practically one in ten of those registered in the State (641).
To this, Carril adds the high age of the salaried population—in 2023, 22.3% of the active population was 55 years old or older—and the “evidence of a lack of security measures in companies.” “Putting the focus on those who are sick and wanting to pretend that working people are abusive seems very serious to us.” More so, he adds, in a health system like the Galician one, “with such obvious shortcomings.”
The trade unionist also warns that labor legislation “is on the path of transmitting more powers to mutual societies”, something that seems “very serious” and that will not stop either the high accident rate or the “hardness of the workers”.
“The culprits are the doctors and the patients”
“It’s an old refrain from the administration: the culprits are the population, who abuse our right to leave, but also the doctor, who is permissive and has no idea.” Manuel Martín, spokesperson for the SOS Public Health platform, sees it as “rejectable” that one of the proposals in the Xunta plan is precisely to “increase” training for doctors. “It is a frontal attack on the group: the family doctor is perfectly trained to assess the clinical status of a person and whether they are fit to work.”
“As always, the Department avoids the substance of the issue.” Martín echoes a statement from the councilor, that most of the sick leave is due to “mild musculoskeletal or psychiatric pathologies”, and reminds him that the groups have been demanding the creation of physiotherapy and clinical psychology services in the health centers.
“He is left with the consequences: that there is an important health care problem for the population and not that he is unduly on sick leave because two very important elements are missing in primary school.” For Martín, providing it with these two services would not only “very significantly” reduce these temporary disabilities: it would also “prevent suffering” for patients.
It does agree with Sergas on the problems derived from bureaucracy, for example, when it comes to making appointments to follow up on sick leave, something that with the new plan will be automatically assigned to each party. “What they have to do is increase the number of doctors and favor face-to-face consultations, not telephone consultations, which makes it very difficult to evaluate the situation of the sick person.”
From now on, the medical reports from the mutual insurance companies will be incorporated into the patient’s medical history. Martín finds it “very dangerous” to also take the opposite path because “the fundamental mission of mutual insurance companies is to control withdrawals and accelerate the registration process.” “It would be an aberration if the employers achieved their old aspiration that they were the ones who controlled the casualties.”
“If there is no effective treatment, the discharge is justified”
“If we want to reduce casualties, we don’t have to persecute people: we have to treat them properly.” Pepe Berdullas, member of the College of Psychologists of Galicia, knows from experience that treatments work “with certain conditions and times.” Therefore, if they do not occur, it is not considered “appropriate” to hold patients and professionals responsible for the malfunctioning of the system. Even more: “Doubting the ability of family doctors to issue discharges seems to me to be entering into a dangerous dynamic.”
The College of Psychologists of Galicia has been collecting data on waiting lists between follow-up consultations for treatment. In most of the community, the list for the first consultation is one year and then four to five months. “A person, from the moment they go to the doctor for the first time, can be seen by the psychologist a maximum of four times in two years.” A time in which anxiety-depressive disorders do not usually stagnate, but rather worsen. In these conditions, “there is no effective treatment and, if there is not, we understand that the pathology remains. Therefore, it is justified that the reduction be maintained.”
Berdullas is struck by the councilor’s use of the term “mild psychiatric pathology.” “Just because anxiety and depression are often viewed that way doesn’t mean they can’t seriously affect people’s lives.” For this reason, he believes that one should not “equate by symptoms”, but rather study each case individually. And remember that immediate care “or, at least, accessible” would not only reduce costs for the system: also the suffering of patients.
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