The situation in primary care continues to get worse. 1.9 million boys and girls in Spain do not have an assigned pediatrician and 600,000 of them do not even have a family doctor who attends continuously, as the Spanish Association of Primary Care Pediatrics has alerted this Thursday in the 21st Congress held these days in Madrid. This forces families to change the consultation to consultation or urgent emergency. “It is a very serious thing and you have to make a change, pediatrics is in a desert,” said its president Pedro GorroTxategi.
The problems, far from improving, have been aggravated since 2018. If there were then 1,729 places without covering a specialist (26%) throughout the country, there are now 1,980 (32%) and 360,000 more affected children. The gap by communities is remarkable: Castilla-La Mancha is the worst stop, with 57.3%of vacancies, ahead of Andalusia (42.9%) and the Valencian Community (44%), both with a serious worsening . The best situation is, in this order, in Cantabria (2.5%), Aragon (8.6%) and Asturias (10.5%).
As a domino effect, this lack of specialists ends up overloading other pediatric partners and causing long waiting. In Madrid, Catalunya and Balearic Islands more than half of the professionals attend to a number of patients that allow the regulations, although the situation is repeated with more or less intensity in all communities. The limit marked by a document approved in 2019 by the Ministry of Health is 1,000 children and, according to their writing, the communities should have reduced these excessive quotas in 2022, with a margin of 10%.
They stay in hospitals
“This causes a fish effect that bites the tail: when there are places with excess of assigned children, the demand makes that they cannot be attended properly in their health center, which increases the demand for urgency and, consequently , hospital pediatrics increases. Primary care are being loaded, ”said GorroTxategi.
This dynamic, they have remembered, is harmful to the system, because attending to the hospital is more expensive; And for children, because they are seen by people who do not know them or their families.
In addition, there are almost so many children health specialists in hospitals (45%) as in health centers (55%) “when children’s needs are in primary care,” says pediatricians. In the last 14 years, according to the official data of the Ministry and the autonomies, the hospital squares have increased by 36%, the triple than those of primary care. The communities that have created the most positions, more than 35%, have been Murcia, Navarra, Cantabria, the Canary Islands, Valencian Community, Catalonia, Balearic Islands and Madrid. In these last three autonomies, precisely, the greatest saturation is concentrated in primary care quotas.
Pediatricians blame this imbalance that the formation of resident doctors is “very focused on the hospital” and barely rotate “three months” in the outpatients: “only three months pass and do not even leave them so that they do not waste their time.”
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