The Ministry of Health will bring to the Official Gazette of the Region (Borm) next week the first 223 places provided for in the Strategy for the Improvement of Primary Care (EMAP), which foresees the creation of 534 places in total between now and 2026. Thus The president of the Community, Fernando López Miras, reminded him this Tuesday during a visit to the new Regional Public Health Laboratory.
The 223 new positions arise mainly from the agreement signed at the end of last year between the regional government and the Cesm, Satse and Csif unions. This pact contemplated the creation, in 2023, of 111 new positions in Family Medicine, 12 in Pediatrics, 30 in Nursing, 9 midwives, 11 in Physiotherapy, 11 in Social Work, 11 in Nursing auxiliary care technicians (11) and 18 administrative assistants. To all these positions already provided for in the document signed with the trade unions, there are 6 for Dentistry and 4 for dental hygienists.
The plan must be completed in the coming years, until the creation, by 2026, of 71 new positions for administrative personnel, 68 for technicians in auxiliary nursing care (TCAE) and 45 for social workers, in addition to 34 new positions for dentists, 33 hygienists, 27 physiotherapists and 23 midwives.
The goal is for all health centers to have a social worker. In addition, the strategy includes organizational changes, such as the “creation of Primary Care medical and nursing directorates in area managers to optimize management.”
Limitation of agendas
For now, what is already underway is the progressive limitation of the schedules of family doctors and primary care paediatricians, so that they do not exceed 30 scheduled patients per day (20 in the case of paediatricians), plus about 5 unforeseen appointments, not delayable. The measure began to be applied at the end of February in 15 health centers whose physicians serve quotas of less than 1,250 health cards, and since last week another 16 centers with quotas of between 1,250 and 1,350 patients are being incorporated.
At the same time, extraordinary afternoon consultations have been activated, which can now be requested when delays exceed four days. This is established in an instruction approved by the general director of Health Care, Isabel Ayala. Doctors will charge 244.35 euros gross for each four-hour module, with 22 patients summoned every ten minutes. This extraordinary day is thus equated with laborers in hospitals.
As the limitation of schedules extends to the most crowded health centers, the litmus test will come for this entire plan. There are still many questions on the table that are not resolved. Fundamentally, how the urgent or unforeseen demand will be managed once the 35 appointments per consultation are exceeded.
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