The measures to improve primary care announced by the president of the Andalusian Government in the last debate on the state of the Community are already known first-hand by those in charge of carrying them out, that is, the health professionals in the health centers. health. As Juan Manuel Moreno announced, non-face-to-face appointments can be referred to any doctor in Andalusia – in another health district or in another province – depending on the availability of the doctors. And this is where their hierarchical superiors intervene: the managers of the health districts.
The medical director of the Poniente district (Almería), Sebastián López, boasts and jokes about the possibility of being able to offer these “continuities” of care to professionals in his area as a kind of Christmas offering. They are, in reality, overtime hours of work to answer calls from patients from other districts in exchange for the extra payroll announced by the president:
“I need volunteers to do telephone continuity (40tlf= 250euros), There you have my Christmas gift. “Whoever is interested send me WhatsApp privately,” says one of the WhatsApp messages sent in a chain to the primary care and emergency teams, and to which this newspaper has had access.
The president of the Board announced several new measures related to public health to try to encourage more free appointments in health centers, something that citizens have been demanding for some time now, both in person and by telephone. The new strategy of the Andalusian Health Service (SAS) consists of limiting to 7% the appointment reservations that health centers keep for unforeseen events [en algunos reservaban hasta el 50%]articulating a kind of “appointment mailboxes” to respond by telephone within 72 hours, or with continuity of care by doctors from a province different from that of the patient.
In this case, the medical director of the Poniente Health District (Almería), who is in office, sent a message to the group of doctors in his area of influence offering them “special continuities that I have authorized from Seville, which are paid for by the SAS” for primary care and emergency teams. “They are continuities of 40 phone numbers [llamadas telefónicas al día] and approximately 250 euros are charged, and they are users from Seville who must be called and their claim resolved by phone,” reads one of the WhatsApp messages.
The manager of the health district of Almería capital and, at the time, a managerial position in the SAS, sent these messages to more than 100 doctors, including the directors and all the doctors of the Poniente district, confirm the sources consulted.
“Whoever is interested send me WhatsApp privately”
The sequence of messages sent to which elDiario.es has had access is the following: “They are called digital district continuities and you can do as many as you want from Monday to Friday. It cannot coincide with the guard or outgoing guard. Whoever is interested send me WhatsApp privately. I need volunteers to do telephone continuity (40tlf= 250euros). Central services, after the success of our professionals, ask me for more volunteers. That’s why I think of you. The telephone numbers are = renew medication, and results of complementary tests, are telephone requests from users in Seville and Córdoba. You can do it from Monday to Friday without limit. It cannot coincide with a guard or outgoing guard. Whoever is interested in working overtime to earn more money, send me a private message. I need name and surname, ID and exact days in December that you want to make these continuities. And from Seville they will contact you and explain how to do teleconsultations. From central services they are surprised by our work and labor and that is why I have to brag, which is why talking to them they challenge me to see how many we can reach. Poniente is a lot of west. I encourage you.”
The SAS has launched the 72-hour telephone response protocol in the testing phase, it is being piloted in health centers in Seville, Córdoba and Jaén, but President Moreno has already announced that it will be extended throughout Andalusia starting in February 2025. Health unions have criticized these measures, which they see as “unviable” in practice.
The manager of the SAS in the Poniente district of Almería speaks in his messages of “digital district continuities”, a figure that has already been activated in his area of influence to assist patients from Córdoba and Seville by telephone within the pilot scheme announced by Moreno. The WhatsApp messages of this manager were sent between December 5 and 11, according to sources consulted.
The new system announced by Moreno has been piloted since December 2 in three provinces, expandable “to all centers and all doctors who want to do them, either for their quota or to provide support to centers with the most accessibility problems. “, indicate sources from the SAS itself. The sources confirm that these “digital continuities” have been launched in the Poniente district given that it has a lower healthcare burden and is already coming to the rescue of the health centers of Seville and Córdoba, as specified by the medical director, since they present a load of telephone consultations that has forced us to “open that part of the piloting” according to the SAS, which in some way approves of the “exclusivity” that the acting manager boasts.
“The most outrageous thing is the message they convey that you have won the lottery”
The same SAS sources confirm that these continuities are paid 46.88 per hour, that is, 234.4 euros per day, plus the proration when the doctor is on vacation. “It is not to answer calls alone, it is to attend to what the citizens need. If you have to renew medication or give results or answer questions. If there is a telephone demand, it will be by telephone. The continuities are for professionals and are channeled through the districts,” the sources detail.
The SAS explains that the new measures were analyzed in coordination meetings with the health areas and districts (a total of 34 in Andalusia) in order for them to transfer the possibility to health professionals, although there is no written instruction on how to do it. . “The instructions for the implementation of the measures are sent from the Central Services to the districts”, but “each one” decides the formula to let their professionals know, distancing themselves from the form and manner chosen by the medical director of Almería who , at this time, is acting, since that position is vacant and in the process of being filled.
Sources from UGT Public Services of Andalusia are “absolutely against these occurrences that the Minister of Health and the president of the Board have had of using patients as if they were shipping packages.” “Continuity of care, absolutely essential in primary care, is shattered,” comment the sources who, in reference to the message, criticize “the commercialism used in this obscene way by a district director.” “We find it absolutely regrettable and reason for immediate dismissal for denigrating primary care and health care for sick people and the professionalism of our doctors,” they point out. “The most outrageous thing is the message they convey that you have won the lottery. That is the most shameful thing,” they conclude.
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