The Spanish Association of Primary Care Pediatrics (AEPAP) has denounced this Thursday that There are 2,130 pediatric seats in unchanged health centers Which, according to this association, leaves almost two million children and adolescents in Spain without assigned specialist. This situation has denounced at the beginning of its 21st Congress that starts this Thursday in Madrid, It is “chronic” and is caused by an increase during the last 14 years of 36% of the places created for hospitalsthe triple that in primary care, which creates an “fish effect that bites the tail” because the demand of the health centers to the hospital emergencies moves, with the consequent “assistance of assistance”.
This has been denounced by the president of the AEPAP, Dr. Pedro Gorrotxategi, during a press conference, held in Madrid, in which he has lamented that in 2018 the primary schools of primary school without a specialist assigned to 1st were 1,729 (26% of the Total), while the latest data collected during the last year by this organization shows an increase in this figure to 2,130 vacancies as a unchanged pediatrics specialist, either because are Squares occupied by doctors not specialists in pediatrics, or low or non -covered day reductions.
According to the data provided by the AEPAP, the Autonomous Communities with the highest percentage of pediatric deficit in Primary Care in 2024 were Castilla-La Mancha (145 of 253 places, 57.3%) are missing, the Valencian Community (110 of 250, that is, 44%), Andalusia (491 of 1,143 are missing, that is, 42.9%) and Balearics (60 of 144, 41.7%) are missing). In absolute numbers of uncovered vacancies, the territories where more specialist pediatricians are missing according to the data collected by the AEPAP are Andalusia, Catalonia (where there are 402 places without covering a total of 1,150) and the Community of Madrid (322 of a total of a total of a total of 1.006)
On the other side of the table are Cantabria, where only two seats of the 84 squares, La Rioja, where it is necessary to cover five of 42 and Asturias, where there are 13 vacancies of 125 total seats are missing. As explained by the pediatrician Eva Ximénez, vowel of the AEPAP in Castilla-La Mancha and in charge of collecting the data in the community that comes out, this territory “It’s very close to Madrid” and has a “very dispersed” population, Two factors that lead to the capital and its surroundings absorbing many specialists. “I suppose it will also have to do with the proximity of Madrid, which absorbs a lot of pediatricians,” he said.
Regarding Madrid or Barcelona, Dr. Gorrotxategi has commented that the two most populated cities in Spain “have to have very specific specialists” in reference hospitals for certain rare pathologies and it is the companions of other communities that refer them to these centers. However, he has considered that “we have to see what needs there are for the population of each pathology” because “The problem is to create a lot of consultations that could be done in primary care within regional hospitals. That is the biggest problem. “
In this sense, Ximénez has added that if Spain does not change the trend detected by primary pediatricians, “we will end as in other places in Europe, where they do not have pediatricians in primary care, which worsens the health of the population. In the United Kingdom they look at us because we are an incredible model. Having pediatricians in primary care is a luxury. We have to take care of it and it is something that as a society we must fight“He defended.
In the presentation before the media, the pediatrician Gorrotxategi explained that “The decrease in primary care pediatricians is related to the progressive increase in hospital pediatrics squares. Hospitals create places for residents to continue working in the hospital. In the last 14 years, according to the official data of the Ministry of Health and the CCAA, the hospital squares for pediatricians have increased by 36%. This increase has not been the same in all autonomous communities, “said AEPAP president.
Specifically, “The most hospital squares have created (more than 35%) have been Madrid, Catalonia, Balearic Islands, Valencian Community, Murcia, Navarra, Cantabria and the Canary Islands. This data coincides with the CCAA with greater excess patients per pediatrician, according to the Ministry data. According to this data from 2024, Madrid, Catalonia and the Balearic Islands were the CCAA with 50% of AP pediatricians attending quotas greater than 1,000 patients, above the maximum recommended by the Ministry of Health for their pediatricians, “he explained, he explained The doctor, while asking that the training of resident doctors is “almost exclusively hospitable” with 93% of the time – four years in total – in hospital and “three months” in centers Health
According to a study by the AEPAP on the professional departures of residents between 2014 and 2017, “several of the CCAA with the greatest creation of hospital places are those with lower percentages of residents who access their job in the health center: Madrid, Catalonia, Cantabria and Community Valencian. ”
This causes a fish effect that bites the tail “, in the words of GorroTxategi. “As there are primary care pediatrics places with excess assigned children, excess demand makes them not be attended properly in their health center, so demand increases in the emergency room and, consequently, the squares increase of hospital pediatrics “. But this increase does not solve the problem, he pointed out, because “the displacement of the care of the hospital health center entails a Assistance to assistanceand also family proximity is eliminated and assistance is provided in a distant area of the child. ”
A solution without results
Among the solutions raised by AEPAP for this problem in the past was to request a MIR places increase“in the hope that, by increasing the places, the residents who go to Primary would increase, but it has not happened that way, and their place the hospitals absorb all the increase in pediatrics residents.” And MIR’s increases in 2015 and 2016 have been accompanied by an increase in hospital squares between 2017 and 2020, so that many of the Pediatrics MIR end up in the hospital “and the lack of pediatricians in health centers, That more and more families denounce in different neighborhoods and locations, becomes chronicle, “concluded the hatxategi.
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