“The bag of doctors is at zero.” The president of Andalusia, Juan Manuel Moreno, has recognized this Thursday in Parliament that they do not have a bench to reinforce hospitals and health centers in this second wave of the pandemic, and that his Executive will request authorization from the central government to be able to hire health workers extra-community, as the community of Madrid has done. The lack of a reserve of health professionals is common throughout the country, although it is the regions most affected by the coronavirus that have raised the alarm. The Ministry of Health assures that it exhausted its remaining number of doctors in August, when 4,254 doctors and nurses were hired (the Andalusian Health System has more than 118,000 professionals).
Sources close to the president admit that in the last hiring, after the summer, “we are pulling youngsters just out of the University”, and they advance that they will ask the central government for permission to be able to sign extra-community physicians for reinforcement. Aware that other communities (and EU member countries) face the same situation and that the market is “saturated”, the Junta de Andalucía foresees that these doctors will be “foreigners”, but “they will have to have the title approved by the European Union “. Health has not yet figured out how many backup toilets it needs (Madrid has requested 400 non-EU doctors).
The shortage of health professionals is an endemic problem in Andalusia, which has faced the impact of the pandemic. In a community with 8.5 million people and ten public universities, there are five medical schools in the provinces of Seville, Malaga, Granada, Córdoba and Cádiz. The Andalusian Council of Universities (CAU) approved in April 2010 the creation of the Faculties of Medicine of Almería, Huelva and Jaén, but the financial crisis of 2008 stopped and bogged down these projects, which ten years later still do not see the light of day.
The then Minister of Health (today Minister of Finance), María Jesús Montero, already had a dense report that warned of the deficit of health professionals that would occur in Andalusia from 2020, as a result of a wave of retirements in the sector. Given that doctors take 10 years to train (six university courses plus the MIR specialization), the agreement between the Board and the universities of Almería, Huelva and Jaén was that the medical schools would be ready in 2012 (the studies would not have started before 2015).
Among the degrees with the highest volume of graduates in Andalusia [últimos datos del curso 2017-2018], the Degree in Medicine stands out for its high level of insertion (82.10%), followed by Nursing (74.1%), the two degrees most in demand until this year. A total of 7,497 students applied for Medicine as their first preference, for around 1,300 places in the five mentioned faculties.
Primary Care, collapsed “for a long time”
“There are no specialty doctors available,” admit sources close to the Andalusian president, who acknowledge that “Primary Care centers are collapsed and will be for a long time.” The saturation of the health centers has focused the face to face between Moreno and the leader of the opposition, the socialist Susana Díaz, who has reproached him for the lack of material and professional resources “in the first trench against Covid-19.” The Andalusian president has admitted that “there are not enough doctors”, but stresses that “this is not new.” “Why don’t you ask yourself what I did in the six years that I was president of Andalusia so that Primary Care is so deteriorated today?”, She replied to Díaz, after reminding her that between 2012 and 2015 -years of the PSOE
Health centers today concentrate the care of infected patients in nursing homes and in the more than 7,000 schools that opened their doors just a few days ago. The overexertion of Primary Care has overwhelmed the service, and protests from unions and the group of doctors and nurses are piling up. This week, Andalusia has chained three consecutive data of terrible infections, above 1,300 and 1,500 daily, with more than a thousand hospitalized covid patients and more than a hundred in the ICU.
At the beginning of the pandemic, the Andalusian Government called for the recruitment of 2,000 retired doctors, if necessary, and already then it was found that there were no specialists available in the labor market. Before this health crisis, the Ministry of Health already needed 1,800 specialized doctors, and warned that the planned retirement schedule for the next ten years was going to triple this deficit. The other determining factor is the exodus of Andalusian doctors to other countries, fleeing a decade of contracts for months, weeks and days, contracts at 50% of the time and a salary cut, in the midst of the crisis, of 25% on average.
The Moreno Executive decided to raise voluntary retirement to age 70 and reduce the eventuality from 40% to 15% to delay the retirement calendar while other hiring formulas are streamlined. For example, a return plan to recover young licensed doctors who went to work abroad, where salaries are much more competitive than here. To convince them, the Andalusian Administration proposed a 20% salary increase throughout the legislature, and the exclusivity complement has already been eliminated. So far, these measures have not convinced many professionals, and the gap in public health remains considerable.
The deterioration of the health centers, the late reaction of the trackers, the delay in carrying out the PCR tests and the delivery of results has focused the control session on the Andalusian president. The reproach from the left-wing forces has been common, both from Adelante Andalucía’s spokesperson, Ángela Aguilera, and Susana Díaz. The socialist has denounced that the Ministry of Health takes an average of seven days to give the results of a PCR, during which time the patient waits in quarantine without knowing if it is positive or negative, while the private health has begun to offer PCR tests , at an average price of 150 euros, guaranteeing the delivery of results in 24 hours.
Sources close to the President of the Board admit that the average of PCR tests in Andalusia is lower than the average, and they explain that the market for the reagents that need these tests is “saturated”, because all governments, central and regional, need this material. “If a child tests positive for Covid in a school, we have to do PCR on all his close surroundings, family and friends, around 150 people,” they explain from Health. The plan is to incorporate new rapid antigen tests into the system to stop the second wave of infections.