“There is an urgent need to lighten the bureaucracy of doctors so that they become doctors again”

The new head of the Ministry of Health, Manel Balcell (Ripoll, 1958), receives EL PERIÓDICO in the office that until two months ago was occupied by his predecessor, Josep Maria Argimon, the brief ‘conseller’. The breakup of ERC and Junts per Catalunya He took one out and another in.

balcells doesn’t have it easy: Doctors have called a strike for January 25-26, which other health groups have joined. He denies that the health situation in Catalonia is the same as that of Madrid, defends that the government is committed to a “quality public health” and announces a support plan for health centers, punished by the overload of care.

What will Salut do before the strike is called? There are already two collective agreements, that of Siscat and that of the Institut Català de la Salut (ICS), and we believe that they should answer many of your concerns. We are convinced that the signing of Siscat, which should take place before the end of the year, will help the union to reconsider whether to go on strike. In addition, last week we presented the emergency plan for Catalonia, which represents a very substantial reinforcement of 45 million in primary care emergencies. [recibirá 16 de estos 45 millones] and hospitals. And, on the other hand, we are preparing two plans: one to improve accessibility and another to urgently remedy the lack of professionals, removing more bureaucratic burdens so that they have more time to work as doctor.

Where will these missing professionals come from? There are measures that must come in the medium and long term, such as the creation of new MIR posts in medicine and nursing. All of this takes time. Another measure concerns partial pensions.

The Ministry of Health has proposed to general practitioners to delay their retirement: working part-time, they will keep 75% of their pension. Yes, we see it positively, it can help us. We know that there are professionals who, at retirement age, would like to continue working partially. And, with these conditions laid down, we can see it clearly. But that’s not the only measure that would help.

When you were “advisor” of universities, in 2006, there was a big strike by doctors. They complained about the overload of care and poor salary conditions. How did we get to this point where 16 years later the demands are the same? There are several reasons. The first is that there was a pandemic that put a lot of pressure on society as a whole, but also on the health system and professionals. There is always a very significant emotional overload and a feeling of exhaustion. Another reason is that the increase in wages that has occurred does not meet expectations compared to the rest of Europe. From 2006 to today, the chronic underfunding suffered by healthcare in Catalonia has not been resolved. The funding system in Catalonia has not changed, we do not have fiscal sufficiency: that is to say, we do not have the necessary resources.

Professionals are tired and there have been no salary improvements because there has not been adequate funding

So it’s not management’s responsibility that Catalonia did it? I think there is never just one responsibility, is there? You ask me the causes. Professionals are tired and there have been no salary improvements due to lack of adequate funding. Probably no provision was made for the lack of professionals either. [en Catalunya se jubilarán 9.000 médicos en los próximos 10 años]. It is therefore a set of causes that causes tensions in the health systems in general, because here there is an announced strike, but in other parts of the state there are active strikes. The situation is general, also in France and in other countries. The pandemic is clearly taking its toll on us.

You announced a few weeks ago billion more for Hi. it’s closed ? The budgets are not closed. We expect them to close, and with them closed we will have a billion more insurance.

Will Junts and PSC support them? That would be great, wouldn’t it? [Risas] I think it would be a very responsible action on their part, because the population needs it, the proposals we have on the table have a great consensus and I think they could perfectly support them both . But, in addition to these billions from the ordinary health budget, primary care, in addition to the 16 million they will receive from the emergency plan already announced, will receive an additional 62 million in 2023 from the European fund React-EU. Of these 62 million, 30 will go to structural actions and 31.4 to investments in technology.

Can you detail it further? They will include 20 projects in CAP and CUAP, as well as a set of technological innovation and model transformation plans that are defined and that we will present in due course. We will present them one by one. We believe that technology can help: it’s not just about putting more money into the system, but about changing the model to make that money more effective. And, when we talk about technology, we are talking about digitalisation, remote control, smart telephone switchboards in all CAPs and also Wi-Fi in all health centres.

In two or three years, primary care will receive 25% of Salut’s budget

And with these 62 million more, will we already have 25% of the Salvation budget allocated to the primary? Not yet. But, if we make a significant effort, I think that in two or three years we will have this 25% for primary education, that is the commitment we made. To do it in one year is complicated, to do it in two or three years I think it’s possible. In the 2023 budgets, once approved, we will see that there will be a significant increase.

In some CAPs in Barcelona you have to wait up to a month before the attending doctor visits you. What will Salut do to improve accessibility? In the weeks to come, we will present an urgent accessibility plan to improve these issues, both at the elementary level and in the specialties. It is true that this happens in some CAPs, but not in others. We’ve identified what the bottlenecks are and why it’s happening, and we’re starting to see that there are solutions. We can greatly improve the situation of certain CAPs, which I have already said during a speech in Parliament which seemed intolerable to me. Therefore, we focus and identify what needs to be done. I sincerely believe that we can significantly improve this accessibility in a short time.

And what would be a possible solution? It’s not just one, but many. And that’s why we say there is a plan and we will explain it in detail when we present it, soon.

I fear that people are not happy with their health center and go to the private health insurance

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Is the Catalan health situation the same as that of Madrid? Not at all, no; not at all Basically because when the State withdrew the covid funds from the autonomies, the Generalitat supplemented them with its own funds. Thus, we maintain the hiring of staff and the commitment of assistance. And so, fortunately, the situation is not that of Madrid, neither in this sense nor in that of the privatization that Madrid has promoted and not Catalonia. Catalonia is consolidating quality public health and that’s the bet.

However, there are more and more Catalans with a private insurance company. In Barcelona, ​​they are already at 40%, a historic record. This is a lower rate than Madrid. [De todos modos] It’s something that worries me, that people are not satisfied with primary care. So we have to reverse that because our desire is for that not to happen, for people to be satisfied enough that they don’t need to go to private mutual insurance.

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