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after two years of Covid, doctors are abandoning the public hospital in droves


According to the medical college, for the year 2021 alone, 30% of young Spanish doctors would have chosen to go into exile from the first year of practice. This figure gives an idea of ​​the extent of the phenomenon: between 2011 and 2019, nearly 26,000 certificates of adequacy, necessary to practice abroad, were thus granted by the Spanish order of doctors. This brutal shortage of doctors risks, in fact, aggravating an already very precarious medical situation in Spain. The lack of staff was already a recurring problem in the health system before the Covid-19 crisis. There is one nurse per 2,500 inhabitants compared to one per thousand in the rest of Europe. Today, in the midst of a pandemic, this lack of doctors is sorely felt.

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Especially since the “seniors”, i.e. around 20% of Spanish doctors who are over 55, are more and more likely to anticipate the age of retirement, exhausted by the working conditions which have worsened with the pandemic. Roberto Colino, a family doctor for 40 years, has just turned 63. He reluctantly decided to retire two years before the legal age. “I never thought I was going to retire before the required age, he explains. I’ve had a vocation all my life, but now it’s no longer worth working in conditions that are indecent both for patients and for us professionals. »

In the sights of Spanish doctors: the public health system and in particular its privatization, which began in 1997 under the government of the conservative José María Aznar. The law approved with the approval of the socialists then in opposition, allows each region to outsource basic health services, as Roberto Colino explains. “The abandonment of public health has been gradual he details. First, we outsourced cleaning services or catering in hospitals, then analysis laboratories, X-rays and even operations which are now carried out in semi-private health establishments, where the cost of the operation and treatments are more important than the health of the patient. »

Privatization and diversion

Madrid is without doubt the region where experimentation with privatization formulas in the health sector has been the most advanced. Of a total of 83 hospitals, 50 are private, according to the report by the Capital Health Observatory. To this must be added at least seven public hospitals with mixed management. Under successive governments of the conservative People’s Party (PP) since 1995, almost 3,000 hospital beds have been closed, or one in five, and 3,200 public health workers have been laid off.

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At the same time, these governments have squandered millions of euros building seven private hospitals with vulture funds and companies involved in the illegal financing of the People’s Party (PP). According to the investigation by Judge Manuel García Castellón, of the National Court, the PP of Madrid would have used the funds for the construction of these seven hospitals while financing itself illegally – through commissions of 1% of the value of each contract – for a value of at least 1.88 million euros.

Lack of doctors

One of the consequences of this privatization has been the development of bureaucracy. “Each analysis or specific treatment addressed to a patient that must be prescribed in a semi-private center must be justified, commented on and budgeted. We are crumbling under the papers addressed to the administration. And this bureaucracy has worsened with Covid-19, especially with the multiplication of absurd, contradictory protocols that keep changing all the time”, protests Dr. Colino.

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The pandemic has further aggravated the relationship between doctors and public administration. A decree-law approved by the Madrid region in the midst of a health crisis has sparked the anger of white coats. “This decree establishes that a doctor can be assigned to any position, regardless of his or her abilities” denounces the union of doctors. The decree allows, for example, to send an ophthalmologist or a gynecologist to the so-called “Covid” units, but also to exceptionally hire non-European practitioners, without their training being approved. The lack of doctors is glaring, apologize the authorities. Indeed, in the capital, there is an urgent need for 750 new family doctors and 250 paediatricians…

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