The health organization of primary care is collapsing like a house of cards. To the doctors’ strike called by the Amyts union for Monday; the 78 24-hour Health Centers that have been reopened for a week without doctors, nurses or guards (or none of them) and the chaos caused by a plan in which most health workers do not believe ―because it consists of opening the same centers as before of the pandemic, but with half of the professionals― now there is a cascade of resignations in the Primary Care management. On Thursday night, all the members of Madrid’s southeast care management (there are seven: north, northwest, east, southeast, south, west and center) resigned en bloc in the face of the disaster of the reopening of out-of-hospital emergencies, that affects the workers of the former 40 Rural Care Service (SAR), who now also have to occupy the positions of the former 37 Primary Care Emergency Services (SUAP), closed during the pandemic, and all those of the centers of health. These are the medical director, the nursing director and the six responsible for the outpatient clinics in the southeast, who ultimately are the ones who answer to the directors of the health centers, completely overcome by the situation caused since October 27, when the the new plan. The resignation was recorded in block by registry. In the rest of care directions they have been considering doing the same for days, according to sources from the Ministry.
That the president of the Community of Madrid, Isabel Díaz Ayuso, has blamed the toilets who are on sick leave for an alleged boycott has finished lighting the flame of an environment that has been heated for a long time in Primary Care. Moreover, this Thursday it was also known that the deputy manager of Primary Care Health Assistance, Nuria Fernández de Cano, was leaving the position voluntarily. As EL PAÍS has learned, Fernández de Cano argued that her decision was “irrevocable” given the “impossibility of continuing to execute the instructions received from the management” of Primary Care.
Before the resignation of the previous manager of Primary Care, which occurred in October, and of the deputy manager of health care in Primary Care, already in November, the problems of regional health already translated into constant changes in the structure of the Counseling. Thus, since July there have been at least five departures (three general directors, a manager and deputy minister Antonio Zapatero); eight changes of functions and at least six other appointments.
The new plan for out-of-hospital emergencies, launched eight days ago, has plunged all primary care into chaos, which was already saturated since before the pandemic. In fact, recent data published by the Mental Health Observatory of the Madrid College of Physicians (Icomem), after conducting a survey of primary care and out-of-hospital emergency physicians, show bleak figures for professionals. Almost 92% of the doctors indicate having suffered or suffering from emotional exhaustion, 86% depersonalization syndrome (when less empathy for colleagues and patients begins to be noticed) and 73% low personal fulfillment. Those numbers speak of the well-known burnout or professional burnout.
It is the x-ray of the mental health of the doctors that the Community of Madrid has to occupy the positions of the 24-hour health centers, those who come from the SAR and those from the health centers, called to voluntarily occupy the guards on Saturdays and holidays. A voluntary nature that has not been such in many cases, since in the face of 57% of the casualties of the SAR doctors, the Community of Madrid has insistently called on health workers from the health centers to go to work. Some of them, by not responding, have even received messages from the Ministry through their relatives or partners.
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All these circumstances have caused a barrage of complaints about workplace harassment, misplaced pressure and calls late at night that have had to be managed by those responsible for the care areas, who have seen how in a week the situation has gotten much worse. more than it already was.
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