El Clínico de Zaragoza, refuge hospital for Catalan doctors

In 2010, a injury in Catalan health that hasn’t stopped bleeding. The structural deficits that the health system of this community has dragged on since the “snip” of 2010 have been punishing professionals in the sector for years, who refuse to hang up their robes. They continue to practice despite the adverse situation, although with an eye on other communities where working conditions are not so precarious. The pandemic, the lack of political will to solve the endemic problems of the system, and, in some cases, the “social tension” generated by the ‘procés’ have been for many doctors the trigger that has pushed them to stop practicing in Catalonia and go to other territories. In the case of Lleida, the transfer of professionals has basically been to Aragon.

The exodus to Aragonese lands, which was fueled by the pandemic, is predicted to be unstoppable. Nor are there signs that the system’s historical deficiencies will be resolved in the near future. For this reason, the sector has convened a unitary mobilization for the next days 25 and 26 January. All the health groups have joined and it will not be called off, according to the union that called the protest, Doctors of Catalonia (MC), “if there is no change from the Government and it agrees to improve working conditions in the sector ».

Less pressure and more pay

Daniel Lacasta He has been one of the last professionals from the Arnau de Vilanova Hospital in Lleida to make the leap to a hospital in the neighboring autonomous community. After 23 years of practice in the Emergency Service of the ilerdense center, he decided to open a new professional stage in the Lozano Blesa University Clinical Hospital of Zaragoza.

Tired of working “to the limit” in Lérida, a city from which he has good personal memories, because he met his wife there and his son was born, Lacasta now works at the Zaragoza hospital with less pressure on care and a better salary. In the month that he has been practicing there, he has already met many former colleagues from Arnau who sought refuge in the Aragonese health system after years of professional punishment in Catalonia. He assures that they have landed there up to almost twenty. The Official College of Physicians of Zaragoza has recorded 12 medical associations from Lleida in recent years alone.

ABC talks to some of them. They all have different personal circumstances, but are united by a common cause: abandon the precariousness in which they were exercising. Daniel Lacasta worked from 8:00 a.m. to 5:00 p.m. every day (1,729 hours per year) at the Catalan hospital. Now, his day ends at 3:00 p.m.; which allows him, as he explains, to reconcile better. Besides, charges about 4,000 euros more per year.

“I did not leave for that reason, the improvement in working conditions, being able to work better and assisting patients in conditions weighed more,” he says. Another work condition that influenced his decision was, for example, the guards. «At Arnau they forced you to do them, even doctors over 55 did them. Here they are voluntary from the age of 50, “says Lacasta, who laments the effect that the lack of resources has had on health. “Two years ago we were heroes and now they spare us everything,” she denounces. Like other professionals who began their career at the Arnau de Vilanova, the doctor was resisting the precariousness until “the lack of transparency” in a contest he applied for to become head of the emergency service finally decided him. “It was the straw that broke the camel’s back,” he says. The bad atmosphere generated by the independence movement since the illegal 1-0 referendum was held did not help.

“I didn’t feel comfortable”

“I did not feel comfortable with the polarized environment that existed,” acknowledges the doctor, who regrets having to leave Catalonia, a community in which he leaves “very good colleagues.” «I have been at the Zaragoza Clinic for four weeks and I can’t stop meeting people from Arnau. There are almost twenty of us who have come from Lleida, “says Lacasta.

Pedro Valdresa family doctor who also works in the Emergency Service, Javier Medranospecialist in Gynecology, and Susana Ros, a surgeon, are three of her former colleagues from Lérida with whom ABC has also contacted. In the first two cases, the social tension generated by the independence movement did spur, as they admit, their march from Catalonia. Medrano, 55, joined the Zaragoza Clinic in 2021. This family doctor made his professional debut in Lleida. “I went there when I finished my degree in 1998. They welcomed me very well,” he says.

His wife, a military doctor, also moved to the capital of Segrià and there they set up their lives. Like other faculty, suffered deteriorating working conditions. Everything had an influence, but he acknowledges that it was the nationalist pressure the trigger for his departure. Although the working conditions were not good, he had some job stability and a permanent position as a professor at the University of Lleida (UdL). “If I had not had the ERC giving us the murga, I would not have left,” he asserts. Javier Medrano, like many of the doctors who work at the Lleida hospital (close to 20 percent of the staff are from Aragon), the apology for independence made by some of his colleagues made him uncomfortable. “I left for a sum of everything,” he says.

Pedro Valdrés, a 59-year-old family doctor, shares his reflections. Valdrés landed at the Zaragoza hospital in 2014. “The pandemic had not arrived, but working conditions had worsened a lot and the nationalist pressure was beginning to be unbearable,” he says. In Zaragoza, where he also works as a doctor in the Emergency Service, his working conditions have improved. “Everywhere the cuts have been noticed, although here there is a better organization”, specifies the doctor who, according to him, he felt singled out by the nationalists. “Exposing any symbol of your country makes you look good,” she says. Susana Ros, a surgeon, also left Lérida and went to Zaragoza in search of improvements. After years of job insecurity, as she says, “I have managed to work under conditions.”

An hour and a half from Zaragoza, to Barbastro, he went to where another of his colleagues went, Mariano Plana, a 55-year-old pediatrician. He left Lleida, where he matured professionally, because, as he explains, “He was healthy and balanced in his personal life”. “If I didn’t get to leave, I would be divorced,” she says. He left for Aragon, his homeland, in 2014. In these eight years of practice at the Barbastro Hospital (Huesca) his quality of life “has improved remarkably.” «It is not the same to have 50 patients waiting than six. The level of stress is different », he assures. Before, in a normal shift, he could care for and supervise about 120 patients. Now, he attends, as he says, to about 20.

The departure of doctors to other communities and abroad is only a symptom of the perfect storm that is forming over the Spanish health system. The demand for care increases due to the aging of the population and the health workforce is reduced due to structural factors that are difficult to reverse. Communities navigate the difficult situation in different ways. Catalonia, one of the communities from which more physicians flee, does not solve it, according to the results, in the most efficient way. Within it, Lérida continues to be the Cinderella of the Catalan public health system.

Lleida, the province with the most desertions

Lleida, with the Arnau de Vilanova as the reference hospital, is the Spanish province with the most flight of doctors to other communities. This is reflected in the latest statistics from the General Council of Official Colleges of Physicians (Cgcom), with data from 2017. According to the report on “Medical Demography” carried out by the entity, Lleida is the province with the highest negative mobility balance, since in that year it was recorded that 233 doctors —11.5 percent of the total— left the demarcation to go, mainly, to Aragon. Tarragona (9.6 percent of all doctors), Valladolid (9.2 percent) and Salamanca (9.2 percent) are the other three territories in Spain with the greatest exodus of doctors to other demarcations.

The citizen’s deputy Anna Grau He affirmed in statements to ABC that «Lleida is the Cinderella of Catalan public health, which once claimed to be leading and exemplary and now ranks among the most clumsy communities in Spain. Less resources and worse employees. «Catalonia, for example, —adds Grau— coincides with Ceuta and Melilla, and differs from Madrid, in not compensating economically or in any way for the overlapping time that the nursing staff dedicates to passing on important information about care to each other required by patients each time they change shifts. Unions speak of many hours of unrecognized or unpaid work. What happens if they stop doing it? Luckily, the toilets are responsible and before leaving their duties they emigrate to another community where they are treated better. To them… and to the patients. That does make your hair stand on end: the growing inequality of medical care in Spain ».

For his part, the spokesman for the municipal group of the PP in the Lleida City Council and provincial president, Xavier Palau, attributes the exodus of doctors “to the decline, both from the political and social point of view of the management that is being carried out carried out in Catalonia and in the province of Lérida by the different governments».

Palau recalls that Lleida has been and is the health capital to which many patients from the Strip and Aragon go, who have the Arnau as a reference, although the “poor economic injection to invest in health matters and low salaries compared to other communities make it They have turned into a city where doctors come only passing through.”

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