Monday, December 5

The doctors pressure Ayuso to increase the Primary Care budget and maintain the indefinite strike

Third round of negotiations between the Community of Madrid and the family doctors and paediatricians on strike without an agreement. If this Tuesday both parties spoke of an “important rapprochement” of the positions, at the table this Wednesday it seems that they have retraced their steps compared to the previous day. The toilets on strike find themselves with “many forces” to continue pressing the regional government of Isabel Díaz Ayuso to increase investment in Primary Care and will continue with the strikes, as reported to the spokesperson for the strike committee, Ángela Hernández, upon leaving the meeting. “We left the meeting with the feeling of groundhog day,” Hernández lamented.

“We have raised with those affected the point at which we were and for them it is not enough. It has been very difficult for them to say “enough is enough” but now that they have said it, a patch is not enough for them or to believe the next agreement to be breached. They need someone to assure them that this is going to be the beginning of the improvement in primary care”, she insisted. “We keep breaking the professionals and this needs someone to come and fix it. I don’t know who it will be, but today the strike continues. And we are going to see how the next few days develop for the next meeting ”, she insisted.

The meeting on Tuesday lasted almost seven hours. The one this Wednesday has been just about two. From Amyts, the majority union of doctors calling the strike, they ask for an interlocutor with resolution capacity such as the regional president Isabel Díaz Ayuso, the Minister of Health Enrique Ruiz Escudero or the Minister of Finance Javier Fernández-Lasquetty.

The president of the Community of Madrid recognized this Tuesday for the first time that more doctors are needed in health centers, that attractive incentives are not offered to residents who finish their family medicine training in Madrid and that the conditions of the toilets in Primary Care are precarious, since they link temporary contracts and the overload is structural. In this sense, Ayuso proposed the implementation of a system that avoids excessive appointments in Primary, end job insecurity and incentives for MIRs in order to retain them. All of this, the toilets recall, goes through a budget increase, something that at the moment is not arranged in the regional government.

The main stumbling block in the negotiation, in any case, centers on the excess of patients in the professionals’ agendas. In this sense, the strike committee demands a maximum of 31 patients per Family and Community Medicine consultation, with the aim of dedicating a minimum of 10 minutes per patient, and 21 patients for Pediatrics, for a minimum of 15 minutes per child, while the last proposal of the Ministry goes through 24 patients in the case of pediatricians and 34 in the case of doctors.

“We would like it to be 31 and 21 but we are not going to discuss if we reach an agreement of 24 and 34, that would not be the problem. The problem would be the management of everything that remains above that number of patients, that is, who sees the patient 25, 26… and even the 60 or 70 that sometimes are in consultation?”, he explained the general secretary of Amyts.

The other big stumbling block has to do with a breach of a previous agreement: the salary increase for professionals that Ayuso committed to in 2020 and then put in a drawer. It has also been requested that more doctors be hired to reduce the care burden or reduce bureaucratic tasks. “They want them to be fulfilled. It seems to me something so reasonable that it is very difficult not to defend it and that implies money ”, he stressed. Hernández has estimated that it is necessary to increase the number of professionals in Primary Care with 350 new pediatricians and some 1,250 doctors.

The proposal of the Community of Madrid

“The Ministry of Health does not understand that the strike is not called off after the preliminary agreements reached last night,” they say from the communication department of the Community of Madrid, which has reported the proposal that it has put on the negotiating table in which it does not a single euro is detailed.

The proposal deals with five points. The first involves establishing an agenda of 30 patients in family medicine and more than four assistance appointments for non-delayable cases, with ten minutes per patient; and 20 patients plus four non-delayable cases for pediatrics, with 15 minutes per patient.

The second point involves retaining residents with a specific loyalty program for residents in family medicine and primary care paediatrics. In this sense, residents who finish training in May 2023 and subsequent years as a family doctor or pediatrician will be offered a three-year contract. It is also contemplated as of January, that all temporary workers become interim or advance in the implementation of mixed shifts so that those who are in the afternoon shift can work shifts in the morning to promote family and professional reconciliation.

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