Madrid was the autonomous community where the pandemic hit the most in the first wave. He was in the lead at the beginning of the second and had one of the highest infection rates during the third. It is also the region with the highest excess mortality and has been the one that has had the most lax restrictions in the entire country during the last year. All this caused the collapse of health, which in spring 2020 was total and in the rest of the waves it has been maintained to a lesser extent with the income in the plant and ICU soaring. The intensive care units were at 100% capacity. The direct consequences of this tension in public health services are increasingly large waiting lists, especially in surgeries. The health of citizens and their quality of life worsens due to these data, experts say.
The delay to be operated has skyrocketed in Madrid, going from 230 people who waited more than 180 days – six months – to receive an operation in February 2020, to 8,176 April 2021, the last month of which the Community of Madrid offers data. In other words, they have increased by 3,500%; It has multiplied by 36. People who wait more than a year to undergo surgery have also multiplied by ten in just over a year: of the 44 in February 2020 – during March, April and May 2020 there are no data– to the current 413.
The time on the average surgical waiting list in the Community of Madrid has gone from 93 days in February 2020 to 159 days in May 2021, according to data published by the Ministry of Health. These figures represent an increase of 60%.
When the coronavirus arrived in March in March 2020, hospitals suddenly paralyzed the vast majority of operations to only intervene urgently. The centers were completely reconverted to contain the wave of patients who first collapsed the emergency rooms and then the plants and ICUs. The lack of toilets and physical space – since the operating rooms were transformed into makeshift intensive care units – were the cause. The following waves, in which Madrid has not fully recovered from those admitted by coronavirus, have aggravated the problem.
The president of the Community of Madrid, Isabel Díaz Ayuso, promised during the May 4 electoral campaign a reduction of the waiting lists by half. It was a promise that already appeared in his program for the 2019 elections. However, during the inauguration speech, Ayuso avoided alluding to health care. The measure is now pending to be materialized while waiting lists for diagnostic tests and surgical interventions continue to grow in the region.
This Thursday, the Minister of Health, Enrique Ruiz Escudero, announced in the Madrid Assembly “a shock plan” to implement this electoral promise, in an appearance on this issue at the request of the PSOE. According to Escudero, this plan will be presented at the end of the year, taking into account the evolution of the epidemiological situation and which will consist of the increase in the evening surgical activity and the promotion of “surgery without admission”, according to the counselor, in addition to increased technology support.
90,978 patients await an operation
The total number of patients waiting for an operation in the Community of Madrid amounts to 90,978 people, while before the pandemic there were 78,171. What is striking is that the number of citizens who wait more than six months for a surgical operation has skyrocketed in one year. Growth has been 3,500% since the COVID-19 health crisis began in March 2020.
Waiting lists have also grown significantly in patients who wait 90 to 180 days – three to six months – to be operated on. It has gone from 11,585 in February 2020 to 17,925 in May. Of the 7,275 who waited a year ago between 60 to 90 days, it has risen to 10,353. And of the 15,080 who waited between a month and two months, now there are 16,434.
For the secretary of public sectors of the Madrid Health Workers Commissions, Sergio Fernández Ruiz, the only way to solve these waiting lists is to “increase the workforce”, in addition to enabling “afternoon and day shifts” to face a problem that ultimately it affects public health.
“It affects the health of the population and their quality of life, since a delay in an operation will worsen the result,” says the health worker and trade unionist. And he adds: “For this, more investment is needed, as is the case in Primary Care and this government has already shown where it does not want to increase spending.”
Ángela Hernández, deputy secretary general of Amyts, the majority union of doctors, also emphasizes that in the worst of the pandemic “there were only COVID patients and, although they have gradually left, there is still a long delay.” The utility explains that “political will is lacking” in these cases and points out, like Fernández Ruiz, that it will only be possible to reduce the waiting lists “either by reinforcing personnel, which seems to be or with overtime.” Hernández explains that the most affected pathologies are hernias, prostheses or cataracts. “The quality of life of people worsens and so can their recovery,” he laments.
Diagnostic tests waiting lists
The CCOO Secretary General of Health of Madrid also refers to the waiting lists for diagnostic tests. Patients here are also counted in the thousands, although they have decreased slightly compared to before the pandemic. Both Fernández Ruiz and Hernández point out that in this case the delay in a diagnostic test can lead to the late detection of a disease that will lead to a worse prognosis in most cases.
The number of patients who wait more than three months to have an appointment with the specialist and to have an MRI or an ultrasound, essential tests to later go to the expert, skyrocketed in Madrid before the pandemic, specifically the previous three years. From February 2020 to May 2021 they have decreased, but it is still a very high number of patients. The number of patients who wait more than three months to have a first appointment with the specialist amounts to 115,841 people. People waiting for a diagnostic test more than 90 days are 49,855 in April 2021.
The cuts in public spending during the last decades in Madrid leave the Community as the one that uses the lowest percentage of its GDP for public spending. In 2019, latest data collected by the Ministry of Health, the Madrid government allocated only 3.7% to health. Only Catalonia was relatively close to Madrid, allocating 4.9%. These data contrast with those of other communities such as Extremadura (8.6%) or Asturias and Castilla-La Mancha (7.6%). The Spanish average is 5.6%, two points above Madrid.
The direct consequence of this reduction in healthcare spending –which has coincided with tax cuts– has been an increase in private health insurance. At the end of last year, almost 2.5 million people from Madrid had contracted health care insurance and its penetration has gone from 32.9% to almost 37% of the population during the last five years.
Experts agree that the only way to reduce waiting lists is to increase healthcare spending by hiring more staff or doubling shifts that must be paid. The quality of life of patients and the better or worse evolution of the pathologies are directly related to their early detection and intervention. Next Thursday, the Minister of Health, Enrique Ruiz Escudero, will appear in plenary session – at the request of the PSOE – to explain these figures and delve into what the regional government’s plan is to reduce waiting lists.