Up to 39 days to see a doctor at CAP La Granja

Rosario Hidalgo, a 72-year-old resident of La Granja, made an appointment to see her family doctor last Friday, October 14. She was given it for November 22, 38 days later. “Having to wait more than a month is a lotand that I take care of myself and I don't need doctors much, but it can't be, "she denounces.

Can be an extreme case of delaybut the pattern of long delays in the CAP La Granja continues, as the neighbors denounce. «The minimum is that we are over 20 days when an appointment is madebut there are much more serious cases», uncovers Manuel Martín Bravo, one of the citizens at the head of the mobilization. Today they will demonstrate at the door of the center, and they plan to do so every Wednesday. Another example in summer was even more flagrant: a neighbor went to ask for an appointment on July 26 and they gave it to him for September 13, exactly 50 days later. One last sample, from yesterday, through an online petition: the most immediate visit is for November 11, 23 days. If the consultation is not face-to-face, the term is shortened to day 3. The delay is then 16 days.

The situation complicate healthcare to a substantial part of the Tarragona population, in an area of ​​influence of the CAP estimated at 30,000 people. The residents of Ponent denounce that, having overcome the worst of the pandemic, it has not returned to normality in the center. “This situation has led to a serious lack of health care to vulnerable people who have a pathology that requires regular monitoring by health services", they denounce.

"Having to wait more than a month is a lot for me," denounces Rosario Hidalgo, a resident of La Granja

The Catalan Institute of Health (ICS) specifies that "currently the delay to visit users ranges from three days to two weeks»and adds that «There are gaps for face-to-face visits in practically all doctors from November 2, in 15 days ». The ICS stresses that «there is an adequate circuit to solve the daily spontaneous demands that do not have to be delayed, includes the nurse's management of the demand, the family doctor's incident agenda and the reservation of spontaneous visits in the majority of the center's doctors' agendas». Despite that, an accessibility improvement plan is being worked on. «As regards professionals, between September 2019 and September 2020, the Torreforta EAP has grown by about eight professionals, basically three administrative staff, three nurses, 1.5 referents of emotional well-being and community intervention and 0.5 nutritionists. , maintaining the number of family doctors and paediatricians », point out from the ICS.

"Ideally, the visit should not take more than five days, and it should be even earlier," says Jordi Daniel, a member of Camfic and a doctor at the CAP in Salou

Jordi Daniel, a doctor at the CAP in Salou and a member of CAMFiC, the Catalan Society of Family and Community Medicine, admits that the waiting list in some centers “it is a worrying issue” that goes against the essence of what the Primary should be. «One of the main values ​​of our specialty is accessibility and currently there are different factors that have contributed to reducing it”, indicates Daniel.

One of them is the lack of professionals, the difficulty of finding physicians for the entire system. "Another factor is that we have expanded the portfolio of services, we do more and more things, and without a correct endowment of resources»points out the Salou doctor.

The weight of social problems

Then external conditions influence. «There are so many totally inappropriate patient lawsuitsthat correspond to other professionals, social problems that appear in consultation and that really delay the programming time”, says Jordi Daniel.

It is one of the keys to the difficulties in CAP La Granja but also in other facilities: social or emotional circumstances They also sneak into the GP's office.

The ICS indicates that "the Torreforta EAP is working on a plan to improve accessibility"

One of the solutions goes through order the tasks and distribute them otherwise. "We have to Enhance teamwork. Not everything has to go through the family doctor. Currently there is a strengthened role of the administration, which can resolve many demands. The infirmary also has a enormous potential to decide and manageor nutritionists and psychologists. All of them can solve situations. It is already being done in some places", says Daniel who, yes, guarantees agility in the circuits and "an extraordinary response time if we see that we are facing something urgent or serious, such as the possible detection of cancer." The ideal, according to this family doctor, would be a visit time of even less than five days.

The vice-president of the Official College of Physicians of Tarragona (COMT), Mireia Garcia-Villarubia, confirms that "There are many centers where visits are taking place 30 days ahead"which "ends up having an impact on the saturation of hospital emergencies, despite the fact that people have to go there and wait for hours."

"There are many centers in which visits are taking place 30 days away," says Dr. Mireia Garcia Villarrubia, vice president of the Col legi de Metges de Tarragona (COMT)

The doctor also claims "lack of staff" that "it will worsen between now and 2025 with the retirement of many doctors", pointing to the demographic problem of templates that the COMT has been exposing for a long time.

Garcia-Villarubia believes that “Ideally, I would not wait more than a week”although it would also be good "for the population to make good use of the service, because there are some things that are more urgent than others." From his point of view, "psychosocial problems have also become habitual" and in the end it depends on the doctor: "Being on top of these situations can lengthen the visit a lot and sometimes there are professionals who are very dedicated to them."

Lourdes Franco, family doctor in Amposta and secretary of Primary in Metges de Catalunya, admits that "the situation in Primary is bad and the wait is generalized, there are centers that give from one day to the next, some for a week and others for a month.

"Short leave is not covered and other doctors take on the partner's patients," says Lourdes Franco, family doctor in Amposta and secretary of primary care at Metges de Catalunya

Franco points to "some overloaded doctors and that has repercussions that many have situations of 'burnout' or even depression». Franco indicates other factors involved: “Many doctors are retiring. The 800 places in Catalonia that were removed by the cuts have not been recovered either. There is a chronic lack of professionals and young people are not going to want to take this specialty. Short sick leaves are not covered and other doctors take on the partner's patients».

Today, protest (11 a.m.)

“Doctors have retired and there has been no replacement”

Manuel Martín Bravo, one of the residents at the forefront of the mobilization at CAP La Granja, denounces that in the Ponent center "many people have retired and those positions have not been filled, nor do the specialists have fixed days." The truth is that CAP Torreforta-La Granja is experiencing a very particular situation, where the problems suffered by the Primary have been amplified. The same neighbors expose it: «In these working class and popular neighborhoods poverty and job insecurity are primed and, therefore, it is where public and quality health care is most necessary». The neighbors demand that “Once upon a time, the expansion works of the CAP are started and that they finish in the shortest time possible.”

This platform explains that it has collected 2,000 signatures delivered in the Health Region and has requested an investigation into the service from the Síndic de Greuges de Catalunya. These citizens have organized an extraordinary concentration for today at 11 am inside the CAP for "this serious problem of neglect."

Attendance at CAPs has recovered this year, although in 2021 remote care was almost equal to that done 'in situ'

There are almost as many face-to-face consultations in primary care in Tarragona as telematics. At least it was like that during the past year, according to the different reports of the health regions. In 2021, in the Camp de Tarragona there were 2.6 million face-to-face visits to the CAPs, somewhat less than those registered adding the telephone service (1.4 million) and telematics (1), which includes platforms such as La Meva Salut or communication through emails.

48% of the visits were not face-to-face. It must be taken into account, yes, that there were more than 127,000 home visits, and that it was a year, unlike the current 2022, conditioned practically entirely by the restrictions of the pandemic.

A similar proportion is reproduced in Terres de l'Ebre, according to the reports of the different health regions. A total of 933,451 consultations were in the center itself, 54% of the total. The remaining 46%, a total of 805,775 visits, were by telephone or internet. Some 80,000 home visits were made.

The reality, with the pandemic under control, is different in this 2022. «The face-to-face has been recovering as far as possibleAlthough everything alternates, we also continue to provide telematic or telephone attention, ”says Dr. Mireia Garcia-Villarrubia, vice president of the Col·legi de Metges de Tarragona. Lourdes Franco, family doctor in Amposta and secretary of Metges de Catalunya, indicates that "we have recovered face-to-face activity, but we will not return to the pre-Covid situation." Frank sees how "something positive this regulation", which “it speeds up processes for many young people”although he asks for autonomy: «There should be a agenda self-management of each professional depending on how the population is.

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