A patient recently went to the Lasarte-Oria health center (Gipuzkoa, 19,504 inhabitants) with severe pain. His family doctor did not receive him. A nurse treated him and she decided to urgently refer him to a specialist. In this hospital consultation he was diagnosed with a very serious illness. “Now you can thank your doctor,” the doctor told him. The patient’s response was as follows: “Not the doctor, a nurse treated me.” In this municipality near San Sebastián there are six doctor positions that are not filled: four are vacant and two doctors are on leave for a long period of time. “Practically, half of the population does not have a doctor,” residents complain about “the disastrous management” of the health authorities. A citizen platform has sent more than 1,500 signatures to Ararteko (Basque Ombudsman) in a letter denouncing that the situation is “extremely serious” due to the “clear decline in the quality of health care.” They also warn that “the citizens of Lasarte-Oria are fed up.”
The Department of Health informs this newspaper that in Lasarte-Oria “there are currently three vacant doctor positions” (a medical leave, a leave of absence and a reduction in hours), and it is assured that Osakidetza “does everything possible to fill them” , although he encounters the difficulty of “having a shortage of doctors” and also that “they do not choose these destinations.” “Basque society should feel proud every time it crosses the door of a health center, knowing that it is in the best hands and that it has a public and universal system of reference at the European level,” said the new Minister of Health, Alberto Martínez (appointed by the PNV), in the presentation to the Basque Parliament of the master lines of his department in health matters for this legislature.
The head of Osakidetza (the Basque public health service) made a general call to political parties, unions and professional agents to reach “a great pact for health in Euskadi” that allows, in his words, “to go deeper into the improvement of the quality of our health system.” Meanwhile, many residents of Lasarte-Oria take to the streets to demand “an effective shock plan” that manages to resolve the “serious shortcomings” that they have been suffering in recent months, says Begoña Castro, a retired clinic assistant and member of the LOOPA platform (Lasarte-Oria for public health, in its Basque acronym).
An elderly woman who suffered a broken vertebra in January of this year has been scheduled to begin rehabilitation this week, almost nine months after suffering the injury. If a chronically ill patient with a heart attack wants to make an appointment with his doctor via on-lineyou are only allowed to book an “in-person consultation” with your nurse. Through the Internet, you are not given the option of being met in person by your doctor. A person responsible for the health area of Donostialdea acknowledged to the mayor of Lasarte-Oria, the socialist Agustín Valdivia, that the situation in this town is delicate: “They told me that we have not hit rock bottom, and that this could get worse,” the councilor tells this newspaper at the end of a popular rally held this Monday in the town square and attended by more than 200 people.
The neighbors have once again displayed the same banner that they displayed on April 13 in a demonstration with the slogan “For public health. Strengthen primary care.” It was a protest in the street a week before the Basque elections, in which one of the central themes of the political discussion between the parties was precisely the deterioration that public health is suffering in Euskadi. The situation has not improved at all since then, according to platform representatives. In Zumaia (Gipuzkoa, 10,054 inhabitants) they are also in a critical situation and last June a citizen protest was organized over the “precarious” management of their health center because there are “two doctors doing the work of six,” as they reported at the time.
The mayor gave an account of what was discussed in the meeting with an Osakidetza board member and the director of the Lasarte-Oria health center, held on June 10, in a plenary session a month later. They told Valdivia that if this municipality has been assigned 12.5 doctor slots (each slot is the group of people that corresponds to each doctor), there are currently six unfilled slots, to which “we must add the periods vacations and short sick leave of active doctors who are not being replaced,” LOOPA representatives denounce. “This shows us a level of neglect that is much worse than we thought,” they say in their letter sent to Ararteko. “Does no one plan to give explanations and assume responsibilities for this disastrous management?” they add.
Osakidetza has promised that four of the six vacant doctor positions will be filled with a public job offer that will be resolved “before the end of the year,” they guaranteed the mayor. Councilor Martínez admitted in Parliament that “if vacations, sick leave or retirements are not replaced, it is because there is no one to do it with.” The percentage of unfilled places is around 10% in the entire Basque health network, and reaches 24% in the months of July, August, December and January. The head of the Basque Government’s Health portfolio intends to correct this situation during his mandate with an OPE of 11,000 places for medical and nursing staff this year. He promised to create 2,000 structural positions to consolidate temporary contracts and reduce the time that professionals dedicate to “bureaucratic tasks,” among other measures. And he announced “primary care without waiting lists”, so that the response to cases of acute pathologies occurs “in the first 24 hours” and in the rest it does not exceed 48 hours. Osakidetza serves more than 100,000 users daily (three million per month) and receives between 1,500 and 2,000 complaints monthly. Neither the health service nor the members of the platform offer data on the population served at the Lasarte-Oria health center, nor on the active staff, nor on waiting times…
The lack of doctors in Lasarte-Oria increases the workload of active health professionals and administrative staff. “The most serious thing,” say those affected, is “the public health model announced by those responsible for Osakidetza,” according to which “the health reference for families will no longer be the doctor, but the nurse.” These professionals, without receiving prior training, “will begin to assume functions that were previously performed by the doctor and that exceed their powers,” they inform Ararteko. The Department of Health denies this and assures that nurses will not replace doctors in any case.
To the institution that runs the ararteko Manu Lezertua addressed a citizen in his personal capacity in mid-March of this year. In his writing he echoed the “environment of insecurity” that was being generated among Lasarte-Oria patients. “The talk in the waiting room is ‘let’s see who I get today’,” he says in his letter, in which he also warns of the “work stress” that professionals are suffering, which in his opinion has an impact on “a greater risk of misdiagnosis. “The perception as a patient is that you work hard,” he says.