Primary care has yet to recover from the 2010 cuts

The primary care it is still not among the priorities of public administrations. “She has always been the poor sister but now she is the pauper sister of the health system, with very serious financing problems and intolerable delays in appointments”, according to a complaint Marciano Sanchez Baylespokesman for the Federation of Associations for the Defense of Public Health (FADSP)an organization that has made A study which shows that health spending in health centers “remains low” and is still 0.74 points per below that of 2010, year in which the first cuts budget in caused by the economic crisis.

The latest data from consolidated expensethat is, actually produced, are from 2019 and the national average of investment in health centers was 14.16% with respect to total health spending, 0.24 points above what was allocated in 2018 but still 0.74 points per below 2010. As of that date, there is no information on consolidated expenditure and it is necessary to resort to budgets approved by the communities, indicating that the coronavirus crisis has taken its toll and administrations have finally decided to increase investment in primary care. But the growth is “not very significant,” according to Sánchez Bayle, who also warns that budgets usually include more investment than what is actually spent afterwards.

Despite this “upward deviation” and the fact that data from five communities are missing, the 2022 budgets indicate that this year the administrations plan to carry out a some cost recoverywith an increase of 0.77 compared to 2019, to an investment of 14.93% with respect to total health spending, which has increased since 2010 but due to pharmaceutical spending and investment in specialized care (consultations and hospitals).

The report also confirms a great variety between regions. At the head in percentage of investment in primary education is Extremadura, with 17.1, followed by Cataloniawith 16.8, and in the queue is still Madrid, with 10.7 (below the expenditure of 2019, when together with the Balearic Islands it was also at the bottom of the ranking). “These differences make it very difficult for the same healthcare services to be provided throughout Spain, which generates great inequalities“, concludes the FADSP analysis.

The Federation, together with the main medical societies, calls for an investment of around 25% of the health budget in primary care, which would mean 10,000 million more, staggered, but especially over the next four years. The amount should be used to increase the templates and that there are no health professionals with more than 1,500 assigned patients, given that currently 37% of family doctors and nurses have a quota greater than that figure, according to the FADSP report. The pediatrics ratio has decreased, but “probably due to the drop in the birth rate.”

In this context and given that the pandemic has caused an increase in consultations (12.5%), 34.7% of patients indicate that they have had to wait more than 6 days to be treated, which “means denying primary care and that many patients put up with it, others go to the emergency room without being necessary and those who can go to the private sector,” according to the analysis carried out by Sánchez Bayle.