Before the horrified look of his wife, José Manuel Brey, 65, died asphyxiated one Saturday afternoon last August in an emergency center in Galicia in which there was no doctor. The Continued Care Point (PAC) of A Estrada (Pontevedra) is one of the 52 centers of the 90 of this type that operate in this community with a single health team, the workers calculate, a controversial lack of personnel that forces the facultative to leave patients unattended when they have to leave to attend an emergency outside.
"It's the fault of the cuts and very poorly managed primary care. In this case it was my cousin José Manuel, but we want it to be known so that it does not happen again, "denounces Manuel Pereira, spokesman for the deceased's family. The workers of these health services are on strike since last Monday to demand, among other things, that the Galician government solve this serious lack that ended in disgrace.
The PAC template is not the only one in strike in the Galician health. The emergency staff of the hospital complex of Santiago accumulates two months of unemployment to claim more means and last Thursday they staged a demonstration in the Galician capital. Their representatives filed a complaint with the prosecution yesterday for the death of two elders on the past day 2 that aggravated their condition while they waited in the corridors to be taken care of.
The more than two hours spent by the PAC of A Estrada without health personnel that Saturday in August in which José Manuel Brey died is not an exceptional situation. It is repeated in the emergency services of primary care of Galicia that only have a doctor. "They are those from rural areas, those farthest from hospitals and those with less population but more aging and dispersed," explains Pilar Rodríguez, a nurse at the PAC in A Guarda (Pontevedra) and a member of the PACs platform at War that leads the mobilizations with the support of all the unions.
The center where Rodriguez works is like that, like that of A Estrada. It serves a population of 20,000 people and from Monday to Friday it only has a team of doctors and nurses who make frequent trips, which causes the center to run out of toilets for an average of two hours a day. "If something happens, the only reference the warder has left is to call 061 to send an ambulance. What happens is that, as those who left took the one that is closest, it can take half an hour or 45 minutes to reach the PAC, "Rodríguez explains.
The PAC of A Guarda, Rodríguez says, has run out of doctors "many times with people in the waiting room or in the middle of an assistance." Last summer they had to leave by ambulance to Oia, about 30 kilometers away, to help a man who had fallen in the bush in a place of difficult access. "The assistance took us five hours in which the center was left without a doctor," he complains.
The government of Alberto Núñez Feijóo eludes clarifying how many PACs in Galicia can stay for hours without a doctor because they only have one and can be claimed abroad. On this situation, sources of the Galician Health Service claim that not all the service provided by these centers is emergency and that "emergency vital care is not usual". And they argue that it is the 061 that, when these circumstances occur, is responsible for coordinating how the possible incidents are addressed, whether in the PAC building itself or in an address.
In the case of José Manuel Brey, a man who suffered from Parkinson's but who attended the PAC of A Estrada on August 4, 2018 due to an intestinal indisposition, 061 did not arrive on time. The head of the Court of Instruction Number 2 of A Estrada has opened an investigation to clarify if the presence of a doctor had saved Brey and if behind his death lie criminal responsibilities. "If it's a PAC there had to be medical personnel, because if not, it becomes a mousetrap," says Rubén Fernández, family lawyer and member of the Fernández y Taboada de Santiago office, who considers, however, that since the legal point of view "it is too early to know if there is a crime".
The family filed a complaint with the Civil Guard immediately after the death of José Manuel, but the procedural machinery has just started this week. In the absence of the final report of the autopsy, the judge of A Estrada has called to testify to witnesses that afternoon were in the PAC and has requested information from Sergas on the organization of personnel in this type of health centers. The complainants wield an order from the Xunta of 2008 that, in their opinion, forced that weekend there were two doctors in the primary care emergency attended by the deceased.
The indefinite strike that PAC personnel maintain in Galicia will not have an impact on patients because, like that of the Urgencies of the hospital in Santiago, 100% minimum services have been established. The workers want the protest to serve to raise awareness among the citizens. They assure that due to the cut in health spending undertaken by the Xunta in 2009 They have the same staff as a decade ago, despite the fact that the population is getting older, chronic patients multiply, hospitalization increases at home, and ambulatory overloads translate into an increase in the number of patients who call their patients. door. "People have to see the conditions in which we work and what it can mean for them", point from the platform PACs in Pie de Guerra.
Manuel Pereira suspects that his cousin was the victim of a cold statistical calculation of the health managers of the Feijóo government, who "must have valued that the chances of someone dying were slim". The workers say that they had been warning of the risk for some time and that Sergas accused them of being alarmists. "My hair stands on end when I think about what happened to this man," says PAC spokesperson Pie de Guerra. "Time sadly gave us reason."
The two deaths of the past day 2 denounced yesterday before the prosecution raise to five the cases taken to the justice by the personnel of Urgencies of the hospital of Santiago. For one of them, the public prosecutor filed a complaint last spring that is in the process of being investigated.
Fátima Nercellas, a doctor from the hospital in Compostela, said yesterday during a parliamentary conference on health cuts organized by the opposition (En Marea, PSdeG-PSOE and BNG) that last day 2 had to attend to 400 people in the emergency room and that they had "29 severe patients in the hallway". This situation led to the fact that she is also the Prevention delegate of the staff meeting to send three emails to the manager of the complex, Eloína Núñez -prima of the president of the Xunta, Alberto Núñez Feijóo-, and to the Health Minister, Jesús Vázquez Almuiña, "warning of the situation of extreme gravity" and demanding that "open spaces of the center that are closed" to attend to patients.
The two deaths reported, explains Nercellas, are those of an octogenarian who waited three hours in the corridor and who "when he entered the cubicle he went into a cardiorespiratory stop" and died at 12 noon. And those of another old woman who was waiting for her with abdominal pain, got worse in half an hour, went into a stop in the corridor, passed critics and died. He suffered from intestinal ischemia.
The Santiago hospital has opened an internal investigation, but clarifies that no patient died that day in the corridors. "In no case were there triad patients [calificados] as a vital emergency waiting inappropriately to be taken care of ", stresses the center, which" makes a call to the responsibility not to cause an unnecessary alarm in the population ".