The scissors budget of the Xunta has left in tatters the public health of Lavadores, the working class neighborhood of Vigo that nurtured for decades of labor the industrial heart of Galicia. In its health center, facing an overload that the professional groups denounce in the entire health area, each of its eight family doctors usually attends to the day more than 50 patients in seven hours, about twenty more than before the crisis. And it is usual, according to patients and professionals, for a neighbor to wait two weeks to see the doctor and then have to settle for a fleeting four-minute consultation.
In the most populated region of Galicia this limit situation has led to the resignation of a score of respected heads of primary care They have received the support of colleagues from different parts of the Galician territory. "They are exploiting 10 years of health cuts and the deterioration is going to get worse," warns a doctor from the health center of Lavadores. "The quality of care has worsened badly and we have not seen anything of the economic recovery that is so proclaimed."
In the last decade, there have been many things that have grown in this outpatient clinic, in which one of the women heads of residence is working and where 14,200 neighbors (2,000 of them children) are assisted. The patients and their age have increased, the paperwork, the diagnostic tests and the waitings. The staff, however, has not done so proportionally: it has gone from eight doctors in total (seven family and one pediatrician) to 10 (eight family and two pediatricians) and eight nurses to nine. And substitutions for holidays or vacations have practically disappeared.
Like the Galician Health Service (Sergas) no longer sends substitutes to Washers, the doctors have to cover the absences of their classmates by extending their day by four hours. They are paid, but they must be done away with. In 11 hours they can reach 80 patients. At Christmas, summer and Easter happens every day, they say. Outside of these holiday periods, almost all.
After years of silent effort and failed attempts before the Xunta to fix the disaster, the residents of Lavadores are not surprised by the punch at the table that has been given by Vigo's primary care managers. "What surprises me is that it was done so late," reflects José Fernández Piñeiro, 66. "They have a lot of people and that results in patients. In spite of everything, the treatment is correct, perhaps more stressed, but it is normal ".
The government of the popular Alberto Núñez Feijóo insists that it does not replace absent physicians for a cause beyond their competence: unemployment in the profession this year is "zero". The manager of the health area of Vigo, Félix Rubial, admits that Lavadores is a center where doctors treat more than 1,500 users each, above the average of the region (1,380). But he stresses that right now there are three doctors without vacations, a circumstance to which he attributes the outbreak of discontent. "In these ten years there have been great improvements in primary care but at the present time we are experiencing the perfect storm, "he says, referring to the lack of professionals, the holiday period and the increase in pathologies in the fall." That generates a feeling of overwhelm. "
"They do not have doctors because they have been thrown out," replies one of the doctors from the Washers clinic. "They are in Norway, in Denmark, in the private … What did they expect? Would they stay here waiting to be called to sign a contract from Monday to Friday and dismissed at weekends? We want stable and dignified contracts. "
In a crowded waiting room at this health center, patients await their heads down. But when asked if they have noticed changes in attention in this decade of crisis, they start talking. María Dolores Fernández, 75, is a Galician emigrated to Venezuela and asked for an appointment for the psychologist in May that she has been given for the spring of 2019. She will not be able to go because in January she returns to her other country: "I'm leaving with double trauma . In Venezuela they do not have doctors but here, where everything is supposed to work, either. "
While other two users agree, Miguel Angel Rivero says that in his case have taken a week to give him an appointment for a telephone consultation with his doctor: "With the cuts this has been done a Christ. And we have protested. In Vigo there was a demonstration that could not be walked and in the telexornal [el telediario de la televisión autonómica] they put it at the end, as if it was not news. "
As the diseases do not wait, at the doors of the Washers consultations every day 15 or 20 people arrive without an appointment. They are not vital emergencies, doctors explain, but they have to be taken care of. In an aging neighborhood, where a decade ago a doctor had a few patients over 80 years and now has many that exceed 90, home visits are also required. For the nine nurses it is a very common task, but they must do it with their own vehicle and run with the fines if the lack of places and the hurry push them to park irregularly. "A compañera had an accident, her car was totally sinister and she had to pay for everything," complain these workers.
Health centers in Galicia have multiplied their work during these years assuming tasks that previously corresponded to hospitals. In Lavadores they are now made, for example, cytologies, more analytical and there are no longer direct appointments with dermatology. It is the doctors and the nurses who have to spend some time a week taking pictures of possible lesions on the skin of their patients so that the hospital specialist assesses whether or not they attend to that person.
This task of unloading the hospital activity assumed by the outpatient clinics has not brought sufficient resources. "We are the poor little sister of public health," says a worker at the Lavadores health center. While cutting spending, the Government of Feijóo reorganized the health areas unifying the management of primary and hospital care under the management of the latter centers. Outpatients have lost this way, say family doctors and public health defense organizations, decision-making capacity over the distribution of funds. Of the waning budget pie they are staying with the "crumbs", they lament.
"It is very nice to have a good device in a hospital and it is true that it is very good to be at the forefront. But I need an otoscope and I've been waiting for two months, "explains one of the facultativas de Lavadores, a health center where doctors wait in line to get a MAP, a device that monitors blood pressure day and night and is key to deciding the patient's medication guidelines. From the management, they assure that 15 million euros have been invested in reforms in the outpatient clinics of Vigo in the last four years, although Lavadores has not been one of the lucky ones, and four new centers have been built. "We have a family doctor rate above the Spanish average," says Rubial. "They serve an aging population, yes, but also waning."
With this pressure that little time for prevention programs and the health professionals of Lavadores are convinced that this abandonment "will be paid in the future". Around the corner, they warn, are also the retirements of many family doctors for the aging of the workforce, a phenomenon that has accelerated because the most veterans can not stand the overload of work.
In the Vigo area, private health has an important weight. The Povisa hospital, owned by the shipping entrepreneur José Silveira, is integrated into the public network and at the top of the waiting lists. Miguel Ángel Rivero tells from one of the waiting rooms of Lavadores that he arrived to go to a vascular surgery clinic with the tests paid out of his pocket in a private clinic to save time.
The doctors of this center have also seen an increase in patients who come to pick up medication from operations carried out in the private one, where they are referred by the Xunta when they exceed certain deadlines. In these years, maintenance service and material supply have been placed in the hands of private companies. "Everything has slowed down," they lament in Lavadores.