We already know the names of all the members of the new Government of Spain. The health portfolio falls into the hands of Monica Garciathe former candidate for the presidency of the Community of Madrid for More Madrid. During her time as a parliamentarian she has done great activism to improve the Madrid health system, always relying precisely on her profession. As an anesthetist, she knows from within what the shortcomings of healthcare are in Madrid, but also in Spain. And that is precisely what she has done to Pedro Sanchez make the decision to appoint her as minister. Now, what are those? Health challenges in Spain who will have to face?
The pandemic revealed that the Spanish health system was much less robust than we thought. The applause on the balconies was losing strength, giving way to institutional mistreatment of the health workers that took its toll on them. But also in patients.
Therefore, the challenges of Healthcare in Spain begin with giving healthcare workers and patients the treatment they deserve. In fact, most of the requests from medical associations They revolve around those two pivots. These point out some general challenges, which can be addressed by the Ministry. Although it must be taken into account that health competencies are delegated to the Autonomous Communities and that it is their Health Departments that have the last word. Furthermore, the situation varies greatly from one to another, so it is impossible to generalize in this sense.
The challenges of Healthcare in Spain according to the healthcare workers themselves
The Institute for the Improvement of Health Care (IMAS), the Collegiate Medical Organization of Spain (OMC), the Federation of Scientific Medical Associations (FACME) and the General Council of Medical Organizations (CGOM) have recently drafted a document in which they describe what should be the challenges of Health in Spain for the legislature that has just begun, with Monica Garcia at the head of his Ministry.
These are based on these objectives: improve the health of the population, improve the patient and professional experience and increase both the quality and equity of the system as well as its efficiency. To achieve this, Mónica García and her team face several challenges, of which these seven can be highlighted.
Reorient the national health system towards health
Currently, the National Health System (SNS) is oriented towards disease. That is, solutions are sought when people are already sick, but much less work is done on prevention so that the population lives in health.
Approximately, between 20% and 25% of health spending In Spain it occurs due to preventable issues. Therefore, complementing health care with public health strategies could involve a budgetary investment at the beginning, but in the long term it would lead to savings for the Government and, above all, a great help for patients.
Develop comprehensive care
Adequate care must be composed of three pillars: social resources, professional resources and services that allow good assistance.
The national health system is very weak in that sense, especially since the elderly and chronically ill population. For this reason, among the challenges of Spanish Health is the design of common strategy plans between social and health services, which make it easier to serve these most vulnerable sectors of the population. Although, in general, all patients would benefit.
Increase mental and oral health services
In Spain, 1 in 4 people will have a mental health problem throughout their life. The most frequent are anxiety and depressionwhich have also worsened since the COVID-19 pandemic began.
Unfortunately, in recent years these figures have only increased, but the resources of the national health system have not been able to cope with the situation. According to a study published in 2021at that time there were in Spain 8,713 professionals specializing in Clinical Psychology with the appropriate qualification to work in the National Health System. However, only 2,816 clinical psychologists were hired by it.
This means that the health system would have a pool of more than 5,000 qualified professionals to expand its portfolio of services. Unfortunately, financial resources are often allocated to other specialties, forcing people with mental health problems to wait long waiting lists or pay out of pocket to a doctor. private psychologist.
Something similar happens with dentists. According to the General College of Dentists of Spainin 2022 there were in our country 40,417 registered dentists. However, in Primary Care there are only contracted between 1,200 and 1,300 dentists. Given that oral health is essential and, in addition, can be related to the prevention of other diseases, there is an insufficient number of professionals to meet the needs of the population. Furthermore, the vast majority of interventions are not covered, so patients must seek out private dentists, even for the most basic needs.
For this reason, another of the great challenges of Health in Spain is to supply the population with resources to work for their health. mental and oral health.
Provide the National Health System with a governance structure
The signatory entities of the document on Health challenges in Spain point out that the return of the National Health Institute to the Autonomous communities “it was not accompanied by the creation of effective cohesion instruments.” They add that “the absence of an NHS governance structure “It favors inequalities, lack of transparency, inefficiency and waste.” And, as if all this were not enough, “it has been accompanied by a recentralization in the governments of the Autonomous Communities, an increase in the interference of party politics in health management and an increase in the bureaucratic-administrative apparatus in health.”
All of this has led to the proliferation of entities (agencies, departments, institutes, services, etc.) in each of the Autonomous Communities/Health Services to carry out activities and services “that would have higher quality and would use resources more efficiently if they were will join together or shared using different collaboration formulas.” Finally, these problems are joined by a great lack of transparency.
As a solution, they propose carrying out four actions: providing the health system with a clear and updated legal framework, creating the SNS Results Observatory, creating a National Quality Agency and developing an information system at the service of patients and healthcare providers. professionals.
Incorporate patients into decision making
Likewise, a government structure is needed within the SNS, for it to function according to its needs it is essential. make patients participate in it. In fact, one of the biggest challenges facing healthcare in Spain is precisely that patients, who are still the ones who support it with their taxes and who should benefit from its proper functioning, have a more active participation.
Therefore, there should be representation of patients within the governing bodies of the system.
Involve doctors in the management and planning of the Health System
In the same way that patients are essential, so are health professionals, who are sometimes left aside in the governing bodies that, after all, are in charge of managing how they should work.
Therefore, for avoid the burnout To which many health workers in Spain are already being exposed, another of the great challenges of health care is precisely to involve them in these new governance bodies.
Promote a digital transformation of the SNS taking the Citizen’s Digital Health History as its axis
New technologies have been gradually incorporated into the SNS, especially since the COVID-19 pandemic. However, the professionals who signed this report consider that It is not being done in the right direction.
“It is absolutely necessary to reduce medical time for the registration of information in the digital history, design models that allow the best use of clinical information, integrate the different systems and sources of information, facilitate pharmacotherapeutic prescription with tools to assist in taking of decisions based on current guidelines and by the particular characteristics of the patient and incorporate drug interaction alerts.”
Entities signing the report
Steps have been taken, but not enough. Therefore, digital transformation continues to be one of the great challenges of Health in Spain.
The challenges of Health for Mónica García
The new Minister of Health, Monica Garcia, has already made some public statements about what challenges the Spanish healthcare system wants to face first.
These are divided into two groups. On the one hand, obey basic patient rights, like those cited in the previous report. He has made reference to the improvement of mental, oral and visual health services, as well as the strengthening of Primary Care.
However, he has also spoken in a very different vein, pointing out that the health of citizens is not achieved only through medicine. He has emphasized the importance of attending to the climate emergencysince this can also deteriorate the health of Spaniards.
You’re right. In fact, the Barcelona Institute for Global Health just published a study in which it is estimated that in 2022 there could be a global excess of 70,000 deaths attributed to heat. The causes of excess mortality cannot be known with certainty. However, the models designed by these scientists find a relationship with the climate emergency, in the same way as Mónica García.
It is clear that caring for the planet and health go hand in hand. Although, of course, there are many other measures to comply with directly from the healthcare environment that should not be forgotten. Professionals and patients demand them and it is to them that we must pay attention to establish the challenges of Healthcare. Hopefully, this Government is capable of listening to them and not just hearing them.