Murillo underlines, among other problems, that “we are seeing how the best MIRs are fleeing Family and Community Medicine due to the appalling conditions and excessive workload”
A healthcare in crisis Juan Torres: “We are facing the worst health crisis the system has experienced in 40 years”
Health Carlos Rus: “Healthcare in Spain is a social achievement and private healthcare is an option of the healthcare model, both at the management and user level”
As a doctor specialized in Gynecology and as president of the AMA medical insurer, Diego Murillo has the background and experience of a lifetime dedicated to the medical profession and the service of its coverage. For this reason, he does not hesitate to point out that as medical professionals “we have lost authority and recognition. What happened to the social prestige and purchasing power of doctors? And as if that were not enough, on occasions, we are victims of attacks or suffer threats.”
What are the reforms of a health system that needs to adapt to the needs of this century?
Needless to say, our system has been one of the great successes of this country in recent years; but since that Compulsory Health Insurance of 1942 up to the present time, many things have happened, such as the transfers from Insalud to the Autonomous Communities, a process that began with the autonomous system and ended in 2002. Twenty years have passed since that and Although there are opinions for all tastes in relation to health decentralization, all diagnoses agree that we currently have deficient health care that needs more professionals and a better integration of resources, undoubtedly relying on private entities; Waiting lists must be reduced and the digitization process must be deepened in order to benefit the efficiency and equity of the system. This is my recipe to improve a health system that, as I said, is not in good health.
Some point out that in the Commission for Social and Economic Reconstruction after Covid-19, there are agreed ideas among all the actors. Could this lay the foundation for a possible state pact?
The political parties have to reach a State Pact that avoids the total degradation of our National Health Service and allows us to face the challenges of the future. I think we are in time to reverse the situation. We have professionals who are a real luxury, our Health is recognized throughout Europe, but we are facing important challenges such as the shortage of professionals, the scarce incorporation of technological and pharmacological innovation, the high rates of aging of the population or the high chronicity of diseases. We cannot allow much more time to pass without undertaking a reform and this requires the maximum political and professional consensus.
Among the major reforms that the SNS needs is the one that affects professionals. What would be the recipe to better manage human resources between care needs and training?
I am committed to a universal, quality and equitable model with financing that guarantees its sustainability. The current system has become outdated and as a result, professionals move abroad or to communities with better conditions, which is generating differences in health services between regions and jeopardizing territorial cohesion and access to benefits. that the citizen has One of the differences between the autonomous regions and the Ministry of Health is in how measures are taken to address needs and problems.
We must not let another day go by without undertaking a reform and this requires the maximum political and professional consensus
One of the differences between the Autonomous Communities and Health resides in how these problem needs are measured. Should the Interterritorial Council have more authority to make binding the decisions made within it?
Of course, everything can be improved. The Interterritorial Council of the National Health System is a coordinating body aimed at guaranteeing equity in the health benefits of all citizens, something that, as I have previously commented, is not taking place and the disparity between health services is clearly increasing. Then there is something wrong. Indeed, there are those who believe that some of their agreements should be binding, especially those that affect equity or access to health services and have a qualified majority. It is a recurring issue that is not fully resolved, like so many others.
One of the pillars of the SNS is the Primary Care group. How are students encouraged to choose the specialty?
There is no doubt that Primary Care is suffering serious problems; We are seeing how the best MIR are fleeing from this specialty due to the appalling conditions and excessive workload. For the second consecutive year, vacancies have remained free in the allocation of MIR positions and a second round of elections has been held, a situation that we have never experienced and that invites a much deeper reflection on what is happening with our Health.
And how is it done so that those who are already first-level faculty do not abandon it or see their work recognized?
Improving their economic and working conditions, fundamentally. I always say that doctors are very poorly paid. Politicians in this country make much more money! But we have also lost authority and recognition. What happened to the social prestige and purchasing power of doctors? And as if that were not enough, sometimes we are victims of attacks or suffer threats. Definitely, the world is upside down, and health workers need all the support and protection possible. And a few days ago something came up that is already the last straw, the one that a judge I think was from Las Palmas, speaks in a sentence of obstetric violence and not only that but also says that you have to ask the patient in state childbirth if you want to give birth vaginally or prefer a caesarean operation, you must remind your wife that the only one who has the capacity and knowledge to be able to make that decision is the gynecologist.
We are seeing how the best MIRs are fleeing from Family and Community Medicine due to the appalling conditions and excessive workload.
Strikes by doctors, not only in primary schools but also in hospitals, have been branded as political demonstrations. To what extent does ideology serve or hinder health care?
Without a doubt, politics has an influence and we have already experienced this situation on many occasions… It is so disappointing that disagreements between parties are the worst enemy of Public Health. You cannot play with something as serious and delicate as people’s health. Health should stay out of the political contest. It has taken us a lot of work and effort to get to this point and we do not deserve these sterile debates that the only thing they achieve is harming professionals who have given everything.
Doctors can choose where to work, in public health, in private or both. Is the professional penalized or judged according to where he develops his work?
In some communities, professionals who combine public and private healthcare are penalized with a decrease in salary, causing economic inequality. This is happening in some autonomous regions, taking refuge in the Law of Incompatibilities of the Public Administrations that includes the complements for working in the two sectors. In other Communities this cut is not applied and this is causing the exodus of toilets to those communities, affecting the proper functioning of Health in these areas.
Health should stay out of the political contest. It has taken us a lot of work and effort to get here and we do not deserve the sterile debates
Public-private collaboration is a management tool that the SNS has to optimize resources. Is this privatizing healthcare? To what extent are citizens aware of its operation?
The support of private healthcare is essential for the public to improve, we see that the waiting lists do not stop growing and confirm that our system suffers from a disorder that must be intervened quickly. I am in favor of private healthcare as a fundamental strategic ally of the public system, since it frees up resources and, above all, improves the accessibility of patients to a wide network of medical centers and professionals, which translates into better healthcare quality.
There are sectors that call for a review of the roles of Nursing and Pharmacy to optimize resources in primary care. How could it be carried out and what actions could they take?
Optimizing the resources of Primary Care Nursing and Pharmacy to the maximum is a positive option along with others such as implementing campaigns that promote a good quality of life that prevents the appearance of diseases… All of them are measures aimed at achieving a rational use of resources, and in this sense the collaboration of professionals in the healthcare framework is always highly valued and taking into account that, above all, it is essential to carry out good management.
