The strike of the out-of-hospital emergency toilets continues, while the Community of Madrid maintains its plan without moving a millimeter.
The president of the Community of Madrid, Isabel Díaz Ayuso, announced this Thursday that the 78 centers that were closed during the pandemic will reopen on October 27, with two more centers included in the new network, those located in El Molar and Alcalá de Henares, for a total of 80. After several months of corrections (a plan was presented to reopen only 17 of the 37 Primary Care emergencies, seven of them without a doctor and only with a nurse), the centers will return to the activity with extended hours.
Thus, they will open at three or five in the afternoon, depending on the time at which they closed until now, and they will attend on average, according to 2019 data, about 700.
000 consultations during afternoons, nights and weekends.
In addition, it will be offered to the 13,600 Primary Care professionals who do complementary paid days in order to balance the necessary staff.
A proposal that is no longer a proposal, but a definitive plan, and that comes in the midst of negotiations on working conditions with the unions and indefinite strikes that will begin on October 25.
"This is unacceptable," Angela Hernández, spokesperson for the Amyts medical union, advanced.
“A joke”, continued Juanjo Menéndez, representative of the nurses, Satse.
"There is no progress with respect to what they had told us at the sectoral table and with which we did not agree", insisted Julián Ordóñez, from UGT.
More information
The emergency department of the Infanta Sofía hospital also goes on strike: “We fear for the safety of the patients”
Yes, there has been one, even if it is only formal: the new Continuous Care Points (PAC) have died before they were born, and are now called 24-hour Health Centers.
A change of nomenclature “for another more understandable for the population”, according to a spokesman for the Ministry of Health.
The previous one had been in effect for a month.
For the rest, the plan presented follows the same guidelines that were already known.
The day began with the president's statements at the Madrid Assembly, discrediting the position of the unions and the opposition and defending that she keeps her word.
"As I promised, before the end of October, 80 24-hour health centers will open in the Community of Madrid, including the 78 out-of-hospital emergency points that existed before the start of the pandemic," she announced.
“I tell you in advance that primary school staff will be able to choose for the first time to carry out paid complementary days.
The hours in the centers with the highest care load will be reinforced, bringing forward the opening of emergency care at 5:00 p.m. ″, she added.
"(...) These centers will be called 24-hour health centers, to which are added the 27 hospital emergency services."
System adapted to demand
Shortly after, the Minister of Health, Enrique Ruiz-Escudero, has expanded that information during an intervention in the regional Chamber.
“These complementary days are what will allow us to respond at all those times”, said the head of the health portfolio.
"We intend to create a system that adapts to demand," he added, explaining that most cases are concentrated during the day.
The Ministry of Health already announced at the end of August that 78 citizen service points would be opened, which would be called PACs, made up of the same ones that existed before: the 41 former SAR (Rural Care Service) and the 37 former SUAP (emergencies located in health centers).
The news was celebrated among the opposition, unions and citizens.
They had managed to stop the first plan to reorganize out-of-hospital emergencies, which consisted of closing 20 of the 37 primary care emergency services (SUAP), leaving 7 of the 17 that would remain open without doctors and only with nurses.
But the conflict was put on the table again when the unions verified at the sector table what the opening of those 78 points consisted of: Of the 360 doctors who worked in all the centers previously, now only 210 will do so, those who belong to the HE.
Meanwhile, the doctors who worked in the SUAPs and were distributed between the Hospital Enfermera Isabel Zendal (HEIZ) and the provisional home care units (UAD) created during the pandemic will be divided.
Those who were assigned to the pandemic hospital (16) will end up forming part of the primary care staff and, therefore, of the extinct PAC, now called 24-hour Health Centers.
The latter will continue to be under the tutelage of Summa 112, as they have been since 2004,
when the Comprehensive Plan for Urgencies and Health Emergencies of the Community of Madrid was changed.
This means that they will no longer return to the fixed position they had in their health center and will continue in the UAD, that is, in a mobile unit that cares for patients at home.
This Thursday, the Ministry has sent in parallel to the unions the proposal that it has presented to the media, since they still did not have it in writing.
On Monday they will have an appointment again in which they will discuss the working conditions of the toilets, who will be forced to work more hours from now on.
"They present us with a table where the medical staff is still reduced by half, a SAR was previously covered by six doctors and now by three, which inevitably affects assistance because there will be fewer doctors attending," complained Hernández, of Amyts.
“We agree that care must be given to patients that was not previously given, but not at the cost of abusive working conditions for health workers,” adds Ordóñez, from UGT.
“The plan to open these centers is based almost exclusively on volunteers showing up to cover the lack of nurses in the SAR and SUAP.
How can programming be done with volunteers?
If there are no volunteers, what are they going to do, close them and put a sign on the door?” insists Menéndez, from Satse.
More hours and more guards
Until now, the SAR doctors worked 1,536 hours per year and, as with the new plan, they will have to cover the positions of 78 health centers, instead of the 41 that they attend now, they will add about 1,642.5 hours per year, plus the obligation to carry out overtime hours (a maximum of 660 hours), consisting of four or five 24-hour shifts per month.
Those of the SUAP, except for the 16 who were in the hospital Nursing Isabel Zendal, will continue in the UAD, the center of all the controversy with the unions.
And therein lies the center of the conflict.
Summa 112 considers that these mobile units created during the pandemic are essential, so it does not want to dispense with its professionals so that they return to their old posts, which will now depend on the management of Primary Care.
Two different managements that fight, in turn, to keep 150 professionals in their ranks.
"This plan basically consists of changing the initials, but maintaining the same harassment and demolition of our public health", lamented the leader of the opposition and of More Madrid, Mónica García.
Both the unions and the Community of Madrid hope to reach an agreement on Monday to improve the working conditions of these professionals as much as possible.
Although the plan presented today completely distances the positions.
If they do not succeed, the next day there will be a strike which they also arrive at without an agreement, after the immovable proposal of the Administration of 100% minimum services.
The decision comes in a very complicated context in the Ministry of Health.
On Monday, the manager of Primary Care, Sonia Martínez Machuca, resigned.
On Tuesday, the toilets in the emergency room of the Infanta Sofía hospital also announced that they will go on strike starting on October 28.
Since July, there have been another five departures from the department, and eight changes in the Ministry of Health.
In addition, the examination that the Administration has underway on hospital managers has already resulted in the dismissal of two.
And to that are added announcements and rectifications in matters as sensitive as that of out-of-hospital emergencies.
Subscribe here
to our daily newsletter about Madrid.