"Why are the CCAA stopping doing rapid flu and covid diagnostic tests?"

Francisco Goiri Madrid

Madrid

Updated Friday, January 19, 2024-01:51

• Health Emergencies and flu: a cyclical 'virus' that chokes the health system

Francisco José Sáez Martínez

does not have a coat rack at home.

He doesn't need it, because he never hangs up the Family doctor's coat.

When he leaves the

pick and shovel

that he picks up every day at the Arganda del Rey Health Center, in the Community of Madrid (he interrupts, in fact, this talk for a few seconds to give instructions to a MIR), he puts on the suit. institutional.

But the robe, everlasting, peeks out from under the jacket.

It is an entire institution in the

Spanish Society of General and Family Physicians (SEMG)

, a

title

that those around him summarize with that classic formula of popular revival: "

Francho

knows everything."

Member of the board of directors of the primary society and coordinator of its

Chronicity Working Group

, he is also, "because of those complications of life", a member of the

Federation of Spanish Medical Scientific Associations (Facme)

.

Carambola upon carom, SEMG exercises - from this week until the end of February - the

spokesperson for the Primary Care Doctors Forum

(a system of rotating representation in which all its members take turns).

It's his turn now, in the middle of the flu campaign,

with many health centers saturated

and with the primary school suffering from a

salad of viruses

that aggravates his chronic discomfort.

To know more

MIR 2024.

Record number of MIR family doctor positions despite lack of interest in the specialty

• Editor: PILAR PÉREZ Madrid

• Editor: NURIA MONSÓ

Record number of MIR family doctor positions despite lack of interest in the specialty

Health.

Failure in flu management: "The peak in respiratory infections always catches us on the wrong foot"

• Editor: FRANCISCO GOIRI Madrid

Failure in flu management: "The peak in respiratory infections always catches us on the wrong foot"

Sáez Martínez, who also "knows everything" about chronicity, speaks through all the primary care organizations that are part of the Forum, which are all those that represent family doctors and primary pediatricians in this country.

"No matter how much we repeat it, it seems that the health administrations do not take notice: the problem raised these days by the rebound in respiratory pathologies, which is repeated, to a greater or lesser extent, every year,

is just a symptom of the serious situation that the first level is going through

. If there is something that worries us as primary doctors, it is that the system is increasingly less equipped to articulate a response, and not only in specific situations, but on a day-to-day basis," he says. the spokesperson on duty at the first level.

The first, in the jugular of the system.

Family and Pediatric Societies, primary school members, first-level union representatives and members of the State Council of Medical Students confirmed last Monday, in the

transfer of powers

between Semfyc (the company that left the spokesperson for the AP Forum) and SEMG, that "the tension that many health centers are enduring these days

is the result of management failures

and the particular circumstances of this year's flu epidemic and respiratory infections, but, above all, of

the lack of response to problems structural

."

The pandemic, Sáez Martínez emphasizes, fell "like a bomb" on primary school, "but the effects of that explosion are greatly amplified when that bomb hits a previously very damaged structure."

The chronic "mismanagement" of the flu epidemic

The "failures" in the management of the current flu campaign have also been, of course, the subject of analysis in the last official meeting of the Primary Forum, but these failures, for doctors at this level, are also the result of

what has not been done

and, in some cases,

what has been stopped doing

: "

Why are communities stopping doing rapid flu and covid diagnostic tests?

Why are there communities that do not even have these tests implemented for RSV? In the middle of the pandemic, these rapid tests became widespread and the Ministry of Health and the communities acted in a coordinated manner. Now, as the tests run out, the

stock

is not renewed and

the communities stop doing them or do them in to a lesser extent

," he denounces.

Extremadura, for example, "does not do this type of test in its health centers, and there we have the incidence data for recent weeks in this region";

and other communities, he says, restrict them: "In the Community of Madrid, where I work,

even the health centers specifically dedicated to the triage of these infections have a limited number of tests

: one hundred per month; that is, 101 per infected person We didn't detect it in advance."

The underlying problem, Sáez Martínez points out on behalf of all his primary school colleagues, is that, at this point at least,

the communities should not go it alone

, because it was already agreed and written what had to be done: in November 2022 , the

Primary Care Working Group of the Human Resources Commission of the SNS

(which brings together the ministry, CCAA and scientific societies) has already agreed to the implementation of rapid tests (and not only for flu, but also) in the health centers of all of Spain.

"In addition to the

rapid diagnostic tests for flu, covid and RSV

, among other infections, there was an agreement by all administrations to generalize in primary (both in Family Medicine and Pediatrics), tests such as MRI, CT or "Ambulatory Blood Pressure Monitoring. On paper, in December 2023, all the details of that agreement should have been finalized, and now,

in February of this year, its inclusion in the portfolio of services should be reflected

."

But the primary representatives who met at the SEMG headquarters last Monday have no news of this inclusion.

"Centers with 50 or 60 patients a day were common in the middle of the pandemic. Today they are common, and not only in rural areas"

That there were health centers with 50 or 60 patients a day was not unusual in the midst of the pandemic wave, but the Facme member assures that "the problem is that these figures are already common in many health areas of many communities, regardless of the moment." when we take the

photo

."

And not only in rural areas, he points out, "but

centers in urban centers such as Madrid, Barcelona, ​​Valencia or Seville have unfilled doctor positions

, and these positions have been assigned 1,600 or 1,700 cards (TIS), which must be covered. physicians from other centers".

The needs of primary care reform

For the primary spokesperson, such a delay between what was agreed and its normative embodiment does not, of course, come as a surprise: "If it were for documents, agreements, working tables and declarations of political good will, the primary would have gone well for years, and it would not "

We would have to remember on

April 12

of each year [

National Primary Care Day

] the shortcomings of the level."

Furthermore, he emphasizes that "at the end of 2021, the Minister of Health [then,

Carolina Darias

]

brought together all the communities in the Canary Islands in a monographic summit

that was supposed to be transcendental for the future; shortly after, the Government illuminated the "Ambitious

Primary and Community Care Action Plan

. It is almost pointless to insist on the same, but where are the practical results of all these initiatives?"

If there is something that primary doctors have stuck with almost as a personal affront, it is

the regulation of self-discharges

, an issue that, in the current context, has gained unusual prominence, but that the Primary Forum, recalls the representative of its current spokesperson,

already proposed in 2016

, "and we were not inventing anything: we were inspired by the example of several European countries, England, Germany, the Netherlands, Sweden, Portugal, where they have been operating for a long time, and in whose mirror we look at ourselves only when it is convenient" .

And it will not be due to lack of experience, he remembers, "because in Spain we already implemented this measure in the middle of the pandemic."

The famous "responsible declaration" is not new.

The full Forum already raised it with Health and the CCAA in 2016

Sáez Martínez, and with him the entire AP Forum, believe that the moment for its definitive regulation may be now, because, on paper,

the institutional winds are blowing in favor

: "We believe that if the Minister of Health and her Secretary of State [

Javier Padilla

] have now put it on the table, taking advantage of this situation, it is because both have perfectly identified the problem. She is a doctor by profession, with hospital experience, but we believe that she is very sensitive to the primary school situation, and Padilla is directly "Family doctor, with many years of practice in a center in Vallecas and, therefore, first-hand knowledge."

But not everything is a tailwind, says Sáez Martínez.

The reluctance aroused by the famous

responsible declaration

by the worker during the first three days of disability (in the case of a mild pathology) are, according to him, clearly unidentified, "on the right and on the left", and their objective is common: "In the Basically, the only thing they want is

to get rid of the

burden

and keep the bureaucratic procedures falling on primary doctors

. Of course, there are no welfare-related arguments to oppose the generalization of the measure."