As much as the report on the needs of specialists says that in Spain there is not a problem of lack of paediatricians, the data indicates the opposite, at least in health centers:
there are about 600,000 children without a reference doctor
, according to the Spanish Association of Primary Care Pediatrics (Aepap), which has exposed the data in the presentation of its 18th congress.
The scientific society has obtained through a survey of its regional members that
in Spain there are at least 595 pediatric vacancies that are not covered by any doctor
-either pediatrician or another specialty- around 10% of the places.
Or what is the same: 595,592 children who do not have a professional who continuously monitors their acute or chronic illnesses, the well-child program, vaccinations...
Madrid and Navarra are the communities with the worst coverage
: they have 20% and 16% of vacancies, respectively,
followed by Andalusia and Catalonia
, with 10% of vacancies.
In other words, the worst figures coincide precisely with the most populated communities.
The association attributes these empty places to poor working conditions: "These are
rural places, with crowded consultations, with professionals who work completely alone
, sometimes not even without an administrative staff, with
precarious contracts, afternoon shifts
...", has explained Concha Sánchez Pina, president of the Aepap.
In many cases
, "young professionals with little experience, who are overwhelmed by the situation," may end up there.
On the contrary,
in Extremadura, Cantabria, La Rioja, Aragón, the Balearic Islands and the Canary Islands they would have all the places covered...
in theory.
And that's because many communities turn to family doctors to fill those vacancies in pediatrics.
According to the Aepap, the problem has been observed above all in communities such as the Balearic Islands, Castilla-La Mancha and Andalusian provinces such as Huelva and Almería.
In total,
they estimate that between vacancies and places filled by other specialists, paediatricians are lacking in 25-30% of the positions
.
And taking into account the lack and aging of the Family Medicine staff, it is possible that these vacancies will continue to increase.
Andalusia, the Canary Islands and Catalonia have come to hire graduates in Medicine who have not even managed to do the MIR
to cover these places, as denounced by the scientific society.
The difference between primary and hospital
With these data in hand, the Aepap refutes the report on the needs of specialists commissioned by the Ministry of Health.
"The report is based on an error: that there is no significant deficit of pediatricians"
.
An assessment that contrasts with previous reports, which indicated that the deficit of pediatricians was at least 10%.
According to a committee of experts consulted by the authors of the report, Pediatrics is one of the specialties that would currently be in balance (that is, it has a surplus and a deficit of less than 5% with respect to demand) and that even
the need for pediatricians will fall in 2035, due to the fact that the population under 15 years of age will decrease by 1.2 million people
, according to estimates by the National Institute of Statistics (INE)
What the report ultimately does are
estimates with the total number of pediatricians, also counting those from hospitals
.
Therein lies the problem: in general,
young paediatricians prefer the second level
, even if it is with guard contracts, while one in four ends up in the health center.
You only have to look at the age of the public health staff: according to the report,
52.8% of primary care paediatricians are 50 years of age or older, compared to 27.6% of hospital paediatricians
.
And while one out of every 5 pediatricians in the primary network will reach retirement age in the next five years, the proportion drops to 11% of those who work in the hospital network.
Sánchez Pina has also alluded to the nurses, denouncing that in four autonomous communities (Valencian Community, Catalonia, Madrid and Navarra) it is these professionals who develop the child health program without the support of the pediatrician, "and also most of the time who apply are Family Nurses" and not those specialized in childhood.
On the other hand, he has made a call to
enhance the management of demand by nurses, especially patients who come without an appointment.
What measures could be applied to promote primary pediatrics?
In addition to better contracts, the Aepap supports the creation of a figure in the Administration, a
coordinator of paediatricians, who ensures that the new reinforcement contracts are dedicated to health centers,
since "we know that in some cases the templates of hospitals are oversized.
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