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The agreements reached in the last Interterritorial Council, on April 17, are giving a lot of electoral play to the President of the Government, Pedro Sánchez. This weekend at the rallies of Valladolid and Valencia has insisted on presenting the fruits of that meeting (agreed between the Ministry of Health and the 17 communities) as measures of the Council of Ministers, specifically for today.

While on Saturday Sánchez announced that primary care would receive 580 million euros to improve the infrastructure and endowments of 13,000 health centers; On Sunday, at a campaign event in Valladolid, it was the turn of mental health: the president announced that today's ministerial cabinet will give the green light to the distribution of 38.5 million euros among all communities for mental health care. Neither one nor the other are 'extra' items to what is already agreed with the Autonomous Communities and already reflected in strategic plans.

'Freeing' the game for the first level of care

In the case of Primary Care, Sánchez said that the decision will be made effective by the Council of Ministers next Tuesday, but what the full ministerial cabinet will do today will be to endorse the agreement that Miñones reached on April 17 with all the regional councilors: release 580 million euros for the first level of care , and not for staff -as the professionals of the level insistently demand-, but for infrastructures, equipment and material.

According to the terms of the agreement endorsed by the Interterritorial Council in April, no less than 85.2% of those 580 million that Health will distribute between the autonomies and Ingesa (Ceuta and Melilla) for the improvement of the first level (493.8 million) will go to the construction of health centers, the improvement and conditioning of existing ones and the modernization of equipment and technology, and all this under the umbrella of the Plan for the Improvement of Primary Care Infrastructures (MINAP).

In fact, Miñones himself announced on Friday, at the ministerial headquarters and in an act to commemorate the Day of Family and Community Medicine, that the infrastructure improvement plan would become effective this year. What he did not specify was when or on what terms, so that his boss would show off in Valencia, flanked by the president of the Generalitat, Ximo Puig, and the deputy mayor of the city, Sandra Gómez, in an electoral rally that, according to Ferraz, brought together more than 6,000 people.

The parrot chocolate of that millionaire investment, just 85.3 million euros, is the item that the Ministry of Health will distribute among all the regional health services to finance the 52 strategic actions contemplated by the Strategic Action Plan for Primary and Community Care 2022-2023, which the Interterritorial Council itself approved in December 2021.

Among these 52 strategic actions of the Plan include some as capital for professionals who practice at the first level of care as the strengthening of thestaff of Family Medicine and Pediatrics or the adoption of organizational measures to favor the debureaucratization of consultations. According to the low percentage that the central administration dedicates to most of the measures of the plan, either the bulk of the investment comes from the regional budgets (as contemplated in the Action Plan itself) or those 52 actions will be unfeasible.

The criterion for the distribution of the millions, also approved by the Interterritorial of April, is exclusively population (the greater the number of inhabitants in the register, the more money), and not based on a specific study of health center needs by health center. Thus, Andalusia, Catalonia and the Community of Madrid will be the three communities most benefited by the credit lines that Miñones will release for the improvement and modernization of infrastructures. Of the total 579,175,000 euros, Andalusia would take 107,705,219 euros, Catalonia 98,727,187 and Madrid (the one that least percentage of its health GDP allocates every year to its primary care) would receive 85,148,318 euros from the ministry to improve its infrastructures.

An item already present in the Mental Health Strategy

As in the case of the item destined for primary, the mental health is not new either, but is included in the Mental Health Strategy 2022-2026, approved no less than in December 2021. And, also as in the case of primary, the last Interterritorial Council approved last April the criteria for distributing the funds that the Ministry of Health will give to each of the autonomies to improve their respective mental health coverage.

According to the agreement adopted in April by the Interterritorial, which Sánchez has outlined today in very general lines, those 38.5 million will be distributed among the 17 autonomies and Ingesa (Ceuta and Melilla) in three clearly differentiated items: 14.5 million for infrastructure and equipment for community mental health, 16 million for the Mental Health Action Plan 2022-2024 (which is included in the Strategy approved in 2021) and the remaining 8 million for the so-called Mental Health and Covid-19 Action Plan, also included within the Strategy, but specifically aimed at "addressing the effects on mental health of the health and social crisis generated by the pandemic", according to the terms set out in the April IC.

As in the case of the funds that the ministry will distribute among the communities to improve primary health centers, the distribution criterion will be almost exclusively population. Specifically, 5% of the budget allocated to mental health will be distributed linearly, applying a minimum amount to each community, and the remaining 95% will be distributed among the 17 health services attending not to the specific needs of each autonomy in this area, but to the figures of the municipal register of January 2022. In short, Andalusia, Catalonia and Madrid are, in this order, the three communities most benefited by the financial manna that the ministry will allocate this year for the reinforcement of mental health care.

In the specific case of the 14.5 million allocated to improving infrastructure and equipment, each community must submit a plan containing the projects for the construction of new centers and expansion and/or remodeling of those already existing in each territory, as well as the clinical equipment projects proposed for financing according to their needs. And, once presented, approved and financed, they have very valued deadlines to execute these projects: until December 31, 2024 for the improvement and modernization of equipment and one more year, until December 31, 2025, for the completion of the works.

  • Health
  • Council of Ministers
  • Pedro Sanchez
  • Jose Miñones

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