FoCAP puts the reortes figures in Catalan primary health care.

Spain, 2011-October Primary care receives less than 18% of total health expenditure Catalan. With these resources, the AP serves the most common health problems of the population, diagnosed, is, makes the health promotion, prevention and care of the elderly and all those who have health needs. When primary care comes to people, often chronically ill, it makes it way agile, low cost, personalized, and continuity in time. Therefore, the World Health Organization recommends to Governments to develop health systems based on primary care. But a progressive decrease in the health budget allocated to primary care looms in Catalonia: in 2003 it accounted for 21.6 per cent of the total, and in 2011 is available only 17.5 per cent.

Fall in the budget for primary care-El Catalán forum for primary care (FoCAP) has analysed for the first time the extent of the reduction and the distribution of costs and investments of the Catalan health system in relation to the first level of care, the PA. One of the most significant data is that in 2011 CatSalut applies an overall budget reduction of 6.45%, but in primary awarded a reduction of 12,86% (EUR 247 million). In hospitals, the cut is 5.16% and 228 million euros. It is the case that primary care has managed to reduce its pharmaceutical expenditure of 23.9 per cent to 14,39% in the last 8 years while maintaining their levels of quality, and on the other hand, these results have not resulted in greater allocation of budget for the PA.

If we look at the figures of the Catalan Health Institute (ICS) is the primary care program budget for 2011 falls 10.71%, while the reduction to the specialized care within the ICS is subject is 0.32%.

5 million Catalans use every year the primary health care

In Catalonia, during 2009, 73.4% of the population made use of primary care, while 7.5% pointed out of hospital services. On the other hand, primary care has only half of hospitals professionals. In addition, from 2004 to 2009, it has been found that the Catalans do not make more use of hospitals and that there is also a fall of hospital emergencies and the days of hospitalization rate. Despite the figures, CatSalut between 2003 and 2011 budget has increased by 24.3% for hospital care and specialized, and has fallen 18,77% to economically provide primary care. As a result becomes a model of medicine tech and fragmented, with obvious opportunities to improve their efficiency with respect to health outcomes.

As the demonstrations of the Catalan Government, FoCAP believes that “say that a health system based on primary health care promotes contradicts totally the budgetary choices”. And beyond: “without any strategy and indiscriminate cuts are affecting very seriously in primary care, and impair the quality and quantity of services, in such a way that will suffer the health system”.

FoCAP argues that “we are witnessing a shift in the orientation of the health care model, contrary to what has stated the health adviser in several demonstrations, and to behaving a rapid deterioration of health services and a history of the working conditions of professionals worsening”.

Staff cuts-the study of FoCAP documents the decline in the overall staffing of centres and services in primary care in Catalonia more than 1,000 people. In the ICS, the template is reduced in 494 people in 2011, of which 428 work in primary care (does not include any). Renewed contracts are no longer 36 h/week but 25 h/week, representing a 30% time reduction of the new template. It must be said that only partially cover retirement, and although in minor degree labor losses and do not cover absences for vacations or training. In this way, and taking account of call points and AP emergency closures, FoCAP warns that “the reduction in the capacity of primary care to respond to emergencies will generate, in winter, saturation of services hospital emergency and serious risk of collapse”.

The reduction of the diagnostic capability, which in the ICS is 12.46% has been evaluated. Health centers may be fewer tests from now on, so that there will be a negative impact for citizens and a worse disease monitoring. This diagnostic capacity reduction will end up generating more costs for the health system. On the other hand, the reduction in spending on maintenance, equipment and investments in the network, falls into the ICS a 54.4%, which will affect its functioning and its ability to service and resolution.