Joint communiqué of the ICOMEM and AMYTS on health cuts

Within our territorial competence, recently the Bar Association official doctors of Madrid (ICOMEM) and the Association of doctors and graduates of Madrid (AMYTS), support a bases agreement to act on behalf of the health system and its quality, to claim the necessary participation of doctors in all decisions that have clinical implications.

The alarm before the present cuts and announced in the public health system justification, the majority trade union organization among doctors working in the public health system Madrid, as the institution that regulates the medical profession and represents all doctors in our community to express its opinion thereon, andare available to public institutions to assist in the solution of the problems raised. For us it’s a basic service provided to society, alter it or reduce it indiscriminately can transfer this basic rule of our individual and collective behaviour that we are not prepared to resign.

We are fully aware of the very serious economic situation in which we find ourselves and the imperative of public administrations to adjust the budget to the limit as a society we can afford. However, we disagree with the way in which being carried out, not so much by direct managers Madrid public health system, but the widespread and indiscriminate instructions provided them imposed from their higher courts.

In that sense and derived both the measures contained in the Act of accompaniment to the general budget of the community of Madrid and the foreseeable development of the basic portfolio of services announced by the President of the Government of Spain in his investiture speech, we pointed out a number of issues whose application will have direct consequences in the massification of healthcare and the consequent and inevitable decline in the quality of care that we want to preserve:

1. No replacement for 90% of the seats of vacant doctors by retirement. result of the announcement that only 10% of the vacancies of civil servants in strategic sectors, among which is drawn to the health and the armed forces were replenished. Its indiscriminate application in Madrid health, 30% of physicians in hospitals, be retiring that between now and 2015 will be a collapse.

2. Removal of temporary contracts. In the community of Madrid, due to lack of regularity of employment bids, 30 percent of the workforce of doctors is occupied by interns and casual, do not perform extraordinary sporadic jobs that address structural needs arising from the increase in population. delete any renewal will involve an overcrowding and unbearable care overload for health care.

3. Addresses health care in primary care. They need an urgent renewal at the current lack of references for the resolution of logistical problems of the day to day. The community of Madrid, on the other hand, has execution pending a ruling of the High Court of Justice of Madrid, not contested, that forced to cease management of health centres non-medical staff who was appointed.

4. Widespread increase of 2.5 hours in the working week to reach a ceiling of 37.5 hours. Measure which has not taken into account that the optional staff develops, for years, days exceeding the weekly 48, 50 to 60 in the case of the residents. Cannot be a tabula rasa of the medical work as if it were a string of industrial production. Each patient requires attention differentiated according to their needs. For clinical reasons, doctors demand to participate in any decision affecting the reorganization of work and allocation of tasks.

5. The situation of disease of a doctor in any case be considered absenteeism. Again, indiscriminately and to apply to all public employees, with the justification of combat absenteeism, compensation for the first 3 days of temporary disability and compensation of 60 per cent of the base (which is not the full pay) has been announced until the day 20, and 75% of this basis from the day 21. Doctors are the professional group with lower rate of temporary disability. Regardless of this fact, applying generalized punishment downward, rather than pursue to whom really be fraudster, so we are in agreement, it represents a grievance. A doctor with a contagious disease like influenza may represent a risk for their patients. Trying to force him to work by means of economic extortion is torticero.

6. While aware of the current context of crisis, it is our duty continue fighting for the introduction of the professional career, even just in the health care plan at an early stage. We believe that the consequence will be a higher quality of care and believe that it can be a useful tool for the future (at level management and incentive).

These are specific examples already in implementation or in developing. In other autonomous communities, which have been closed primary schools, hospitals plants, points of call, completely altered the schedules, etc. the situation is more serious, but this does not represent any consolation. We are confident that such extreme measures do not reach the community of Madrid, but if they came to produce doctors we are facing.

Doctors denunciaremos to public opinion, and where appropriate, any measure cutting which represents a risk to the quality of care we have committed to our patients.

Our proposal

No one better than the doctors know the health system, its possibilities and its inefficiencies. From the bitter recognition that will be required to apply, also in health care, some cuts from the ICOMEM and AMYTS offer to the Ministry of health of the community of Madrid our selfless collaboration to contribute our knowledge to the application of any measure that has direct or indirect implications in clinical practice. Our goal is to avoid any damage to patients and in any case, from a perspective exclusively medical, prioritize in case of need the attention of those who need it most. The Ministry has in his hand have the critical mass of experts to carry out the difficult task that has fallen.