Healthcare without doctors: the silent replacement

"The number of doctors will not increase, despite the waiting lists, despite the retirements, despite the layoffs, despite the lack of specialists. The new mantra of the regional ministry is that there is no shortage of doctors." This, which could be written today and would still be just as valid, I wrote on July 28, 2021, in an article titled Medicine without doctors published in this same newspaper.

Four years and three Health Ministers have passed, and the plan to replace doctors with other professional profiles, at a slightly lower cost to the administration, continues to sail ahead, full sail. It's a strategy, moreover, not at all hidden. New professional profiles in primary care, a document presented in December 2021 and prepared by the Department of Health and the Agency for Healthcare Quality and Assessment of Catalonia (AQuAS), you can find phrases like this: "The move towards an increased use of administrative staff as part of primary care teams is taking place internationally, and their activities may include reviewing the results of the procedures and performing basic therapeutic interventions." Surely the people reading this article have wondered why they should explain what is wrong with them, what their health problem is, to an administrative staff member. Well, this is the department's plan: for a non-health professional to assess their health status and whether or not they need medical attention.

In four years, the Department of Health's budget has grown by more than 30%, but the increase in resources has had no effect on waiting lists or on accessibility to primary care or hospital specialist consultations. And it's as easy to check as making an appointment with your family doctor: "Your referring doctor doesn't have any available appointments in the next 30 days."

It seems that replacing doctors with other professional profiles, in white coats but lacking the same problem-solving skills, doesn't work, as always. Just look at the countries around us. The veneer of modernity and efficiency our politicians are trying to impose is already an outdated model.

Councilor Olga Pané and the CAIROS committee, charged with reforming the Catalan healthcare system, would be wise to apply the saying "whoever is a shoemaker, let them make shoes."

In this regard, according to the latest data published by the Department of Health's Directorate General for Health Planning and Regulation, 33.1% of Catalans have health insurance (in 2014, it was 25%), with the province of Barcelona leading the way, with 37.2% of the city's population having insurance. This transfer of patients to private healthcare may be a good thing for our leaders, and that's the hidden intention behind all these plans. But what care—and quality—is available to the 70% of the population who can't afford a mutual insurance company?