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En las últimas semanas hemos conocido la intención del Servicio Cántabro de Salud de centralizar todos los análisis en un gran laboratorio regional ubicado en el hospital Valdecilla bajo la premisa de un ahorro de costes que, la Consejería de Sanidad, ha estimado en un 30%. Los laboratorios de los Hospitales de Sierrallana y Laredo se verían reducidos a la realización de los análisis de los pacientes ingresados y de urgencias.
Tal y como ha reconocido el Gerente del SCS, los laboratorios de los hospitales públicos de Cantabria son eficaces, y prestan una asistencia eficiente, centrada en el paciente, en estrecha colaboración con los profesionales de los hospitales y Atención Primaria. El coste de estos laboratorios, de donde pretende ahorrarse un 30%, es una pequeña parte del coste global de las analíticas que se realizan en todo el SCS. Pretende ahorrarse de un capítulo de gasto mínimo invirtiendo en un gran laboratorio central de coste de varios millones.
La concentración de laboratorios no se ha demostrado económicamente eficiente en los sistemas de salud. Aunque es frecuente encontrar estudios con los ahorros teóricos que podrían producirse, hay una ausencia total de resultados. Los modelos centralizados complican el transporte de muestras, deterioran la relación entre el facultativo que atiende al paciente y el facultativo del laboratorio y olvidan aspectos tan importantes como la adecuación de la demanda. Muchos profesionales consideran que, frente al axioma no demostrado de que la centralización es coste efectiva, se impone la certeza de que conducen inevitablemente a una pérdida de calidad en la atención sanitaria.
A pesar de ello, el SCS sigue manteniendo que la creación de un laboratorio centralizado es un proyecto “decidido”, siguiendo la hoja de ruta marcada en el Contrato de colaboración Publico Privada en el Hospital Valdecilla en el que se establece “la centralización de laboratorios, radiología, anatomía patológica, esterilización y almacenes en el nuevo edificio o en instalaciones externas al mismo”. Parece que la Consejería de Sanidad actual pretende “mejorar el contrato” con Ferrovial para finalizar el edificio de Valdecilla, aumentando las partidas de los contratos de servicios ya externalizados y adjudicados a Ferrovial como compensación por la inversión en la edificación y aumentar en todo lo posible la oportunidad de negocio que se le ofrece a la empresa constructora, en perjuicio del presupuesto de Sanidad de Cantabria de los próximos 20 años. La centralización de laboratorios y de la informática de todos los hospitales en el nuevo edificio y su adscripción a Ferrovial es un buen ejemplo de esta política de desmantelamiento de lo público y trasferencia de dinero público a empresas privadas.
La Asociación para la Defensa de la Sanidad Pública (ADSP) sostiene que el ahorro anunciado por la Consejería no se fundamenta en ningún estudio. Por el contrario, el cambio de modelo organizativo supondría un gasto superfluo: la inversión millonaria necesaria para la creación del nuevo laboratorio y la condena a la ineficiencia de los ya existentes en los hospitales comarcales.
La ADSP considera que se pretende realizar una reorganización al margen de los criterios de los profesionales, basada en una serie de mantras y paradigmas importados de la industria sin evidencias que demuestren que mejoran los resultados que, en el caso de los laboratorios clínicos se miden en mejoras en la salud de los pacientes y no sólo en aspectos contables.
Por todo ello, la ADSP solicita a la Consejería que mantenga el compromiso adquirido con los responsables de los laboratorios de iniciar un estudio “desde cero” para establecer el modelo organizativo más adecuado que no pasa, necesariamente, por centralizar las determinaciones de Atención primaria que ya realizan, de manera eficiente, los laboratorios comarcales.
Federación de Asociaciones para la Defensa de la Sanidad Pública
1 de Abril de 2014
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