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La Gerencia de Atención Primaria de la Consejería de Sanidad de la Comunidad de Madrid ha hecho llegar a los sindicatos de la Mesa sectorial una “ PROPUESTA DE MODIFICACIÓN ORGANIZATIVA EN ATENCIÓN PRIMARIA PARA ADECUAR LA ATENCIÓN SANITARIA A LA DISTRIBUCIÓN DE LA DEMANDA ASISTENCIAL” que contempla como principal medida que se deje de citar en la AP madrileña a partir de las 18,30-19 hs, lo que supone una disminución del horario de atención normalizada en AP de 2,30-2 hs según el caso.
Esta propuesta supone claramente un deterioro de la AP madrileña que desde la Asociación para la Defensa de la Sanidad Pública rechazamos totalmente por los siguientes motivos:
- Disminuye la accesibilidad de la población a la AP, la cual debería asegurar a toda la población una atención da calidad en el horario más amplio posible para permitir la continuidad asistencial. Según los datos de la Propuesta se dejarían de citar 3.567.950 citas de medicina de familia, 715.777 de pediatría y 1.828.538 de enfermería. Es decir 6.114.625 personas dejarían de recibir las citas de AP y quedarían a expensas de la asistencia urgente.
- El efecto inmediato de estas medidas será incrementar las demoras en las citaciones en AP que ya tienen una situación muy preocupante. Así según el último Barómetro Sanitario solo el 51% de la población de Madrid tiene cita, cuando la pide, en las primeras 48 hs. Las demoras en las citas de AP se incrementaron notablemente durante el periodo 2010-2017. En 2018, el 66,67% de quienes pedían cita para médicos de familia la obtenían después de 24 horas frente al 26% en Pediatría y el 33,18% en Enfermería. La Consejería con esta medida aumentara estas de manera significativa, especialmente en los momentos de mayor demanda asistencial.
- El efecto sobre las urgencias hospitalarias es otro de las previsibles consecuencias negativas de esta medida. Es bien conocido que las urgencias hospitalarias aumentan en relación con la disminución de las consultas de AP y con el incremento de las demoras en las citas de estas. Analizando la tendencia en el Sistema Nacional de Salud puede calcularse que el impacto de esta reducción de horario será un aumento anual en 1 millón de urgencias hospitalarias de medicina y 200.000 de pediatría, lo que producirá un efecto devastador sobre unas urgencias que ya actualmente están saturadas.
- Otra consecuencia va a ser el aumento de la utilización de los recursos de la medicina privada de aquellas personas que no sean atendidas por el sistema público y que tengan recursos para permitírselo, fomentando la deriva privatizadora de la Sanidad Pública madrileña y las desigualdades en el acceso a los servicios sanitarios.
- Por fin es evidente que la medida pretende también en el medio plazo una disminución paralela de los ya escasos y recortados recursos de la AP de la Comunidad. Un calculo aproximado cifraría estos recortes en unos 1.700 efectivos de todas las categorías (especialmente en medicina y enfermería), cuando la situación es de carencia de profesionales y para que la AP madrileña pueda responder eficazmente a las necesidades de la población de precisa 500 profesionales de medicina mas, 5.000 de enfermería y 600 en el área administrativa.
En resumen rechazamos una medida que solo pretende deteriorar la AP madrileña, que tendrá repercusiones muy negativas sobre la accesibilidad de la ciudadanía y sobre los tiempos de demora, que aumentara la presión de las ya saturadas urgencias hospitalarias y que esta pensada para disminuir la plantilla de los trabajadores de la Sanidad Pública y para favorecer la privatización sanitaria.
ASOCIACION PARA LA DEFENSA DE LA SANIDAD PUBLICA DE MADRID
27 de Noviembre de 2018.
La ADSP rechaza una propuesta pensada para destruir la Atencion Primaria y privatizar la Sanidad Pública Madrileña
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