Minister of Health since the departure of Junts from the Government, in October, Manel Balcells (Ripoll, 1958) fights against the lack of budget, the discomfort of doctors expressed through a massive strike, waiting lists, the lack of professionals or the aftermath of the covid. He defines himself as a lifelong independentista and defends the patient’s right to be treated in his own language.
What are the main problems of the system today?
One, underfinancing, which is a chronic issue. Two, the fatigue of all the professionals. And, three, the adaptation to the demographic and sociological change that we have.
But the aging of the population is not something sudden.
It has involved more chronic, multipathological pathology. In addition, we must add the new addictions in youth or the emotional well-being and mental health problems of post-covid adolescence. Addictions to screens, eating disorders, suicide attempts… are things that we never imagined before.
To what extent does this situation place the system against the ropes?
There are signs of discomfort on the part of the professionals and on the part of the citizenry due to the difficulties of accessing both primary education and specialties. The covid has taken its toll and makes managing the situation highly complex, but the system is not on the ropes. He’s not in the ICU. Needs upgrades, a boost, transformations, however it is a top of the line system.
Are doctors and nurses well paid?
We have already raised salaries, but they are still not quite well paid. The improvement is substantial, compared to how the concerted healthcare was, which brings together more than 60,000 workers. Now we are working on the ICS agreement, in which the improvements will also be substantial.
With that there will be no more strikes?
I hope and wish not. Here a margin of confidence has been generated with a work group between the doctors’ union, the medical associations and the Servei Català de la Salut that is addressing a set of issues that basically affect the work overload of professionals.
How does the new system accessibility plan help?
The changes in circuits and organizational approach are equivalent to the incorporation into the system of 300 doctors and 100 nurses. It’s enough? No, but it is essential to reduce care burdens and improve quality for professionals, which in turn has repercussions for patients. Thus, they have accessibility to face-to-face visits in less than five days and they have more accessibility to complementary tests and specialist care, now with a wait that seems inadmissible to me.
The maximum of five days of waiting for primary care, when can it materialize?
Today, any citizen who needs urgent primary care has it in 24, maximum 48 hours. The scheduled, routine visit, one hundred percent of the citizens who need it will be attended in a maximum of five days. It is 70% of the people who ask for it. We will achieve this because the set of measures has been extensively studied, due to patient-physician ratios, because we introduce the case manager nurse and the administrative staff as part of this healthcare team. In addition to incorporating technological elements. These measures should allow us to make it a reality in six months. There will be specific solutions for each location.
Do we make good use of hospital emergencies?
They could be used better. If we give primary care the problem-solving capacity it needs, if we do the necessary dissemination of the CUAPs (ambulatory clinics with emergency services), which are very decisive, and we also do something else that we are starting to do, which is integrated social care and home healthcare, the pressure on emergencies will be frankly much less.
Telephone support has proven to be a failure.
We have to rethink the use of telephone service, e-consultation or videoconference. There is a large digital gap between older people who do not access it and among young people who thought that e-consultation could replace face-to-face consultation, and it is not that either. Therefore, a reconsideration of e-consultations, a reconsideration of telephone access, which must respond and, above all, they cannot leave you stranded and you must feel well cared for. In six months we have to start noticing that all this is changing.
How do you address the lack of professionals?
There is a problem with family doctors that is not solved by having more doctors because there are places that cannot be filled. We have to generate prestigious and economic incentives to be more decisive. We are working on this. In other deficient specialties, such as paediatrics, radiology or anesthesiology, we are proposing new organizational models through which professionals can move between hospitals.
An acquaintance requested an appointment in November for a stomach ultrasound and they gave her an appointment for July.
This can not be. Examples like this are what prompt us to remove the system. That is why we endowed the accessibility plan with 110 million euros, that is why we are analyzing where and why it happens.
The deficit is covered by professionals trained abroad.
They are welcome. What we have to do is certify that they are well trained and give them specific training for the healthcare model, so that they can provide care in Catalan. It is an essential requirement of the system. From the Department we must guarantee the quality of care.
Do you regret your reaction against the Tiktoker nurse even though President Aragonès called the case anecdotal?
What I said I stand by. I found it intolerable for many things. Not only because of the content [he referred to the “whore oppositions” and the “fucking C-1 of Catalan”] but also for making a TikTok video in the workplace, with the ICS gown, without a mask… What I said it is very measured and I ratify it.
Are you worried about computer attacks like the one affecting the Clínic?
These cyber attacks are terrorism. These people who have attacked the Clínic have gone to attack the health care of almost 1.2 million people for whom it is their reference hospital and who are people who are undergoing extremely serious treatments. They have been some terrorists who apparently are very expert and are, let’s say, one of the bad guys. Bad people who are going to do harm and are going to look for money.
