Wages are slashed and waiting lists grow as Catalonia’s health cuts biteBMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d6466 (Published 07 October 2011) Cite this as: BMJ 2011;343:d6466
The government of the Spanish autonomous community of Catalonia, which serves 7.5 million people, is cutting the salaries of 40 000 public health professionals in the region’s eight university hospitals and more than 300 primary care centres to save €70m from the regional health budget till the end of 2011.
The savings will be made by halving staff’s Christmas bonus of between €420 and €1120 and delaying payments of other entitlements, such as out of hours and on call payments, which will be paid after 60 days, instead of the usual 30 days. More than 12 000 doctors, 18 000 nurses, and 10 000 other health workers employed by the Catalan Health Institute (Instituto Catalán de la Salud) are affected.
Similar cuts are affecting health professionals from other hospitals working in partnership with the public system, such as the Hospital Clinic of Barcelona, where workers have agreed to forsake certain overtime payments to avoid layoffs.
Antoni Gallego, general secretary of Metges de Cataluya, the main union of the Catalan health sector, told the BMJ that Catalan doctors are “shocked and outraged.” They have already has a 5% wage reduction imposed on them by the national ruling party, the Socialist Workers’ Party (PSOE), which affected all public sector workers since June 2010.
These measures add to several others implemented by the regional government of Artur Mas, from the Catalan nationalist party Convergència i Unió (CIU), since he won the regional elections in November 2010. The administration agreed a 10% reduction of the healthcare budget in the first weeks of its mandate intending to save a total of €1000m by the end of 2011. Since then about a third of hospital beds and 40% of operating theatres have closed, emergency care has been reduced overnight in many primary care centres, and payment to drug providers has been delayed from 35 to 65 days.
According to regional unions health centres are already feeling the pressure. Between the end of 2010 and June 2011, surgical waiting lists rose by 23%, (from 56 670 to 69 967), the highest number since June 2004. Average waiting times also rose by 4.4%, from 4.1 to 4.2 months.
Speaking at a press conference on 4 October Boi Ruiz, head of the regional health department, said, “Waiting lists will grow even more in the second semester.” Although a regional law limited maximum waiting time to 6 months for the 14 most common interventions Mr Ruiz announced that the limit will be extended to 12 months for certain operations and that urgent care will be prioritised according to clinical criteria.
Dr Gallego said that the cuts are affecting the quality of care because 4000 healthcare staff have not been hired, there are fewer consultations, and diagnostic times are increasing.
Although unions are still negotiating, the alternative given by health authorities has been to fire 1500 temporary workers.
Staff have been protesting. One meeting between unions and health bosses had to be postponed when about 500 protesters dressed in white coats started demonstrating. “We cannot rule out a general strike,” said Dr Gallego pointed out.
To try to ease the situation some surgeons from the Bellvitge Universitary Hospital offered to operate on cancer patients for free. However, hospital management said in a press release they had to turn down the offer because “unfortunately, the cost of surgical interventions is not only the cost of surgeons, but all other professionals, materials, drugs, and auxiliary services.”
Cite this as: BMJ 2011;343:d6466