Wednesday, February 04, 2015

Flu Collapses The Health Service

In the middle of January, the nursing union in the Balearics was complaining about the saturation of the emergencies unit at Son Espases hospital. Thirty patients were said to be waiting to be admitted to the hospital at a time when cold weather led to increased pressures being placed on the health service. The minister for health, Martí Sansaloni, insisted that all beds in all hospitals were open and that fifty additional medical staff had been drafted in to help tackle what was described as a temporary peak in demand.

There is now, three weeks later, another peak. It is one caused by flu. At the time when the nursing union was complaining about the overload in emergencies, flu entered the Balearics, specifically during the week from 15 January to 22 January. It was later than usual, but now it is here, the peak in flu cases in Mallorca will be from now until 12 February. And this peak is much greater than is normal. Between 22 and 29 January, it was already three times more. There is something of a flu epidemic, though it will be a few days before the number of cases is being revealed, and with the cold weather for this week an additional factor, hospital emergency services will be even more hard stretched.

According to records, the year 2001-2002 was when the Balearics registered the greatest incidence of flu - 322 cases per 100,000 people: approximately 3,500 in all. By no means all flu sufferers need emergency treatment and there are doubtless some who clog up the emergencies unnecessarily; it is predominantly the elderly who do require this treatment and with the flu peak only just starting, emergencies already can't cope.

The incidence of flu in Mallorca is typically lower than elsewhere in Spain. This, so it is argued, should mean that demand can be adequately met, but, and despite Son Espases being one of Spain's most modern hospitals, the health service seems to be caught out every year by the peaks. Of the public hospitals on the island, they are all struggling, with the exception of Manacor. Regardless of the comparative number of cases across different regions of Spain, the Balearics is a region identified in a report by local ombudsmen which points to an impairment of patients' dignity because of the "repeated examples of saturation" and so to the unacceptable situation whereby patients are kept in corridors on stretchers and are also subject to potential violations of rights to privacy and to health information confidentiality.

Of solutions to this regular crisis, one that is being considered is to transfer patients to private hospitals and to convert the old hospital of Son Dureta into some form of residence for elderly patients. The problem with both of these is finance, and as was seen towards the end of 2014, it was a lack of finance which caused local health centres to suspend appointments. The health ministry blamed a computing failure, but very few people bought that argument, including many health professionals who were not brought in to cover for sick leave or holidays, which was the real cause of the appointments suspension.

Using Son Dureta would clearly be advantageous, but getting any agreement on what to do with the former hospital is proving to be stubbornly difficult. Sansaloni raised the idea of a commission to look into its future last November, which was strange as you might have thought that there already was a commission and some idea as to what function Son Dureta would have, if any. Sadly, when Son Dureta was closed there was no plan in place. It has pretty much just been abandoned.

With the new Son Espases and the other public hospitals, it was felt that there would be adequate supply and generally speaking there is. There have been rumblings about lengthening waiting times for operations and other treatments, but by and large the health service does cope, except when there are the peaks as at present. A further solution to the current situation is that operations should be postponed, so freeing up beds, but the unions maintain that this will not happen because of the imminence of the elections. Yes, but then saturation in emergencies doesn't do much electoral good for the government either.

If it all boils down to financing, then the regional government can argue, with some justification, that its overall funding from Madrid is inadequate. It is inadequate, but  the specific budget for health in the Balearics is the biggest of the lot (1,181 million euros in 2015, a 10% increase) and, surprisingly enough, it is bigger than regions with higher populations - Andalusia, Catalonia, Valencia, Galicia, Madrid all have lower health budgets. So, maybe financing isn't the issue. Instead, perhaps it is just one of better management. In Manacor, they cope by working longer hours and also by adopting rigorous procedures for admission and discharging.

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