The Welfare State is an inseparable element of democracy. The public, universal and free provision of fundamental services and rights for the development of a full life is one of the greatest historical achievements of humanity. In fact, the weakening of the social system in recent decades is closely related to the crisis of democracy.
Welfare states have to face multiple challenges, such as population aging and the multiplication of people who need assistance, but without a doubt there are three elements that continue to be the backbone of any prosperous society: education, social policies to protect the most vulnerable people and public health. The objective of this article is to expose what in my opinion is a worrying health situation on the islands.
Let's look at some data. Perhaps the most eloquent is the poor assessment that the canaries themselves give to their health. According to the CIS health barometer, the rating of six out of ten that the Canarians give to their health system is the second lowest score in Spain, only worse than that of the Andalusians (5,9).
And it seems that there are sufficient reasons for dissatisfaction. The average time that a patient waits for an appointment with a specialist is 122,8 days on average, the second worst figure in Spain and which represents an increase of more than 20 days in one year. For surgical interventions the situation is even worse, a Canarian patient waits 153 days on average for an operation of this type, which represents an increase of 9 days compared to last year. Note that the data refers to an average, the reality is that in many specialties and surgical interventions the waiting time can be between six months and a year. The indicators of mental health care are from the court of duty. Overcrowding in hospital emergency rooms is inhumane. We see that the figures not only indicate a bad situation but also a continued deterioration of health care on the islands.
There are currently 36.395 patients on waiting lists in the Canary Islands (almost 3.500 more than a year ago) and almost 145.000 waiting for a consultation with a specialist. It is an unsustainable situation and its solution has to become the absolute priority of the Government of the Canary Islands, because the consequences on public health are devastating.
However, primary care is an area where the figures are even more serious due to their consequences. Primary care in health centers is one of the foundations of our system; if this first step fails, referrals to a specialist cannot be made and the entire chain of care begins to fail. According to data from the Association for the Defense of Canarian Public Health (ADSPC), only 10,8% of patients get an appointment in primary care within 24 hours and the wait is usually about 7 to 10 days, but it can be longer. 14 days in some cases. This also has the consequence that some ailments become more serious and emergencies begin to be saturated.
The association in defense of public health services has been insistently denouncing the shortage of health personnel to deal with this situation. They demand that the current quotas be lowered to go from 1.500 patients per family doctor to 1.300. They also demand an end to the temporary and precarious nature of health personnel, who in more than 60% do not have a permanent position, and who are chaining temporary contracts in many cases for more than 10 years.
The consequences of the discredit of the public health system are already beginning to be seen. According to a report on the situation of specialized care in the autonomous communities, 54,7% of the population prefers to be treated by a specialist in private healthcare rather than in public healthcare. And the state of public health forces the middle classes who can afford it to take out private insurance (their hiring does not stop increasing) and leaves the poorest families to their fate, who see their quality and life expectancy drastically reduced. . If we combine this with the growing concerts between public and private healthcare, we are faced with a scenario of gradual and covert privatization of our public healthcare system.
I would also like to dwell on a fact that sometimes goes unnoticed but that has a brutal effect on the health system and that is the worrying public health data, especially with regard to overweight and obesity. 24,5% of the population between 6 and 9 years old in the Canary Islands is overweight and 18,5% is obese. We are the second autonomous community in Spain with the highest prevalence of childhood obesity. In the case of adults, 17,5% of the Canarian population over 18 years of age is obese and 39,87% are overweight.
Furthermore, this is not an individual problem of people and/or families, but rather it is a phenomenon that is directly linked to poverty. People (especially boys and girls) with lower incomes suffer from this problem to a much greater extent. It is the consequence of the lack of economic resources to access quality food, lack of time to dedicate to food (as a consequence of precariousness), lack of education in nutritional matters, etc.
All of this implies that the incidence of ailments related to overweight and a sedentary life (hypertension, cholesterol, diabetes, coronary heart disease, cancer, etc.) will be very high, especially from certain ages onwards, which undoubtedly implies a greater demand for health services to alleviate these consequences, which in many cases are chronic.
We need a great pact for health and public health in the Canary Islands. As defended by the Association for the Defense of Public Health in its manifesto, universal and quality Public Health is one of the pillars to ensure solidarity and equity within a society, and even more so within an impoverished and unequal society like the canary.
This pact has to be broad and have a comprehensive view. A shock plan must be drawn up to put an end to waiting lists, provide adequate staffing to the health system, ending precariousness and temporary employment, stop the galloping growth concerts with the private sector, reinforce primary care and build adequate health infrastructure to decongest the system (the south and southeast of Gran Canaria need a regional hospital, for example).
But it is also important to assume the social dimension of health, investing in prevention, in nutritional education, with a network of public school cafeterias that provide quality food based on our local farmers and ranchers. We must promote grassroots sports, even in schools, and reinforce public sports infrastructure in neighborhoods and towns, with low prices or free prices for the lowest incomes, etc., etc.
In short, we need a collective commitment to address a complex problem but one that has a great impact on the lives of the Canary Islands. The alternative would undoubtedly mean a worsening of public health data, a breakdown in a fundamental piece of our Welfare State and an increase in inequality.
