The University Hospital of Móstoles, since the beginning of March, closes the operating rooms to Cal and singing in the afternoon. It has not been a decision of the center’s management, but a kind of strike of the professionals of the surgical service and anesthesiology, who have unanimously decided to stop working at that time. It has been an extreme decision, which “has not been taken from one day to another”, with which they try to attract the attention of management and the sermas with respect to these overtime and work overload ,. With the so -called management pacts, or peonadas, the Community of Madrid, for more than a decade, has tried to give way to the long surgical waiting lists in public hospitals at the expense that the staff work extra hours, either in afternoon or weekend shifts. From the Ministry of Health, they clarify that the suspension of extraordinary surgical activity in the afternoon in this hospital “has had a limited impact on care dynamics.” Instead, professionals assure a “rise like foam” and fear that the solution will be absorbed.
The Hospital Management has already pointed out to the members of these services, according to several professionals consulted by this newspaper, for not prioritizing the “commitment” to their work against “enrichment.” However, for Fermín, one of the surgeons in this kind of strike whose real name prefers not to reveal for fear of the directive’s reprisals, there is no greater commitment than their classmates demonstrating by making up to six guards a month and working extra hours. “We must bear in mind that we made those afternoon shifts after working in the morning,” he clarifies. Workers denounce that the management system of management pacts is “unequal” and “little transparent” according to the hospital and ensure that in Móstoles the price per hour is 30% or 40% below other centers.
Since the end of last year several workers of the surgical service and anesthesiology asked the directive of the Móstoles hospital to increase the payment of the afternoon hours according to the IPC ascent, Elena, an affected worker who does not want to reveal her real name does not want to reveal. “It was a rise from 20 to 30 euros in the afternoon, no more,” he says. However, both the hospital itself and the Sermas management began to give long saying that the current system is “adequate and fair,” says Elena, and became little more.
However, a spokesman for the Ministry of Health ensures that work is being done on the review and update of a centralized catalog of procedures and evidence included in the management pacts, “taking into account the increases in salary costs and other factors to continue improving the distribution of resources.” And he adds that, also, a “homogenization of criteria and rates between centers, which avoid inequalities between hospitals” is carried out and that it works on “the standardization of the distribution criteria of the amounts assigned for the performance of extraordinary activity”.
“Our base salary is very low throughout Spain and we have to complement it with these activities,” confirms Juan, another of the surgeons of the Móstoles hospital, whose name prefers not to reveal. However, it clarifies, there comes a time when the overload is so much that “or you leave the hospital, or you stay and do something.” If since October 2024, a large part of the surgical service workers stopped doing these peonadas, the definitive closure of the operating rooms occurred in March with the unanimous decision of the anesthesiologists – whose work is transversal to all specialties – to join the rest.
From the Ministry they report that, in addition to the homogenization of the catalog, “the possibility of increasing the resources assigned to management pacts is being evaluated,” but has not given more details about it. Increasing the payment of the afternoon hours will improve the current situation of doctors, but this is not the definitive solution for the service deficit, clarifies Mar Láinez, Urgenciologist and delegate of Amyts at the Móstoles hospital. “Surgical activity should be done completely within the ordinary day,” he says. “It is not that we defend the management pacts, but that we want, if they already exist, at least they are regulated and paid as it should.”
The waiting list grows in the ‘low cost’ health
The surgical teams of the Móstoles hospital that have stopped are those of general surgery, traumatology, urology, ophthalmology, dermatology and anesthesiology. All operations of those specialties that were previously carried out in the afternoons, now, according to gravity, are repaired in the morning shift or are put on the waiting list. “In the morning we used to operate oncological tumors, which unfortunately we have many and are more complex, and in the afternoon other minor pathologies, such as hemorrhoids,” explains Juan.
The Ministry of Health notes that the surgical waiting list in March is 1,613 patients, with a delay of 43.7 days, add that 87% of cases correspond to interventions with normal priority, 7% are preferential and 6% oncological. “These figures reflect the correct adaptation to the priority criteria, to reduce, even more, the waiting times,” says the spokesman.
However, Juan estimates that in the last month he has stopped attending about 90 patients only in the area of general surgery. Although the official data on the waiting list are not yet very striking, the workers know that every day that passes with the operating rooms closed in the afternoons, the delay accentuates. “We don’t know what they have done with them [los que no han podido ser intervenidos]. That will create a waiting bag that will have to leave somewhere. ”The fear of doctors is that the solution is the usual: passing work to private health.
In Móstoles there are two hospital centers of Sermas, the University Hospital of Móstoles, 100% public, and the Rey Juan Carlos Hospital, which is public but managed by the Quirón Group. When the waiting list accumulates in the first, one of the solutions is to send the patients to the second ,. It is what is called the outsourcing of the service, or system of free choice in case it is the patients themselves who decide to move from one center to another. With this procedure, the citizen loses that it cannot be attended in their reference hospital, but the private health companies that are enriched with the decline of the public win. Juan summarizes it differently: “In Móstoles we have a private management health with a new and fast hospital, and then a health low cost, Where we do the same, but they pay us less. ”
