When trust is broken it's very difficult to repair the ties that have been cut. That is what's happening with the regional Health Department, the Andalusian Health Service and the doctors who provide primary healthcare around the province of Malaga. After several years of cuts, very little recruitment, a decline in the quality of care given and a lack of time to practise medicine with the dignity deserved, the doctors who work in our health centres have started to feel increasingly disillusioned, frustrated, uncomfortable and impotent.
At the same time their resources, staff replacements and incentives to further develop their work have gradually declined. All of this can be summed up in one word: disappointment. The feeling that they are not receiving the support they deserve from the directors of the Andalusian public health service has made what was once a small snowball gather speed over time and cause an unstoppable avalanche. The consequence is the strike GPs and paediatricians offering primary healthcare started this week.
The Health Department couldn't or wouldn't take notice of the professionals' demands when there was still a chance of reaching a reasonable agreement. When it tried to stop the action and offer some improvements it was too late; they just came up against the indignation and disappointment of doctors who feel ignored and who now need to see to believe. Promises, as any slightly seasoned politician will know, are made to be broken, or to be kept only by halves. That's why the professionals who work at our health centres don't trust the points included in the strategy to renovate primary healthcare, a document that the Health Department wants to use to prove its intention of bringing an end to this dreary period. How can they be sure that these will be followed through?
It's a bit like the story of the boy who cried wolf. Peter had lied so many times about the arrival of the wolf that when it really did come no one believed him.
I don't know how long the doctors will keep up their strike for. It all depends on the capabilities of those who are negotiating in the name of the Health Department and whether they have the autonomy to accept the demands that the doctors' union is putting on the table.
The conflict, sooner or later, will have to be solved. Let's hope, for all our sakes and especially the patients', that the dialogue between both sides will be productive.
As the doctors' demands are fair, the Health Department has an excellent opportunity to confirm that its interest in improving primary healthcare is genuine.