La gran preocupación y sensibilidad social en torno a la AP se puede ver en el éxito de la campaña Queremos el 25% por la AP JA , impulsada por Amnistía Internacional, Foro Catalán de Atención Primaria, Marea Blanca, Medicus Mundi Mediterrània, Médicos de Cataluña y Rebelión Atención Primaria, que ha recogido la adhesión de más de 100 entidades, 30 ayuntamientos y más de 2500 firmas individuales.
La AP sufre un déficit presupuestario histórico. Desde 2013 el porcentaje que se dedica es de alrededor del 15%, con excepción de 2020 que bajó al 12%. En cifras absolutas estamos hablando de 1.880 millones de euros en 2021, frente a los 8.031 millones de euros que se destinaron a la atención especializada. La asfixia económica de la AP impacta en los servicios que presta, que se han convertido en menos accesibles y de peor calidad, lo que tiene que ver con el empeoramiento de las enfermedades, los retrasos diagnósticos y el incremento de la mortalidad evitable.
Un 69% de los médicos y médicas de familia afirman estar agotados
La satisfacción de la ciudadanía ha caído un 9% respecto a los resultados de 2018 y entre los profesionales impera el desgaste y el desánimo. Según un estudio realizado por la Sociedad Catalana de Medicina Familiar y Comunitaria (CAMFiC) y el Instituto de Investigación en Atención Primaria (IDIAP Jordi Gol), un 69% de los médicos de familia afirman estar agotados y un 43% estresados. Una encuesta realizada por la Asociación de Enfermería Familiar y Comunitaria (AIFICC) pone de manifiesto que el 52% de las enfermeras se ha planteado abandonar la sanidad.
Elaboración propia basada en las memorias anuales del CatSalut
La situación es grave y puede empeorar más si no se toman medidas decididas y bien fundamentadas. Como puede verse en el gráfico, en los últimos ocho años se ha producido un incremento espectacular del gasto del Departamento de Salud, un 60%, que ha ido a parar en su mayor parte a la atención especializada. Esta inversión no se ha correspondido con mejores resultados globales en salud ni en la calidad del sistema, cuyas listas de espera son más largas que nunca.
Puede hablarse de si se necesitan aún más recursos o no, pero hay que reconocer que hay mucho margen de mejora en la gestión de los que ya tenemos. Hace unos años, se reclamaban 5.000 millones de euros para tener suficiente financiación. Desde entonces tenemos otros 4.000 y poco se ha notado. Los gastos que ha supuesto la COVID no justifican la falta de impacto del aumento presupuestario. El sistema tiene bolsas de ineficiencia que es necesario detectar y corregir desde el deber de la buena administración de los recursos públicos. Ineficiencias en servicios terciarios, en el uso de los fármacos, en pruebas y diagnósticos innecesarios o en mala distribución de tareas por colectivos profesionales o ámbitos asistenciales.
El sistema tiene bolsas de ineficiencia que es necesario detectar y corregir
Desde hace años están bien documentados los beneficios de la AP con investigaciones muy sólidas. Y se han identificado las características que se relacionan con estos beneficios, que son la accesibilidad, longitudinalidad, integralidad y capacidad de coordinación de todas las acciones que recibe la persona enferma por parte del sistema sanitario. Cuando una AP es fuerte en estas cuatro dimensiones logra disminuir enfermedades, complicaciones, muertes, ingresos hospitalarios y consultas a especialistas focales y servicios de urgencias. La reducción de enfermedad y de carga asistencial hace que el sistema en su conjunto sea más sostenible y que la inversión pública tenga una elevada rentabilidad social.
En los últimos años se han ido perdiendo los atributos definitorios de la AP, si bien de forma desigual según equipos y territorios. Es tan poco accesible que sólo el 35% de las consultas se realizan en 48 horas y ya no es la principal puerta de entrada al sistema, que ahora son el 061 o los servicios de urgencias. Los profesionales referentes, de cabecera, son cada vez más un espejismo del pasado porque muchas personas no saben ya quién es su médico o enfermera, y si lo saben, a menudo no la encuentran en la consulta. La visión de la persona y de su salud en demasiadas ocasiones se hace por partes, una profesional para cada problema. Y de la capacidad de coordinación basta con decir que algunos especialistas focales se niegan a visitar a enfermos derivados por su médico de familia.
El 25% que se reclama es primordial para la recuperación de la AP, pero por sí solo no será suficiente si no se acompaña de un cambio de paradigma que pase de un sistema centrado en los hospitales, la tecnología y los medicamentos en un sistema centrado en la AP.
El consejero Balcells ha anunciado un incremento presupuestario que se concretará en los presupuestos de la Generalitat que se están preparando. Y ya suenan cantos de sirena para atraer dinero en forma de nuevos equipos, nuevos programas y nuevas concertaciones, que se venderán como innovación necesaria. Pero se sabe que no todo vale, no todo es beneficioso, por eso las inversiones deben estar basadas en el mejor conocimiento científico, al desarrollar los atributos determinantes de la AP: garantizar la longitudinalidad, mejorar la accesibilidad a los referentes, potenciar los profesionales troncales y dar mayor capacidad de decisión a la AP dentro del sistema.
El 25% que se reclama es primordial para la recuperación de la AP, pero por sí solo no será suficiente
Las inversiones que necesita la AP son básicamente en profesionales y equipamientos. Los profesionales son el capital más importante de la AP, que con su «tecnología blanda» (el conocimiento de la persona y la comunidad, la escucha, el acompañamiento, la exploración física), son capaces de llevar a cabo las mejores intervenciones para cada persona y momento. De ahí que sea clave la longitudinalidad que pueden ofrecer sólo los profesionales con formación generalista, médicas, enfermeras y las a menudo olvidadas administrativas, que constituyen el «tronco» o núcleo de la AP.
Pep Martí denunciaba que se pudieron levantar en pocos meses cinco hospitales que han servido de poco (¡otra ineficiencia!) cuando hay una larga lista de CAP que llevan años esperando ser ampliados o construidos . El abandono de los equipamientos de la AP no tiene justificación y sólo puede explicarse por el escaso valor que se le da y por el escape de dinero hacia el sector privado, como es el caso de los servicios informáticos, el 061 o las centrales telefónicas.
Es la hora de la AP, de enfocar el sistema hacia ella, de darle oxígeno y poder clínico, de reorientar el papel de la atención especializada, de realizar cambios valientes que den la máxima utilidad a los 14.000 millones de euros que pueden llegar a contemplar los presupuestos de Salud para 2023. Ésta sería la verdadera innovación, poner el dinero donde más útiles son, hacer cambios consecuentes en la distribución de los recursos y poner la AP al frente del sistema. Porque, tal y como dice el cardiólogo Gonzalez-Juanatey : «Sin atención primaria liderando la medicina no habrá buena medicina en ningún caso».
2026 Catalunya Plural.
21 comentarios
Herbal medicine cure me from diabetes and lupus respectively
I was suffering from Lupus and Type 2 diabetes for over 8yrs. I tried many recommended drugs by our family medical Doctor. none was able to cure me , at last became dependent on saferoom and metformin due to the weakness and constant pains, i found that life was just sinking & there was no way of hope. i read about a herbalist from african Dr Ofua Ofure online i decided to consult him through his contact i got WhatsApp (+2347059497969) and (thegreatherbalhealinghome@gmail.com ) for herbal treatments, cause i have read testimonies of his herbal medicine curing several people from different disease and infections online, two days later, I make order for the herbal medicine and a week later i receive it at my house here in Manitoba CA, After some couple of days taking this herbal medicine, Things started to change, The symptoms started to decrease , a week later all symptoms were gone permanently .
At this point i was saying to myself i cant wait to complete the dosage as instructed by him, I became fully free from all the symptoms of Type 2 diabetes and Lupus, at the completion of the dosage after 21 days. i feel healthy again and i rush down to the hospital for check up and the test result confirmed it that am now free from diabetes and Lupus, off which i told the medical Doctor how it was possible and gave him the herbalist Dr Ofua Ofure contact. am sharing this here for anyone who is having health issues either it been diabetes, lupus or any other disease/infections, should please contact Dr Ofua Ofure for lasting solution.
Martha Ivana
I have had papillomavirus infection (HPV) for 3 months now. I have searched for cures everywhere. I have spent more money on the disease to make sure that it got cured. I was searching online on facebook, I got a review on how Dr Onokun cured People with herbs. So I ask him for help and the way he talks to me I believe in the medicine because other people are getting cured completely and I order the medication. I got it and I applied it on this disease. Within 14 days I was cured from the HPV thanks to herbal medication Dr Onokun send to me. If you need help he will be able to help you get rid of the Diseases, contact him on
Facebook page: http://www.facebook.com/naturaltreatmentcenter1
WhatsApp +1 424 738 1393
Website: onokunherbs.com
Dr Onokun helped me healed from hpv with his natural herbs i can give more info of how this good man cured my hpv completely, the herbs he offered me really helped me out that’s why i’m dropping this testimony with joy in my heart kindly massage this doctor to help you out no matter the disease you are suffering from. His email address:
Dronokunherbalcure@gmail.com
Website: Onokunherbs.com
I almost lost hope and faith after paying so much money for several failed IVF, SURROGACY and other medical fertility solutions. I almost cried my life out of me when I realized I was having nothing left with me, my marriage was almost gone. I have not conceived in the past 9years of marriage. I met a friend who was kind enough to introduce me to a spell caster “DR ONOBUN”, a powerful spell caster who she said had helped her with a lottery number that gave her more than a million dollars in the power-ball jackpot. At first, I resisted because I never wanted to have anything to do with magic or spell casting, but she told me that if this sorcerer could make her rich with accurate lottery numbers. She is confident that he [DR ONOBUN] can also restore my fertility. I thought of this for many days and finally gave Spell a chance to get my heart’s desire. After providing all that was required to get the spell done. Feb 15, 2024, was so great when I realized my monthly flow didn’t come as usual. That was when I felt the powerful spell of DR ONOBUN. Today I have my twins because DR ONOBUN powerful spell made it possible to become a mother. Thanks to him and his genuine powers, I do not know what your challenges or desires in life are right now. I’m very sure and confident that the DR ONOBUN spell can give you peace of mind. Contact him via email: [dronobunspiritualhome@gmail.com] Call or Whats-App him +2348051300199. I wish everyone success.
I got cure from HPV within 2 weeks of applying the natural herbs from Dr Onokun the great herbal healer kindly contact him and get healed via http://onokunherbs.com or Facebook.com/naturaltreatmentcenter1
I want to use this opportunity to testify of the marvelous work of Dr. GUBA and how he has helped me in curing my sickness and bringing happiness into my life. I can really vouch for Dr. GUBA in herbal treatment. I was suffering from Cervical Cancer and infected with HPV 16. I used to have unusual vaginal bleeding and painful urination. There was nothing I could do until a childhood friend introduced me to Dr. GUBA Remedies. I spoke with him and ordered his recommended medication which was delivered to me through DHL. Immediately I began using herbal medicine, and within a week I couldn’t feel any pain. It took me 2 weeks to finish the medicine and afterwards I was completely cured. I highly recommend that you order your herbal medication through Chief Dr. GUBA. Contact his email Drgubahealingherbs@gmail.com OR What’sApp/Call him at (+2348162388034 )
Hello, it’s a lovely morning here.. I am Vanessa Craig, and I am writing this article to inform everyone that just because we overlook certain information due to our lack of knowledge doesn’t mean it isn’t real. I am currently valued at more than £70 Million Pounds because I acknowledged this vital information. I had assistance from a man named Meduza I found online whose impressive testimonials about his spell work are legit and genuine. His lottery spell enabled me to win £65 Million Pounds in the lottery by providing me with the accurate winning numbers after he performed a lottery spell for me. I placed my full trust in him and followed his instructions without any hesitation and right now, I am proud to say that Meduza’s spiritual advice for winning the lottery is superb and outstanding. I am very grateful to him for his help. To learn more, reach out to him at
WhatsApp: +1 807 907 2687
Email: lordmeduzatemple@hotmail.com
Facebook: lordmeduzatemple
I am a very happy woman with the help of Dr Krish Spiritual who helped me restore my relationship with my ex husband. My name is Agnes Smith and I am from Alaska, USA. I met Dr Krish Spiritual through a testimony online and I never thought I would have my ex husband back after 4 years of separation. After my contact with his email, he told me not to worry and I would really be happy as I am now. Trusting in his words was the right decision for me. After 2 days, my ex husband called me saying that he wants to return back to me and live with me forever and I was very shocked. This made me believe that Dr Krish is really a very great spiritual man. Today, I am very happy to write this testimony about him and want others to testify to his power as I am currently happy in my restored marriage. Don’t waste time on that relationship problem. Contact Dr Krish Spiritual directly through his email at lordkrishshrine@gmail.com to help you solve that relationship problems in your marriage
Good day viewers, I wish to share my testimony with all of you. I have daily 9 to 5 jobs, but while I work, I try my luck at playing instant Lotto. On this particular day, I decided to seek help online regarding tips for winning the lottery, and I saw many individuals testifying about Meduza spells. I reached out to him and informed him that I needed help to win the lottery, and he clarified the process to me, stating that after he casts the spell, it will take 48 hours for him to provide me the winning numbers, which I accepted. I followed all his instructions, and he provided me with the numbers to enter the Lottery. After the draw the following morning, I received a notification on the Lottery app on my phone indicating that I was the lucky winner of $273 million on the New Jersey Lottery and I’m here to extend my heartfelt gratitude to Meduza. If you seek for assistance in any aspect of your life, WhatsApp Meduza via +1 807 907 2687 or Email: lordmeduzatemple@hotmail.com
THE BEST HACKER RECOVERY YOU CAN COUNT ON/HACKERZED NEMESIS.
I want to express my deepest gratitude for the outstanding job you did. I was truly amazed by your patience and dedication, especially as I waited for 24 hours. You delivered exactly as promised, and my patience was definitely worth it. I honestly didn’t imagine you could deliver so well, but you exceeded all expectations.
Words can’t fully express how grateful I am. Thank you so much, Hackerzed Nemesis! I wish I had more ways to show my appreciation. For now, the best I can do is spread the word and give you referrals.
Thank you once again
Whatsapp +1 (639) 395 4628
Email: hackerzednemesis001@zohomail.com
Web: Hackerzednemesis.com
Hello to everyone around the globe. I’m Jefferey Vargas from Malta. My girlfriend ended our relationship for seemingly no reason and I came to understand that my financial struggles may have contributed to this as a healthy relationship is difficult without money and aside from God, having more money is often seen as vital. For spellcasting, Lord Meduza is the right person to turn to. My girlfriend left me for another man due to my financial situation, but after connecting with Lord Meduza, he created a spell that not only brought my girlfriend back but also made me a lottery winner of €116 million by providing me with the 6 lucky numbers. Everything feels almost unreal but I assure you this is genuine and it’s occurring. My life is incredibly beautiful and I owe my deepest appreciation to Lord Meduza as his efforts are the epitome of excellence. I strongly encourage everyone here to reach him for help via email: lordmeduzatemple@hotmail.com or you WhatsApp this number +1 (807) 907-2687.
Using herbal natural remedy was what got me tested negative to HSV 2 after being diagnosed for years. I have spent so much funds on medications like acyclovir (Zovirax), Famciclovir (Famvir), and Valacyclovir (Valtrex). But it was all a waste of time and my symptoms got worse. To me It is very bad what Big pharma are doing, It’s also crucial to learn as much as you can about your diagnosis. Seek options reach out to: WORLD REHABILITATE CLINIC
A POWERFUL SPELL TO HELP YOU GET YOUR EX LOVER BACK NO MATTER HOW LONG YOU BROKE UP OR WHOM HE/SHE MAY BE WITH NOW DR BOB WILL HELP YOU GET THEM BACK CONTACT DR. BOB VIA WHATSAPP : ( +2349153314547 )
EMAIL: foreverspellcast49@gmail.com
Hello am STEPHANIE JANE from the united state, i read some testimony about Dr Bob on how he has helped people in bringing back there ex within 48hours i was just thinking if that was real, And decided to call a lady who made a testimony and also dropped her number, So i called her and ask her about Dr Bob she said Dr Bob is a trustworthy man and he his ready to bring back my lover for me, i was just so happy and a little bit relief that my lover will be back to me soon, Then i decided in contacting Dr Bob which i did, And before i could share him my problem he has already told me what i came for, And he said everything will be okay within 48hours that my lover will be back to my arms, So he said he would be casting the spell and that within 48hours my lover would call me, So i hoped so truly before the 48hours i got a call from a man who has left me for the past 1years saying he is sorry and he wants me back, i was happy and i said i also want him back, Then i traveled to Canada to meet him up, And he apologized for what he has done to me now he proposed to marry me and we are both preparing for our wedding soon, All thanks to the great and World best spell caster.
WhatsApp him directly :+2349153314547
I was diagnosed with an infectious lung disease four years ago. For over two years, I relied on antibiotics, inhalers, and various medications, but unfortunately, my symptoms continued to worsen. My breathing became more difficult, I suffered from persistent coughing fits, and my energy levels declined rapidly. The illness began to take over my daily life.Last year, driven by both desperation and hope, I decided to try an herbal treatment program from NaturePath Herbal Clinic. Honestly, I was skeptical at first. I had tried so many things with little relief but within just a few months of starting their herbal treatment, I began to notice real improvements.My breathing became easier The constant coughing eased up, Most surprisingly, my energy started to come backIt has truly been a life changing experience. I feel like myself again stronger and healthier than I’ve felt in years.If you or someone you love is battling an infectious lung condition and conventional treatments aren’t providing relief, I highly encourage you to explore the natural healing approach at NaturePath Herbal Clinic. Visit their website: www .naturepathherbalclinic .com
Hey guys, I can assure you that you will get your ex back within 48hours with Dr Kwale love spell just go to google & search for Dr. Kwale and read about him or you can send him a direct email at (Kwaletemple@gmail.com). I couldn’t share more details here and my testimony about how his spell helped me.. After he did his love spell for me, my partner came back after 2days. I can assure you guys that Dr. Kwale is a great spell caster.
I’m at a loss for how to express this. My sister welcomed twin daughters in July, and I found myself in a difficult financial and emotional state. I am known as Celta Vallecano, and during my quest to find quick cash, I came across an advertisement claiming that Lord Meduza provides precise numbers to those genuinely selected for freedom from financial struggles through his genuine spell. I felt compelled to take a chance, and ever since reaching out to Lord Meduza, my life has significantly improved.. As I write this, I am now a winner of €375 Million Euros after adhering to all the guidance and utilizing the MEGA MILLIONS numbers provided by Lord Meduza. I want to express my gratitude for the fact that assistance is indeed possible, regardless of how difficult your circumstances may seem. I highly recommend him in case you require any assistance. Simply WhatsApp +18079072687 or Email: lordmeduzatemple@hotmail.com and for more inquiring, visit: lordmeduzatemple.com
Thank you Dr Oseremen for what you have done for me. I am so grateful my lover is back to me and we are now living happy together. And also he can also cure you from any infection you’re diagnosed with trust me,You can get in contact with dr Oseremen for any kind of spiritual problems and needs help with getting your health back And you can get in touch with him viaWhatsApp: (+2348153622587)Emall: droseremen005@gmail. com
Thank you Dr Oseremen for what you have done for me. I am so grateful my lover is back to me and we are now living happy together. And also he can also cure you from any infection you’re diagnosed with trust me,You can get in contact with dr Oseremen for any kind of spiritual problems and needs help with getting your health back And you can get in touch with him viaWhatsApp: (+2348153622587)Emall: droseremen005@gmail. com
When the Bible states we are gods of the earth I felt this truth during my encounter with Lord Meduza the spell master. I’m Denzel Chau and I’m here to present the individual who transformed my life from poverty to becoming a multimillionaire Jackpot victor. I reached out to Lord Meduza for assistance with winning numbers and he successfully helped me after casting a lottery spell for me. I utilized the numbers to enter the Jackpot lottery and I was announced as the winner of $368,000,000. Acquiring the numbers from Lord Meduza took 72 hours and I want to express my gratitude publicly to him for his remarkable service to humanity and for deciding to assist me during my life’s lowest moment. Not everyone is meant to win the lottery, but with the assistance of Lord Meduza, you can achieve it. To reach him drop a message to his email: lordmeduzatemple@hotmail.com or Whats App +1 807 907 2687. To know more, visit: lordmeduzatemple.com and you’ll appreciate it later.
I got my man back with the help of Kwale Temple. Without delay I was able to get my man back after 6 months of break up, I got him back after 48 hours with the help of Kwale Temple. You can contact Dr Kwale on kwaletemple@gmail.com
My girlfriend ended our relationship for seemingly no reason and I came to understand that my financial struggles may have contributed to this, as a healthy relationship is difficult without money. For spellcasting, Lord Meduza is the right person to turn to. My girlfriend left me for another man due to my financial situation, but after connecting with Lord Meduza, he created a spell that not only brought my girlfriend back but also made me a lottery winner of €116 million by providing me with the 6 lucky numbers to play the lottery. My life is incredibly beautiful and I owe my deepest appreciation to Lord Meduza I strongly encourage everyone to reach him for help through his email: lordmeduzatemple@hotmail.com or you Whats_App this number +1 (807) 907-2687 or visit: lordmeduzatemple.com