Twenty years ago, after too many temporary contracts and too many hours delivering pizza to pay the rent, Joan Pons finally abandoned his dream of working as a nurse in his native Spain.
“I’d love to have been able to stay,” he says. “The problem was that I finished my nursing degree in 1997 and couldn’t find any stable jobs. There were daily contracts, or ones for a week, where they used to sack me on a Friday and hire me again the following Monday so that they didn’t have to pay me for the weekend.”
After seeing a recruitment advertisement for nurses to work in the UK, Pons left his home in Catalonia, flew to Luton airport and then began nursing in Sheffield. He only intended to stay a year but now two decades have passed, and Pons has put down roots, has a family and is a senior charge nurse at Sheffield Teaching Hospitals NHS trust.
He is one of more than 4,500 Spanish-trained nurses and midwives working in the UK. Their absence is being keenly felt in Spain as the country experiences a second wave of the coronavirus that is once again revealing chronic staffing problems in a public healthcare system routinely held up as one of the finest in the world.
Isabel Díaz Ayuso, the regional president of Madrid – whose handling of the pandemic in the worst-hit part of Spain has been widely criticised – recently admitted the scale of the medical shortfall, while the central government has approved measures to draft 10,000 more health professionals into the fight against the virus.
Graph
“Spain has an obvious problem when it comes to doctors and nurses,” Ayuso said on 21 September.
“I understand the primary healthcare situation and I’m absolutely convinced that, above and beyond the reinforcement programme, a lot more needs to be done. We need more doctors and we can’t fool ourselves about that. There aren’t doctors in Spain and there are various reasons for that.”
Tomás Cobo, vice-president of both Spain’s general medical council (CGCOM) the European Union of Medical Specialists, offers a slightly different analysis.
“The problem isn’t a lack of doctors; the problem is the lack of places for specialist training,” he says.
Cobo points out that there are a limited number of training places up for grabs through an exam, meaning there are about 7,000 Spanish doctors who are trained doctors, but who can’t access their specialist training.
One solution would be to create more places so doctors can train in their specialisms and then work in Spain’s national health system.
The second problem, he adds, is a familiar one: “Contracts and salaries are much worse here in Spain than they are elsewhere in Europe. That’s why you have a flight of doctors who leave once they’ve had their specialist training, or before they’ve had it.”
Importing doctors from abroad is another answer, says Cobo, but checking the skills and qualifications of doctors from outside the EU can be a slow process.
The pandemic has laid bare the need for more GPs and nurses, who have been on the frontline of both waves.
“There was a lack of doctors in primary health centres in Madrid before this whole mess with the pandemic even started: we were short of 400 GPs and 150 paediatricians,” says Ángela Hernández Puente, a surgeon and deputy general secretary of Madrid’s Amtys medical association.
The pandemic, she adds, has made only things worse and she estimates the region now needs 750 more GPs and at least 200 more paediatricians.
“The reasons for the lack of staff go back a long way,” says Hernández Puente.
Promised improvements to working conditions, made years ago, have yet to materialise in Madrid. And, faced with poor contracts and the prospect of having to see 50-60 people a day, many GPs take up more attractive posts in other Spanish regions, or head overseas.
“How is a shift here, seeing 50 patients going to compare with one in Sweden, where they’re going to see 15-25 patients at the most?,” says Hernández Puente. “And once you’ve gone abroad, you’re not likely to come back because of the pay.”
The current situation comes as little surprise to the Satse nursing union, which has spent years warning of the lack of national health nurses.
According to Satse spokeswoman María José García, the country needs 88,000 more nurses: 72,000 of them in hospitals and the rest in primary healthcare.
“What we could do straight away would be a plan to encourage people to return from abroad,” says García.
“We’ve invested in training some of the best nurses in the world but thousands of them are working outside our country so it’s neighbouring countries that are reaping the benefits of that investment.”
She also highlights job stability and pay as key factors in the drain.
“A nurse in Spain can be offered a contract for a day or two, or maybe a week – or, if they’re very lucky, for a fortnight,” she says. “But what they’re doing in other EU countries or in Australia or Abu Dhabi, they put a six-month minimum contract on the table. But it can also be a year, two years, or even three.”
Joan Pons has been mulling a return to Spain since Brexit – as it seems, have many of his compatriots. In March 2016, there were 7,260 Spanish-trained nurses and midwives in the UK; by March 2020, the figure had fallen to 4,464.
Were he to be offered a job similar to his current one, he might consider working in Spain during the week and flying back to England at the weekend. But Pons doubts he would get as good an offer back home.
“What makes me angry is that things haven’t changed in Spain in 20 years,” he says.
“When Ayuso was saying we didn’t have clinical staff in Spain, I just got very angry. We do have them, but we’ve had to leave because they’ve given us shit contract after shit contract.”
Свежие комментарии