Blow on the table of the communities due to the traffic jam in Primary Care. Galicia and the Basque Country have signed an “open” manifesto in which they propose “urgent shock measures” to the central government for the incorporation of “more medical professionals” into health centers. In addition, they call on the rest of the autonomies and the Ministry of Health to “a joint commitment” to “carry forward with the maximum consensus” the “measures of state competence that have the key to solving this situation.”

In the manifesto they assure that “urgent shock measures are needed” within the “training competences of specialists that depend exclusively on the Ministry.” Specifically, they are committed to “ensuring that the MIR vacancy selection system does not leave empty vacancies, as has happened this year with 200 vacancies throughout the State.”

They also ask that the Emergency Medicine Specialty be created.

Thirdly, they indicate that an urgent increase in the number of places for specialized medical training in Family and Community Medicine is necessary in order to “face the generational change and the prospects of deficit. They also prescribe that the Government of Spain and the regional governments draw up an extraordinary training plan to undertake an increase in the training places in this specialty in the MIR calls for the coming years. And they estimate “the need for urgent expansion of an order of 1,000 annual training places in family medicine.”

Andalusia and Catalonia have already adhered to the text.

Here is the full text:


On June 15, we held a new meeting of the Interterritorial Council of the National Health System (CISNS) in which, once again, no point on the agenda addressed the great problem facing public health at the moment: the serious shortage of doctors Specialists in Family and Community Medicine who suffer from our primary care.

As was demonstrated in the time for questions and answers and in the conversations that we held before and after the meeting, the health officials of governments from different geographical parts of the State and of different political colors, this problem is manifesting itself with practically identical circumstances in all regional health services.

It is, therefore, a critical situation at the State level and that consequently requires measures at the State level that allow us to jointly overcome this situation. Not in vain, the Supply-Need for Medical Specialists 2021-2035 report, presented by the Ministry itself at the last Plenary Session of the Human Resources Commission of the National Health System, identifies the specialty of family and community medicine as the specialty with the worst prognosis of deficit.

Given this perspective, the Spanish State urgently needs to adopt shock measures that complement the 2022-2023 Primary Care Action Plan adopted by the CISNS last December.

The regional governments are actively participating in the development of this Action Plan, which includes measures that are on the right track for the medium and long-term reform of our primary care model, but which still do not solve our most pressing problem : the lack of specialists in Family and Community Medicine available for hiring. In addition, if we are not capable of resolving this situation, we compromise the viability of the implementation of reforms in the medium term, since the care overload, chronic fatigue, lack of time per consultation and the consequent lack of motivation that it generates, prevents the promotion of any initiative of the Action plan.

That is why, from the utmost loyalty and with the aim of jointly building solutions for the Spanish State, we want to convey a proposal of five urgent measures that are the responsibility of the Ministry that, if taken, could help to begin to resolve the situation that is currently under our attention. primary.

1. First of all, we have to guarantee that the MIR vacancy selection system does not leave empty vacancies, as has happened this year with 200 vacancies throughout the State. Given the exceptional circumstances in which we find ourselves, it is necessary to arbitrate exceptional solutions that make it easier to cover all the places offered.

In case of not returning to a face-to-face system, the telematic process must be carried out with maximum transparency, guaranteeing real-time knowledge of the places available at all times by the applicants. This change should be effective for the next MIR call.

In addition, it should be facilitated that the Order that regulates the FSE would allow that those places that, being awarded, finally do not take possession of them, resigning before signing the contract, would not remain unfilled.

2. Secondly, we must not continue to validate a training system that generates a growing displacement to other healthcare scenarios that have not yet been resolved. This generates a worsening of the chronic deficit of specialists in Family and Community Medicine that aggravates the problem of retirement in this area. We refer at this point to the need to create in Spain the Emergency Medicine Specialty. We must proceed as soon as possible to create this new specialty with preferential processing, as has been done a few months ago with Child and Adolescent Psychiatry, if possible before the next MIR exam is carried out.

3. Thirdly, it is necessary to increase, through emergencies, the number of places for specialized medical training in Family and Community Medicine so that we can face the generational change and the prospects of deficit that the report itself warns about. Ministry.

But in order to carry it out, we need a more flexible and more agile teaching unit accreditation system. For this reason, it is also necessary to approve, before the next MIR call, the revision of the regulations on accreditation requirements for teaching units in the specialty of family medicine, which, among other measures, should keep the call for accreditation open. permanently open.

4. Fourth, once this accreditation system and the specialty training program are reformed and allow a greater number of places to be accredited, it is necessary to do so through a call for extraordinary MIR positions in the specialty of family and community medicine. . The Government of Spain and the autonomous governments must agree on an extraordinary training plan to undertake a significant increase in the training places in this specialty in the MIR calls for the coming years to correct the deficit situation to which the retirement forecasts lead us . We estimate the need for an urgent expansion of around 1,000 annual training places in family and community medicine throughout Spain.

5. It is mandatory to develop the instruments that allow the National Health System to plan its offer more rigorously in the future, given that the MIR system is an instrument of state coverage in which specialists are trained in the different Autonomous Communities for all the national health system, the definitive creation of a State Registry of Health Professionals that can guide the training needs of specialists to prevent the appearance of deficits of professionals in certain specialties is essential.

6. We must promote and implement, through the State Action Plan, all possible measures that facilitate the competence development of the specialist in Family and Community Medicine, giving him time and space to recover his role as the backbone of the best comprehensive care. of the citizen. We believe that these proposals can serve as the basis for a major national agreement on shock measures to deal with a problem that is currently affecting professionals and patients throughout the State.

The future of the National Health System cannot allow us not to act with the utmost diligence in a matter of such paramount importance. Right now there is no more urgent problem or more pressing need in Spanish healthcare. For this reason, we must adopt a joint commitment to carry out with the maximum consensus the measures of state competence that hold the key to resolving this situation.