The pandemic and the agony of primary care

Andreu Segura
 

I thank Xavier Blancafort for the photograph, as well as 

his suggestions, I also thank Laia Riera and Vicente Giner.

COVID-19 has been a real stress test for Spanish health system as a whole, especially for primary care services (PC) ‒particularly in the most advanced phases of the pandemic‒ and public health facilities (SP) in general, although these are rarely the object of evaluation, although we have all paid for their limitations and deficiencies. For some time now, both levels of the national health system have been languishing as illustrated - although, in my opinion, this is not the worst - the continued decline in the proportion of the public health budget that corresponds to them, especially in the SP, which does not reach 2% of the total. Of course, the proportion of spending is not a sufficiently precise indicator of the efficiency neither of the efforts nor the value that its activity contributes to improving and maintaining the population health. That is why I consider the absence of health strategies more serious and, even worse, healthy public policies, since the appeals to health in all policies have been above all rhetorical. Healthy public policies should naturally include health policy, so that it could effectively contribute to the collective promotion and protection of community health, as one more element along with educational, labour, urban, economic policy, etc.

More primary care, a disruptive innovation

Jordi Varela
Editor

 

One of the bad news that 2020 brought has been Clayton Christensen's death, a Harvard Business School professor who developed the theory of disruptive innovation and who already deserved the care of our blog with the commentary on the book The Innovator's Prescription, where the author analyzes the reasons why healthcare systems are so refractory to innovation. As I believe that the effort that Christensen has made to adapt his theory of innovation to healthcare is worth it, as a tribute, I have recovered a video of a lecture he gave at King's Fund in 2013.

Do we really want to change things? About Kotter’s 8 steps

Jordi Varela
Editor

 

Our iceberg is Melting is a fable that illustrates very well that detecting problems is not the same as wanting to fix them. Fred, an observant penguin, realizes that his iceberg is cracking, a matter that will be catastrophic for the entire colony living obliviously to the problem. The author, John Kotter uses the fable to unravel the 8 steps that any individual, in Fred's circumstances, should follow if they want to save the penguin colony:

The health care system of the future is here now

Josep Mª Monguet
 

Who took the chestnuts out of the fire?

In difficult moments, everything is shown as it is and that is when authentic leadership can be identified. In this sense, a revelation of the recent stage, which we could already intuit, is that health care professionals have shown an exceptional capacity for response. It’s not a common occurrence in the public system. Despite the multiple deficiencies faced, they have assumed the difficult part of the situation and overcome it.