PRIMARY IN SPAIN 
few months ago I wrote a short text about what primary care within a health system like ours, and served as an introduction to the thesis of a famous (I had nothing to do with health, and poor did not know what to put on AP).
As I could not do anything more with that text, and I think the end was decent, hereby publish it here to see if you like.
PRIMARY HEALTH
The Primary Health Care (PHC) has become its own merits a pillar of the health system of all developed countries. The World Health Organization (WHO) and health officials from all governments have demonstrated on numerous occasions that it is profitable to invest in APS to improve the well being of a population, both short, medium and long term, in fact used the degree of organization of health systems as an important marker of a country's development. At a time like the present, where the sound management economic resources has become a matter of first line, especially in the health sector, which consumes so much of these resources, progress and improvement in the response capacity of the APS has proven crucial for a sustainable improvement and rational health of individuals.
The APS was described in the International Conference of Alma-Ata in 1978 as "essential health care technologies and methods based on practical, scientifically sound and socially acceptable methods available to all individuals and families in the community through their full participation and at a cost that the community and country can afford in each and every stages of development in the spirit of self-reliance and self determination. It forms an integral part both of the national health system, which is the central function and main focus, and the overall social and economic development of the community. "
This definition includes several of the fundamental concepts governing Primary Care:
a) essential health care: Universal and undeniable to all individuals without distinction of origin or condition (including people without legal permission to reside in a country, detainees, refugees, etc.).
b) Based on methods and technology: Logical and manageable in consultation with a health center. It would not make sense to include a magnetic resonance between the portfolio of APS to give much information about the patient, because the apparatus required is excessive.
c) Scientifically founded: Any action taken in APS should be justified by the scientific expertise available at the time, in all cases adapted to each site and situation specific.
d) Socially acceptable: The methods should not be unnecessarily invasive or subjecting the patient to inappropriate situations.
e) Making available to all individuals and families in the community: The APS is not limited to issues specific to the individual but also of his family as a unit and the community in which they reside, whereas these three elements are in themselves cause and resolution of conflicts that concern them.
f) By full participation: Patient and non-taxable health procedures, but central and crucial part of the process, taking in each case the final decision on specific approaches, and therefore the responsibility they shared with their doctor.
g) A cost that the community and country can support: You're worth revolutionary strategies that can not be done. The best procedures, and the most resolute, are those who can pay.
h) In every stage of its development: The APS is the individual during the time of his life, taking charge of all health issues that concern both the biological and psychological terrain and social. This continuous monitoring, in most cases for years or even decades, creating a bond of trust and understanding between primary care physician and the patient (and therefore with all their family and social) to facilitate their relationship.
i) Primary care is the central function and main focus of the NHS: Patient care is organized so that the APS becomes gateway to the individual to the health systems of their country, with physician figure of the family as the primary evaluator of the case, deciding if you are able to solve it by itself or requires a specialist opinion on the matter, a situation in which the patient is transferred to the next level of care, specialized care (either in his local hospital or specialist consultations that apply). The APS solves about 90% of queries that are presented. This chart differs and the one used in the private health insurance, in which the individual has free access to specialists who want (but then your problem is not that specialist subject, for anyone who does not pass through the filter).
Primary care as we know it today stems largely from the WHO program "Health for All by the Year 2000" theme of the Conference of Alma-Ata, 1978, and the final declaration consists of ten-point non-binding:
1) Definition of health: "Health is defined as a state of complete physical, mental and social, not merely the absence of disease or ailments, being a fundamental human right, and making the search for the highest attainable standard of health in the most important social goal worldwide, whose realization requires the participation of other social and economic sectors in addition to health. "
2) Equality: "The existence of a wide disparity in the quality of the health of people, including developed and developing countries and within countries is politically, socially and economically unacceptable and therefore a concern common to all countries. "
3) Health as a socioeconomic issue, "The social and economic development, based on a New International Economic Order, is of basic importance for the level of health for all and to reduce the gap between the health status of developing countries and developed countries. The promotion and protection of health is essential for sustainable economic and social development while contributing to improving the quality of life and the attainment of world peace. "
4) The right approach to health: "The people have the right and duty to participate, both collectively and individually, in the planning and implementation of their health care."
5) Government Accountability: Governments have an obligation to care for the health of their peoples which can only be obtained through the provision of adequate health and social measures. The main objective of the various governments, international organizations and world community during the coming decades should be to achieve by 2000 a state of health that will permit people to have an economically and socially productive lives, with the APS the key to achieving this goal of development in the spirit of social justice. "
6) Definition of primary health care: The same as that already mentioned at the beginning of this work.
7) Components of the APS: "The Primary Health Care:
a) is both a reflection and consequence of economic conditions and sociocultural and political characteristics of the country and their communities , and is based on the implementation of the relevant results of social research, biomedical and health services, and experience in public health.
b) addresses the main health problems in the community, providing prevention services, advocacy, treatment and rehabilitation needed to solve these problems.
c) Includes at least the following activities: education about health problems and methods of how to prevent and control, promotion of food supply and proper nutrition, developing an adequate water source water and basic sanitation, maternal and child care, including family planning, immunization against major infectious diseases, prevention and control of locally endemic diseases, appropriate treatment of common diseases and injuries, provide essential drugs .
d) involves, in addition to health sector, all sectors and fields of activity related national and community development, including agriculture, animal husbandry, food, industry, education, housing, public works, communications and other sectors, and requires the coordinated efforts of all of them.
e) requires and promotes maximum self-reliance and community participation and the individual in the planning, organization, operation and control of primary health care, making the best use of resources local and national and other resources available, and to this end develops through appropriate education the ability of communities to participate.
f) should be assisted delivery systems integrated, functional and mutually supportive, in order to achieve the progressive improvement of comprehensive health care for all, giving priority to the neediest.
g) is based both locally and in the reference and consultation cases, health personnel, including, where appropriate, doctors, nurses, midwives, auxiliaries and community workers and as practitioners of traditional medicine, as they are needed, suitably trained socially and technically, to work as a health team and meet the expressed health needs of the community. "
8) National health policies: "All governments should formulate national policies, strategies and action plans to initiate and sustain primary health care as part of a comprehensive national health system and in coordination with other sectors. This will require a political exercise to mobilize national resources and use external resources rationally. "
9) Commitment to all peoples of the world: All countries should cooperate in the spirit of solidarity and service to ensure primary health care for all people, considering that the attainment of health for the people of a country directly benefit other countries. In this context the joint WHO / UNICEF report on primary health care constitutes a solid basis for the development and its future application worldwide.
10) It is possible to achieve an acceptable level of health for all people in the world by the year 2000 if it extends and improves resource use, a considerable part of which now goes to weapons and military conflicts . A genuine policy of independence, peace and disarmament could and should release additional resources that could well be used in accelerating the economic and social development.
Today we know that this goal of "Health for All by the Year 2000" has not been possible to accomplish, and in many cases has widened the gap between rich and poor since 1978, not only in the health issue. The causes of this disappointment are attributed to lack of medical and political will in all countries of the world and especially in the more developed, still evident on the long road that still remains to Primary to reach quality standards postulated the Alma-Ata, still observing a policy clearly "hospitocentrista" on how to address the medical and political management of the APS, rather than the approach "primariocentrista" by advocating Alma-Ata.
Another of the major issues that has completely changed the landscape of health, in this case in our country, was the process of transferring powers to the respective Health Autonomous Communities, which are themselves who manage and organize all processes related to health, both in the field of Primary Care and the Specialist, leaving the Ministry of Health as a guarantor of solidarity between regions and equity for all citizens.
As part of this decentralization process absolute breakthrough in the competencies and skills of primary care, an appeal Improvement Plan Primary Galicia 2007-2011, submitted by the Galician Health Service ( SERGAS) on March 2, 2007, which seeks to provide measures and targets to offset as much as possible the structural defects of the current model.
