New La Fe hospital, worse than the old one?

I didn't know what thread to put it on, so in the end I have left it in this general.

In Valencia, the reference hospital is faith, it is the greatest, the most specialized and probably the one with the best professionals (in global).

The political leaders, the end of the 90s with Zaplana in power, set out to make a new hospital (like almost everything that is done here with the coletillas of: the largest in Europe, the most modern, more rooms, more of all of all... :?

The fact is that the project was commissioned to an architecture study (I don't know who it is or interest me) and they had to think that they knew a lot because they consulted little with health professionals.

The result, 10 years later, is a monumental building, mastodontic but that paradoxically before opening there are already voices against.

The voices against the pediatricians.And it is that someone came up with the brilliant idea of ​​integrating the different pediatrics services together with adult services, eliminating specialized nursing services, the emergencies are shared, the hemodialysis service: shock:, oncology ...

A reference hospital is not an integrated services hospital (which are most local and regional hospitals, and that fulfill their function very well).
In the Valencian Community there is not a single children's hospital ... and at this step the only one within 1 year melts it.

As if this seemed little, it is said that the new hospital reduces the number of pediatric beds by 25%: shock:

Given the (usual) mutism of the administration, an association has been created to defend the integrity of pediatric care.
Much better that I explain in this blog:

Well that, that this Thursday we will give a walk to see if the XXXXXXXXXX that govern us gives them to use what they have on top of the eyebrows

Owash, here, well, in Oviedo, they are also making a new macrohospital.
I don't know how it will be, although the works are already very advanced, but I'm afraid they will also cut beds.
Right now, the one that is, the HUCA, consists of: a central building (the old sanitary residence), the General Hospital, with two buildings (the building "A" is the one that houses the endocrinology and kingdom of Santa Teté), The maternal-infantile, the Silicosis Hospital (now of lung and heart), the polyclinics, the external consultation building and the Hematology Center ..., that if I do not forget some.
Anyway, a maze of hospitals and buildings, all in the same area.

What I like about the new is the location.You don't have to cross everything Oviedo from where I live and is on the outskirts, with more space.We will see the bad when it starts working.

The bad thing is that politicians are not exactly good managers ...

We will have to fight that of faith.

Health

Public Health: Efficiency or quality?
Most of the professionals of the La Fe Valencia ChildrenIf its foreseeable care organization is modified.

Like other reference hospitals in Spain, Children of Faith has worked since its creation in 1970 as an autonomous unit and independent of the rest of the sanitary complex, in which the different specialties centered on the child congregate, a type of patientvery different from the adult.The child is not a small adult, requires peculiar attention from the different specialists, who must work well articulated to each other to be able to provide comprehensive assistance.
However, the configuration of the new faith dissolves the unity and independence of the care circuitFor special units.
What reasons are adduced to justify this dispersion?Two are at least usual -the growing specialization of health and the triumph of the demand for efficiency over quality -but both require careful review.

As far as the first is done, without a doubt the specialization involves progress in assistance, but provided it is articulated in such a way that it does not break the unit of comprehensive care.There are no diseases, but sick, each with their peculiar configuration.
And as regards the fever of efficiency, it is a problem that we have been dragging for more than three decades, when health spending began to increase prodigiously when the social state gain strength and justice problems arose in the distribution of the distribution ofhealth resources.

That branch of the economy, today flourishing, the health economy, which introduces economic rationality, the analysis "cost / benefit", to rationalize the expense, was born today.With this, in public health centers three types of protagonists began to meet, in addition to patients: health professionals, concerned about the patient's good when they are good professionals;Managers, determined in the efficiency in resource management, and public administrations, which name managers and demand that desired efficiency, measurable in money and in actions that generate votes.

The question is very complex.Without a doubt, efficiency is a good thing, it is necessary to optimize resources, which are always scarce, and waste is immoral.And it is important that public health is efficient, because it is not true, as it is often believed, that the public is inefficient by necessity, while the private waste efficiency and effectiveness: the economic crisis we continue to suffer has come from an irresponsible private sector,ambitious and incompetent.
But also the public sector must be efficient, provided that it combines efficiency and equity, and, above all, provided it maintains the quality of health care.Monetary profitability can never be detrimental to quality, the increase in specialization cannot lead to losing the patient's integral vision, in this case, of the child with their peculiarities.

With so many protagonists in the health world (the professional, the manager and the politician) it is convenient not to forget the obvious, the truths of perogrullo: that the goals of health, those that give it meaning and social legitimacy, consist of preventing the disease,Cure what can be cured with the means available, take care of what cannot be cured and help die in peace.Those goals have toTo be achieved in the context of health organizations, directed by managers, within the framework of political institutions, but the specific thing of this plot is to facilitate professionals necessary to promote the patient's good.And more in the case of the child, particularly immature and vulnerable.
"Efficiency" in health cannot mean cutting of spending without more, nor proving votes to politicians with actions that allow them to show off, but optimize human and economic resources at the service of patient, comprehensive and quality care.

There has been much talk about the doctor as a "double agent", which must at the same time attend to the patient's good and the containment of spending, when the truth is that his own task is the first.And yet, there is little talk that there are two agents - fender and political for public health - that should serve professionals and introduce a fourth interlocutor, in this case, parents.It matters that parents know what consequences will be followed for their children in the configuration of the new health complexes, lend the voice to professionals so that they can explain it, and attend to each other.Not doing so would be typical of bad management and bad policy.

Adela Cortina.09/07/2009

Adela Cortina is Professor of Ethics and Political Philosophy of the University of Valencia and director of the Ethnor Foundation

efficiency.

(From lat. Efficientĭa).

1. f.Ability to have someone or something to achieve a certain effect.

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If efficiency was put at the service of quality in patient care, problem solved

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