La atención primaria en Irlanda

espanolLos medicos siguen saliendo de Espana en busca de trabajo de calidad. Irlanda no cuenta con demasiados profesionales espanoles, pero es interesante conocer su particular sistema sanitario. Irlanda se encuadra dentro de los sistemas nacionales de salud, aunque coexiste con un sistema de seguros privados. Todos los ciudadanos que llevan al menos un ano en Irlanda tienen derecho a asistencia sanitaria. Las condiciones de acceso son diferentes dependiendo de la edad y la renta: gratuito para ciudadanos de categoria 1 y no gratuito para el resto. Esta division genera importantes desigualdades en la poblacion. Los medicos son autonomos y trabajan independientemente, aunque desde 2001 se tiende a trabajar en equipos multidisciplinares para fomentar la atencion primaria. El salario es la suma de las actividades publica y privada, que no estan diferenciadas. Los medicos se ocupan del tratamiento de las enfermedades agudas y cronicas, cirugia menor, pediatria… No existe coordinacion entre atencion primaria y atencion especializada. El acceso a especialistas esta limitado por el coste de la consulta porque el medico de atencion primaria no tiene funcion de gatekeeper. Son necesarios 3 anos de formacion especializada para poder trabajar. Despues, la formacion medica continuada es obligatoria y existen controles aleatorios anuales realizados por el colegio de medicos. El sistema irlandes es un modelo sanitario que no tiene cabida en Europa. La falta de una division clara entre asistencia publica y asistencia privada genera grandes desigualdades. La pobre coordinacion entre atencion primaria y atencion especializada origina ineficiencias que Irlanda no puede permitirse despues de la crisis economica de la decada pasada. EnglishSpanish doctors are still leaving the country to look for quality work. Ireland is not a country with many Spanish professionals but it is interesting to know its particular Health care system. Ireland is one of the countries with a national health care system, although it has a mixture of private health care insurance schemes. People have a right to health care if they have been living in Ireland at least for a year. Access to the primary care health system depends on age and income: free of charge for Category 1 and co-payments for the rest. This division generates great inequalities among the population. Primary Care doctors are self-employed, and they work independently. However, since 2001 they have tended to work in multidisciplinary teams in order to strengthen the Primary Care practice. Salary is gained from a combination of public and private incomes which are not differentiated. The role of the General Practitioner consists in the treatment of acute and chronic diseases, minor surgery, child care, etc. There is no coordination between Primary and Secondary care. Access to specialised medicine is regulated by the price of consultation. Primary Care doctors are not gatekeepers. To be able to work here, doctors must have three years of training after medical school. After that, Continuing Medical Education is compulsory, and the college of general practitioners monitors it annually. The Irish health care system does not fit into the European model. Lack of a clear separation between public and private health care generates great inequalities. The non-existence of coordination between primary and specialised care leads to inefficiencies, which Ireland cannot allow itself after a decade of economic crisis.