La Salud se el que importa, sabemos que los principales determinantes negativos de la salud se tienen que hacer frente con políticas globales que están fuera de las competencias del Sistema sanitario. Pero también se necesario y urgente un cambio radical del modelo sanitario, cambio de paradigma, pasando de un Sistema sanitario centrado fundamentalmente en la enfermedad y la medicalización, a un modelo público de salud integral de las personas y la comunidad.
CIUTADANS I PROFESSIONALS
Els ciutadans i ciutadanes són els protagonistes dels serveis de Salut. Cal impulsar polítiques actives de reversió de la cultura de la medicalització entre ciutadania professionals i polítics . Cal apoderar a les persones en la protecció de la seva salut amb decisions compartides i fomentar la salut de la comunitat amb l’ús raonable dels serveis sanitaris. Els professionals estan al servei d’aquests protagonistes i la seva salut. I per fer bé això s’ha de vetllar per les seves condicions de treball i tinguts en compte en la governança . Però alhora millorar la seva autonomia i corresponsabilitat i en la incorporació d’altres professionals i competències en el món de salut més adients als canvis per la presència de nous perfils dels pacients.
ATENCIÓ PRIMÀRIA
Proposem una atenció primària i comunitària orientada a atendre prioritàriament les necessitats de salut de la població amb la col·laboració de la resta d’agents locals de salut i de la mateixa comunitat, gestionada amb la participació activa dels professionals i la ciutadania que realitza una atenció accessible, longitudinal integral, centrada en la persona i que també coordina el conjunt d’intervencions assistencials.
HOSPITALS del segle XXI
No calen mes hospitals, si cal assignar recursos per millora, manteniments i noves dotacions planificades. Planificar el terciarisme (caldrà definir-lo) en pocs hospitals distribuïts pel territori de Catalunya i fer sinergies i aliances entre comarcals i terciaris. L’hospital ha de tornar els pacients a l’Atenció Primària que no necessitin llit, alta tecnologia o expertesa d’especialistes de l’hospital.
PER UN SISTEMA SOCIAL I SANITARI INTEGRAT
El model més efectiu per afrontar els problemes de salut vinculats a la cronicitat, l’envelliment o pluripatologies que provoquen pèrdua de l’autonomia, és un model integrat social i sanitari. Per avançar en aquets model caldrà la definició i disponibilitat dels elements instrumentals, Sistemes de registre compartits, Guies d’actuació social i sanitària front els casos més prevalents, Envelliment amb solitud i necessitats complexes, Risc o situació d’exclusió social, infància situació de risc, addicions i problemes de salut menta.
POLÍTICA DE MEDICAMENTS
La industria farmacèutica te com ha prioritat el negoci i la malaltia. La prioritat del Sistema de Sanitari ha de ser la Salut i la cura de totes les persones, per això el Sistema de Salut ha de ser totalment independent dels interessos de les companyies farmacèutiques i de productes sanitaris.
GENERE SALUT I SISTEMA SANITARI
La salut de les dones és diferent a la dels homes perquè existeix diferencies per la diferent biologia; i també és desigual perquè els determinats de la salut impacten de manera diferent a les dones a causa dels imperatius de gènere, cal polítiques que modifiquin els determinants socials i ambientals, amb accions de promoció de la salut específiques per a les dones i amb reconeixement dels drets sexuals i reproductius. Aquesta diferència i desigualtat ha d’estar reconeguda en els sabers i les pràctiques dels Sistemes Sanitaris. Cal eliminar les iniquitats i l’esbiaix de gènere en la pràctica mèdica perquè els Sistemes Sanitaris no siguin una font més de discriminació i violències envers les dones. Per això cal introduir la perspectiva de gènere en les polítiques sanitàries, en la pràctica clínica, en la docència i en la investigació.
ELS DETERMINANTS DE LA SALUT
Cal reconèixer i planificar des dels diversos governs de les institucions públiques polítiques globals per fer front a les desigualtats econòmiques i socials, fonamentals com a polítiques de millora de la salut i l’equitat de les persones. Posar Salut en totes les polítiques.
LA SALUT MENTAL
Cal desplegar un pla integral que unifiqui estratègies socials i sanitàries coordinadament amb els serveis socials, atenció primària i els serveis de salut mental emmarcat en un àmbit territorial per poder detectar i donar resposta àgil a les necessitats dels ciutadans d’aquell territori. Cal un increment considerable de recursos a la salut mental ambulatòria per tal de poder abordar amb suficiència la demanda creixent i de major complexitat que té la ciutadania.
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