Oscar Castellano has just seen a customer at his optician’s on Calle Lleida who has come to repair a hearing aid for the second time. Due to the state in which the device was, the ideal would have been to replace it, but its owner, an elderly man, cannot afford it “even financing it” with the pension he receives.
Castellano assures that when it comes to glasses and hearing aids, more and more is repaired and the time to change them is hurried as much as possible.
Castellano’s perception is in line with what the study ‘Impact of Covid-19 on Tarragona society’ found, prepared by the Municipal Institute of Social Services, IMSST, with the collaboration of the URV. In the survey, which was carried out at the beginning of the pandemic and was repeated a year later (between February and March of last year), among many items, questions were asked about the difficulties of those interviewed in paying for health services that covered by Social Security or only partially covered.
The result was that in the second stage, when we were supposed to be in the recovery process, 20.1% of those consulted from 16 to 64 years old said that they would have difficulties buying glasses or hearing aids; 15.1%, to go to the dentist; 5%, to get dental prostheses; 7%, to go to the psychologist; 2.5%, to go to the podiatrist, and 2.5%, to acquire other types of technical assistance such as wheelchairs, adapted baby seats, prostheses and crutches.
“These data show that a very high percentage of families in the city of Tarragona have serious difficulties in accessing health care resources that are not covered by Social Security and, therefore, the incidence of social and health inequities increases” , the report noted.
Alfons Bielsa, president of the Col·legi Oficial d’Optics Optometristes de Catalunya, is not surprised by the results of the survey either; Similar data was reflected in the White Paper on visual health in Spain prepared by the schools of his specialty in 2019.
After the pandemic, he acknowledges, they found a paradox; On the one hand, the population with sufficient economic means who went to have their eyes checked increased because they were more aware than ever of its importance due to teleworking and video calls.
On the other hand, there are the most vulnerable, for whom “an expense of 300 or 500 euros is unaffordable at one time.” He emphasizes that there are opticians that offer financing and that they have social foundations. The school itself has an agreement with Creu Roja, but, with everything, it is not enough.
He is especially concerned about children because, he points out, 3 out of 10 have not had a check-up and it has been shown that one in three cases of school failure has to do with vision problems. In the case of adults, it can affect their work performance. To all this we must also add the increase in myopia due to exposure to screens.
Problems behind the mask
Maria Dolors Ceperuelo, president of the Tarragona board of the Col·legi Oficial d’Odontòlegs i Stomatòlegs de Catalunya, answers “absolutely yes” when asked if she and her colleagues have seen an increase in the number of patients who stop undergoing treatment. She points out that some delay them waiting for more income.
He also explains that having passed the Covid and the use of the mask has especially increased the problems of gums and cavities.
She also sees two distinct groups; one in which the use of the mask has facilitated the performance of dental treatments and the other group in which the mask has served to camouflage the problems, which has caused them to postpone the treatments.
Regarding dental coverage provided by public health, Ceperuelo considers that “unfortunately, few resources are allocated to care for the most disadvantaged population, especially early childhood and the elderly, who should benefit from specific plans to cover their needs. We believe that dental treatment is a topic widely used by politicians in electoral campaigns to win votes, but the reality is very different and what is promised is rarely fulfilled. We should think about it.”
The luxury of the divan
But if the pandemic made anything clear, it was the importance of having psychological care. The president of the Tarragona board of the Official College of Psychology of Catalonia, Eva Llatser, says that the figures are clear: «In Spain there is an average of 6 psychologists for every 100,000 inhabitants, and in Catalonia, 10 for every 100,000. It is misery and we are very far from the European average, which is in the 18 psychologists ». All in the midst of a peak in demand in which anxiety and depression have been seen to increase, especially among young people.
The summary is that in public health, especially in primary care centers, psychologists have been incorporated, but they are far from being sufficient, which has left part of the problem in the hands of general practitioners. Hence, explains Llatser, the huge number of anxiolytics and antidepressants that are prescribed.
In the end, he acknowledges, psychological care is given especially in private and is a privilege for those who can afford it.
He believes that two avenues should be explored; or provide public health with professionals or seek solutions such as that of France, which decided last year to provide 40 euros for an initial session and 30 euros for subsequent ones (up to 7) to its citizens so that they go to the psychologist.
Remember also that the school has the Psicoxarxa solidària (www.copc.cat/es/psicoxarxa-solidaria) in which people who need it but have few financial resources are cared for.
For her part, Silvia Labodia, spokesperson for the Grup de Treball en Defensa de la Sanitat Pública a Tarragona, acknowledges that the lack of psychologists in the public network is something that “we are very concerned about”. She gives the example of a patient who, after weeks of waiting, finally got a 20-minute visit with the psychologist. She was not given a date to return “unless she felt unwell. She is outrageous ».