Catalonia is launching a new budget allocation system for Primary Health Care Centers (CAP). Now, a portion of additional funding will be directly tied to how effectively doctors handle prolonged sick leaves and delays in diagnostics. This decision could change healthcare professionals’ approach to their work and impact the quality of patient care, as it concerns the actual waiting times for tests and the start of treatment.
In recent years, residents of the region have increasingly faced months-long delays in getting a diagnosis and starting therapy. The issue has been especially acute for mental health disorders and musculoskeletal diseases. The new initiative aims to speed up the examination process and prevent situations where people remain on sick leave for months without a clear diagnosis.
Changes in funding
According to the new rules, CAPs will be eligible for additional payments if they manage to reduce the number of sick leaves without a confirmed diagnosis and speed up necessary examinations. The basic budget of the institutions will remain unchanged, but access to extra funds will depend on meeting the new criteria. Authorities stress that this is not about cutting costs, but about improving the efficiency of the healthcare system.
The Catalan Ministry of Health notes that optimal sick leave durations are determined by medical standards and recommendations from the National Social Security Institute (INSS). The new incentives do not override medical indications but encourage centers to work more efficiently. The decision on the length of temporary disability still rests with the physician.
Reaction and details of the new measures
The medical community has already voiced concerns that financial incentives could affect the independence of medical decisions. Some specialists fear that pressure to shorten sick leave periods may lead to insufficient examinations or premature returns to work. Authorities assure that all changes will be implemented in line with medical standards and without compromising citizens’ health.
Alongside the introduction of new funding criteria, the region is launching pilot projects aimed at optimizing the process for patients on temporary disability. These voluntary projects do not affect the main CAP funding. Their goal is to identify best practices and implement them throughout Catalonia.
Context and consequences
In recent years, the effectiveness of the temporary disability system has been repeatedly discussed in Spain. Some regions have already made attempts to speed up the diagnostic process and reduce waiting times for medical services. However, such measures often sparked debate between the medical community and officials, as finding the balance between speed and quality of care remains a complex challenge.
Other autonomous communities in the country have also launched pilot projects to reduce the duration of long-term sick leaves, but the results have been mixed. Some experiments have improved certain metrics, while others have led to an increase in patient complaints about insufficient attention from doctors. The Catalan initiative could set an example for other regions if it succeeds in finding the optimal balance between efficiency and patient care.
Overall, the changes in CAP funding reflect the authorities’ desire to increase transparency and the effectiveness of the healthcare system. The question of how this will affect the daily lives of patients and doctors remains open. In the coming months, it will become clear whether the new system will help reduce waiting lists and speed up diagnoses, or whether it will provoke new disputes and protests among healthcare workers.
In recent years, Spain has repeatedly seen initiatives to reform the temporary disability system. Madrid and Valencia have already piloted projects aimed at speeding up diagnoses and reducing the duration of medical leave, but their implementation has drawn criticism from unions and healthcare professionals. In some cases, this has led to temporary disruptions in medical facilities and growing dissatisfaction among patients. Despite these disagreements, the authorities continue to seek ways to improve healthcare efficiency by experimenting with new funding and management models.
