Inspectors from the National Institute of Social Security (INSS) incentives can not charge high as the percentage of giving in their reviews of patients due to temporary disability (TD). So says a judgment of the High Court last December 18, which dismisses appeal by the Government. The ruling confirmed an earlier judgment of May 24, which overturned one of the criteria I had set the Administration to calculate a productivity of medical inspectors or evaluators, a group of some 900 professionals throughout Spain.
In 2011, the INSS determined that 4% of the allowance would be charged if the inspector was discharged at least 15 % of patients referred for medical examination. Now the High Court confirms that it can not impose this criterion because all that should govern the conduct of a medical inspector is " the health of the worker, and intimately connected with it, their ability to work." That is, the Court argues that these professionals have to decide " on objective and scientific criteria " because their decisions would be affected " if certain quantitative indices are established, as in this case, which would affect the right to health ".
INSS inspectors are responsible for monitoring the lower temporary disability of workers. Is family doctor who gives low and high for a sick, but occasionally inspectors cite certain persons to medical examination if the INSS detects that a low is taking longer than expected according to their standards. The INSS, the Ministry of Employment and Social Security, adopted in 2011 recalculated productivity supplement charged by inspectors. One of the criteria is that 15 of every 100 visits must end with one of three outcomes: medical discharge, opening file for permanent disability or suspension of payment of the benefit when the worker has not unreasonably recognition.
The controversy over incentives for health professionals to reduce the amount or duration of sick leave in 2009 jumped when the INSS signed agreements with regions such as Madrid and Catalonia to "improve the management of temporary disability." It was " rationalize" the management of these processes, according to the data given then the INSS, costing the state between 6000 and 7000 million per year. According to these agreements, the Social Security gave some regions amounts of money intended, among other things, to encourage family physicians to reduce the number of casualties or duration. In some cases this add is also delivered medical inspectors of regional health services and administrative.
The judgment now confirms the High Court stated that " the medical examiner can not see his performance conditional on the decisions taken on high medical or the initiation of proceedings for a declaration of permanent incapacity, as the only criterion that should govern his performance is the health of the worker, and intimate relationship with him, your work capacity. And this regardless of the percentage that can statistically correspond to said action. " The ruling recognizes the "legitimate" set strategic objectives of officials and IT control processes, but "what is not acceptable is that the result of that control is conditioned by the fulfillment of objectives that are entitled to receive a supplement productivity, when it has come determined, as appellants point out, that the state of health prevents him from working or not working. " It was an action of the Inter Galician Confederation which initiated the legal proceedings.
" The approach has overturned the Court conditioned the medical and technical function INSS inspectors," said Jose Maria Moran, vice president of the Federation of Associations of Health Care Inspectorate (Faiss). "The arguments of the judgment can be extrapolated to comparable situations, such as incentives received by primary care physicians in the community," he adds. Moran explains that the now canceled criterion has been maintained since 2011 and assumed a measure criticizes " APRIORITIZE decisions and press freedom of action of a technician." " I may be incentives to make inspections or to compare myself with other inspectors, but we can not say we have to exceed a certain threshold," he adds.
Xaime Rei, Galician Confederation of Inter, says his organization appealed the decision of the Ministry of Social Security which approved the new criteria at the request of several of its members, medical inspectors INSS. "Now that the judgment is final, we will require this parameter to withdraw from the 2014 objectives that have not yet been published," he adds.
"We are analyzing the sentence," a spokesman said Thursday the Ministry of Employment and Social Security in response to the various questions put to him by this newspaper.
Tags: charge, incentives, inspectors, medical