Primary Health Care: Functions, EU Rights & Spanish System

Functions and Objectives of Primary Health Care

Health Promotion

Health promotion is a crucial function, aiming to maintain population health levels. It emphasizes healthy habits as a major element of human well-being. Health education, both individual and collective, is a primary tool for health promotion.

Disease Prevention

Prevention and promotion are complementary. Prevention activities are selectively directed to avoid specific diseases, such as through vaccinations.

Treatment of Health Problems

This function has been traditionally developed by health systems. The modern perspective allows primary health care (PHC) to integrate assistance with preventive and health promotion activities.

Rehabilitation

Rehabilitation should be understood broadly, involving the restoration of life for individuals with deteriorated health. It includes overcoming physical sequelae and accepting the physical and mental consequences of acute or chronic diseases.

The Right to Health in the EU

The approach to community health problems in Europe has evolved through three stages in the twentieth century:

First Stage (1900-1940)

• Growing fight for rights and development of social insurance schemes (Bismarck).
• Development of preventive medicine and hospitals.

Second Stage (1945-1973)

• Development of the European welfare state.
• Surge of national health systems (Beveridge).

Third Stage (1973-2001)

Implementation of the neoliberal model, with conflict and progressive evolution of the European social model in two phases:

Confrontation (1973-1990): Conflict between the concept of health care from Alma-Ata and neoliberal goals. Example: Thatcherism against the English National Health Service.

Ratifying (1991-2001): The neoliberal model. The Treaty of Maastricht (1992) is a European response to neoliberal globalization.

Primary Health Care in Spain

The Legal Situation: Compulsory Health Insurance

First Stage

The Health Act of 1855 was based on the free practice of doctors, with individual health care being a personal responsibility. There was no structure to cover the general population's health. The public sector created a structure for poor health care and public health programs, such as vaccinations.

Second Stage (The Republic)

A dual system addressed health issues: public welfare for the impoverished and a private system with mutual insurance for those with resources. Public health problems were managed by state institutions.

Third Stage (The Dictatorship)

The Law of December 14, 1942, established mandatory health insurance (SOE) for workers, based on the Bismarck model. The SOE was part of the National Welfare Institute (INP), initially focused on restorative health, with benefits and coverage expanding gradually.