Listening to the social stethoscope: MPLP health workers are redefining healthcare in Belgium : Peoples Dispatch
People’s Health Officer doctors hold a protest to demand access to medicine. Photo: MPPL
Workers at the Medics for the People’s (MPLP/GVHV) health center in the Deurne district of Antwerp are currently providing care from another location, while their original building is being extended. The idea behind the reconstruction is to create a space where patients can access care but also meet health workers and participate in the planning of common actions for the improvement of health conditions in Belgium.
The social determinants of health are one of the fundamental concepts around which the work of Medics for the People is organized. Doctors, nurses and other workers employed by the MPLP play an active role in organizing at the community level, speaking out for the strengthening of public infrastructure and the protection of workers’ rights. In fact, health centers run by Medics for the People are emerging where struggles for better living conditions are taking place.
This is also the case with the Deurne Health Center, the second facility of its kind created by Medics for the People after its creation in 1971. At the time of its creation, a group of left-wing lawyers launched a campaign for the safeguarding of a public park. . Medics for the People moved into the same building as the lawyers, serving the health needs of neighborhood residents. When the lawyers moved to another location, Medics for the People remained with the intention of creating a different model of primary care delivery in the district.
Professional equality and interdisciplinarity at the service of patients
Today, people always enter the health center knowing that they will not have to pay for the consultation. This is not the norm in Belgium. In many GP surgeries and health centres, patients are asked to pay upfront, meaning those who cannot do so struggle to access care. Every year, 900,000 people in Belgium postpone care for financial reasons. Health workers at Medics for the People centers know this is an effect of the current system, which prioritizes a commercialized idea of health care over people’s well-being.
The fact that the Deurne health centre, like other People’s Doctors establishments, is able to provide care without demanding money from patients is linked to its internal structure. The funds that allow the center to operate come from a combination of capitation and health insurance payments, as is the case in many other practices in Belgium. But instead of using the money to cover a few high incomes and using the rest for day-to-day operations, Medics for the People distributes it evenly to cover their workers’ salaries and provide forms of care that are rarely provided to the primary care level because of limited resources or cost issues, for example consultations with psychologists.
“We are following the national agreement for healthcare workers to set salaries in the organisation. In practice, this means that doctors at the health center have lower salaries than other doctors. The underlying idea is that we are able to protect the rights of all workers and strengthen equality at work,” explains Sofie Blancke, one of the doctors at the center in Duerne.
As Blancke guides us through the center’s temporary building, most of the staff are already on their way to Ostend to finalize the Medics for the People program at ManiFiesta. But a group of psychologists, nurses, receptionists and doctors are still there to attend to patients in the waiting rooms. Over the past 10 years, the center has focused on building interdisciplinary teams. They are now moving away from the narrative where the doctor is seen as the center of the health care system and the others as mere extras. Again, this is not something that should be taken for granted, since most other healthcare facilities are still struggling with this concept.
Many nurses who joined the health center after working in hospital wards were surprised when they were asked to take such an active role in the care process. “Nurses have a different expertise than doctors. For example, they will know how to heal wounds better than me. So it’s very nice to be able to work together on an equal footing, each with their own expertise, for the benefit of patients,” says Blancke.
Another group of workers that Medics for the People is trying to empower at this time are receptionists. Blancke explains that the intention is to provide receptionists with extensive training to enable them to triage effectively. “Receptionists play a key role in ensuring people get the care they need. If they have the proper training for triage, they can make sure the patient gets to the kind of care they need as quickly as possible,” she says.
Health as a political issue
Medics for the People’s Deurne center has 30 workers in total, including Blancke. While some of them got to know the organization through internships at universities, others arrived after working in other health institutions. “Before coming to Medics for the People, I worked for another group practice in Flanders. The doctors at this practice were also very dedicated to the care of their patients. But the difference that Medics for the People brings to the table is the recognition of health as a political subject,” says Blancke.
Speaking to health workers in Deurne and other centers of people’s medicine, it is immediately clear that they are very different from conventional health professionals operating from their dispensary. Instead, they are on the streets with their patients, observing living and working conditions and constantly looking for ways to improve them. One of Medics for the People’s current areas of interest is the relationship between work and health. During consultations, health workers in the organization’s centers record information on how the workers’ bodies are worn down by work, especially when it comes to positions such as cashiers, cleaners or temporary workers. . But they are also making their findings public, pushing for change in alliance with workers and unions.
Blancke calls this method “listening through the social stethoscope” – listening intently, prompting and prompting action based on people’s needs. The technique should not be confused with a purely theoretical approach. On the outskirts of Antwerp, health activists from Medics for the People and the local community waged a decade-long fight against a heavily polluting highway and won. Likewise, they quickly set up tracking, tracing and testing operations for COVID-19 as the government lagged behind. Deurne health center workers operated a testing center at a local church after it was found to be the best fit when it came to space requirements.
Even as the organization grows, Medics for the People health workers remain committed to their understanding of people’s health. They also remain steadfast in their political interpretation of health. Thanks to their close ties to the Workers’ Party of Belgium and the communities in which they work, they are able to mount resistance even as a harsh winter threatens workers in Belgium. For Medics for the People, the key is to remember that health workers have a dual role in building a health society. As Janneke Ronse, president of Medics for the People, said in a recent announcement of the organization’s vision document: “In your consulting room, you cure disease; together, in action, you heal all of society.