The breast cancer screening scandal has highlighted the shortcomings in the communication of doubtful cases of the results of this type of cancer and the collapse of visits for mammograms at the Virgen del Rocío Hospital in Seville, considered the epicenter of the crisis of delays in inconclusive diagnoses. But the bottlenecks do not exclusively concern the Seville hospital centre. In the Regional Hospital of Malaga, the largest in the province, at least 5,400 unanalyzed samples have been found in the 20 freezers of the pathological anatomy service since August, as confirmed by internal sources at the Malaga reference hospital. A traffic jam that implies a delay of between a month and a half and two months in knowing the stage of the biopsies which, in some cases, could be malignant. The hospital’s management has pledged to strengthen staff to end the bottleneck, motivated by pressure from healthcare workers, and this week strengthened the service with five new additions.
As of October 29, in the 20 freezer drawers of the pathological anatomy service there were 5,400 blocks awaiting analysis, according to data managed by internal hospital sources, of which 3,395 correspond to unreported patients; 1580 are diagnostic biopsies; 1,549 surgical specimens or 104 cytology specimens, among other specimen types. “This equates on average to a month and a half or two months of waiting to know the result,” explains a healthcare professional who knows the collapsing situation of the pathological anatomy service. These samples come from biopsies of all kinds of lesions where something suspicious has been found – “from a tumor to a mole,” says another healthcare professional – the result of which can ultimately be malignant or benign. “In some pathologies a two-month delay implies a differential diagnosis and in some types of cancer it is very likely that they could have progressed significantly while waiting for the tests,” he adds.
Examples of this traffic jam are observed in the case of blood compatibility tests, which evaluate the mother’s immune risk of rejecting the embryo during pregnancy, where the specialist in charge of carrying them out has not yet been replaced and is retired; To alleviate the bottleneck, a decision was made in the last two weeks to outsource the analysis of 500 cytological tests and 1,200 autopsies, sources within the hospital report.
The increase in backlog tests began in August. Union sources estimate that the number of uncut frozen samples in recent months reaches 7,000. “If there are 20 drawers and in each there is room for 320 samples and they are practically all full…”, they indicate. A hospital spokesperson denies this high figure and points out that the center “has recorded a 29.5% increase in the number of biopsies this year”. “To respond to this increase in activity, the center has strengthened the service with new pathological anatomy technicians and with the additional inclusion of pathologists,” he adds.
Health workers had alerted hospital management to this situation for some time until they forced a meeting with management in early November. There, in addition to recognizing the traffic jam, it was explained to the representatives of the doctors’ unions that one of the reasons for the traffic jam was due to the poor functioning of the centralized management throughout the provincial territory, which forced some of the staff – already insufficient at the Regional – to take samples for other hospitals. Seeing that delays were accumulating in the Malaga referral center, the doctors themselves called for a break with that system at the beginning of 2025.
But the fact that staff replacements ran out in that period and the impossibility of increasing an already depleted staff, due to the obligation to reduce staff by 9.90% for the whole of this year, imposed by the Andalusian Health Service, as revealed by this newspaper, prevented us from being able to resolve the delays accumulated in the analysis of the biopsies. “There are not enough pathologists, but there are not enough radiology technicians either. Without professionals it is impossible to cut the samples”, warns one of the interlocutors consulted, who recognizes that in recent months the eight pathologists have doubled their shifts to try to unblock the studies. “But the pending tests do not fall below 4 thousand”, warns another professional from the hospital centre.
At that meeting the management committed to completing the workforce by compensating for the losses of technicians who had not been covered in recent months and hiring two more newly created ones. “The hospital has completed its committed hiring: two technicians specializing in pathological anatomy, inserted as temporary vacancies in newly created positions, and three replacement appointments,” says the spokesperson for the regional hospital. “They kept what they promised,” congratulated one of the union sources consulted.
“The number of tests continues to grow, but the number of technicians stagnates or absences due to illness and permits are not replaced,” warns one of the interlocutors. In recent weeks, four technicians have been put to work in the morning and another four in the afternoon, to alleviate the bottleneck. “But with this distribution you would have to spend a month alone like this, and the problem is that in the meantime tests keep arriving,” says another of the professionals who knows how the pathological anatomy service works. “The urgent comes forward, but the colleagues are very worried, they see the tests in the drawers without being able to carry them out and they think that they could be the results and the future of their neighbour, of a friend, of a family member…”, the specialist elaborates on the degree of stress and worry experienced in the service.
Notice for the replacement of seats
The lack of planning and staff also extends to other hospitals in the province of Malaga and, as in the case of the Regional, the government of Juan Manuel Moreno wants to prevent internal disorders from amplifying the echo of the problems that have emerged in the Virgen del Rocío. Last week, the SAS management met with the managers of the various hospital centers in Malaga to confirm that a tender for the replacement of vacant posts would be launched to consolidate on a permanent basis the positions that were being filled on a precarious basis and that the services of the recently created hospitals, such as Estepona, would be open to 100%, as internal sources from some of the centers concerned confirmed to this newspaper.
The High Resolution Hospital of Estepona, in many respects, has had a similar evolution to the old Military Hospital of Seville. Opened in 2021, the lack of staff has meant that only the Radiology service is operational at almost 100%, while the Emergency Service is closed at night and on weekends and the operating theaters close their cabins until they are no longer operational. In the case of the Costa del Sol, measures for the expansion of the Radiodiagnosis service are proceeding very slowly and the radiodiagnosis and nuclear medicine unit, completed last year, with cutting-edge and very expensive equipment, has not yet been opened, mainly due to lack of personnel, internal sources indicate.
Health workers are waiting to see that the promises of greater hiring and opening of services are not only kept and are not part of the Council’s strategy to silence criticism of the management of screening with tenders, but that they last over time. Everyone knows that the regional elections are now upon us. “We are used to these maneuvers in an election year,” says one of the interlocutors consulted.
