Listening through the social stethoscope: MPLP health workers are redefining care in Belgium : Peoples Dispatch

Medics for the employees of the National Health organize a protest demanding access to medicines. Photo: MPLP

Workers from the Medici for People Medical Center (MPLP/GVHV) in Antwerp’s Deurne district are currently providing care from an alternative location while their original building is being expanded. The idea behind the renovation is to create a space where patients can access care, but also meet health workers and participate in planning joint actions to improve health conditions in Belgium.

The social determinants of health are one of the core concepts around which Medici’s work for people is organized. Doctors, nurses, and other workers employed by the MPLP play an active role in organizing at the community level, speaking out in favor of strengthening public infrastructure and protecting workers’ rights. In fact, health centers run by Medici for the people are emerging where struggles for better living conditions are taking place.

This also applies to the health center in Deurne, the second such facility created by Medici for the People since its foundation in 1971. At the time of its creation, a group of left-wing lawyers launched a campaign to preserve a public park. Medics for the People moved into the same building as the lawyers to handle the health needs of the people in the neighborhood. When the lawyers moved elsewhere, Medics for the People stayed with the intention of building a different model of providing primary care in the area.

Employees of GHVH Deurne outside the health center during a campaign for Public Health Day 2018.

Workplace equality and interdisciplinarity for the benefit of patients

Today, people still enter the health center with the knowledge that they will not have to pay for the consultation. This is not the norm in Belgium. In many general practices and health centres, patients are forced to pay up front, meaning that those who cannot do so have difficulty accessing care. Every year, 900,000 people in Belgium postpone care for financial reasons. Health workers at Medics for People centers know that this is an effect of the current system, which prioritizes the commercialized idea of ​​health care over people’s well-being.

The fact that the health center in Deurne, like other Medic for the People facilities, is able to provide care without demanding money from patients is related to its internal structure. The funds that enable the center to function come from a combination of capitation and health insurance payments, as in many other practices in Belgium. But instead of using the money to cover a few higher-end incomes and using the rest for day-to-day operations, Medics for the People spreads it evenly to cover its workers’ salaries and provide forms of care that are rarely provided at the primary care level because of limited resources or cost issues, for example consultations with psychologists.

“We are following the national agreement for health workers to set salaries in the organization. In practice, this means that doctors in the health center are paid less than other doctors. The idea behind this is that we can protect the rights of all workers and strengthen equality in the workplace,” says Sophie Blanke, one of the doctors at the Duerne centre.

As Blanke takes us through the center’s temporary building, most of the staff are already on their way to Ostend to finalize the Medici for the People program at ManiFiesta. But a team of psychologists, nurses, receptionists and doctors is still there to take care of patients in the waiting rooms. Over the past 10 years, the center has placed a strong emphasis on building interdisciplinary teams. Now they are moving away from the narrative in which the doctor is considered the center of the health care system and the rest are just extras. Again, this is not something that should be taken for granted as most other healthcare institutions are still struggling with this concept.

Sophie Blanke shows the People’s Health Dispatch around the reception of the temporary health center GHVH Deurne decorated for ManiFiesta 2022

Many of the nurses who joined the health center after working on hospital wards were surprised when they were asked to take such an active role in the care process. “Nurses have a different experience compared to doctors. For example, they will know wound care better than I do. So it’s very nice to be able to work together on equal footing, each with our own experience, for the benefit of patients,” says Blanke.

Another group of workers that Medics for People is currently trying to empower are receptionists. Blanke explains that the intention is to provide receptionists with in-depth training that will enable them to perform efficient sorting. “Receptionists play a key role in making sure people get the care they need. If they have adequate triage training, they can make sure the patient gets to the form of care they need as quickly as possible,” she says.

Health as a matter of politics

The Medici Center for People’s Durn has a total of 30 workers, including Blanke. While some of them got to know the organization through internships at universities, others arrived after working in other healthcare institutions. “Before I came to Medici for People, I worked for another group practice in Flanders. The doctors in this practice were also very dedicated to the care of their patients. But the difference that Medici for the People brings to the table is the recognition of health as a political issue,” says Blanke.

Talking to the health workers of Deurne and other Medics for the People’s Centers, it is immediately clear that they are very different from the conventional medical professionals working from their dispensary. Instead, they are out on the streets with their patients, observing living and working conditions and constantly looking for ways to improve them. One of the current focus areas of Medics for People is the relationship between work and health. During consultations, health workers at the organization’s centers note information about how workers’ bodies are worn out by work, especially when it comes to positions such as cashiers, cleaners or temporary workers. But they are also publicizing their findings, pushing for change in alliance with workers and unions.

Medicines for the People and Patients in Action for Fair Access to Medicines, 2017

Blanke calls this method “listening through the social stethoscope”—listening carefully, advocating, and eliciting action based on people’s needs. The technique should not be confused with a purely theoretical approach. In the Antwerp area alone, health activists from Medics for the People and the local community waged a decades-long battle against the highly polluting motorway and won. Likewise, they quickly rolled out operations to track, trace and test for COVID-19 as the government lagged behind. Workers from the Deurne health center ran a testing center in a local church after it was found to be the most suitable in terms of space requirements.

Even as the organization grows, Medics for People health workers remain committed to their understanding of human health. They also remain steadfast in their political interpretation of health. Through their strong ties to the Workers’ Party of Belgium and the communities in which they work, they have been able to resist even as a hard winter looms over workers in Belgium. For Medics for the People, the key is to remember that health workers have a dual role in building a healthy society. As Janneke Ronse, president of Medici for People, stated in a recent announcement about the organizations vision document, “In your consulting room, you treat diseases; together, in action, you heal the whole society.”

Public health care is a bi-weekly newsletter published by Movement for public health and People’s Dispatch. For more articles and a subscription to the People’s Health Dispatch, click here.

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