COFA attributes pressures to structural issues like underfunding and aging population, not overuse of

The Col·legi de Fisioterapeutes d’Andorra (COFA) has pushed back against suggestions that physiotherapy is driving pressure on the health system, insisting the challenges stem from broader structural shortcomings including poor planning, insufficient funding, and resource constraints.

In a statement issued this Tuesday, COFA urged a “calm, rigorous, and constructive” discussion on health system operations, stressing that rising demand cuts across all medical fields. The college described physiotherapy as a vital service, supported by scientific evidence and guided by physician referrals grounded in clinical needs, rather than a primary source of overload.

COFA attributed growing patient volumes to the profession's evolution and broader remit, which meets new population demands, enhances well-being, and curbs chronic disease progression. President Theo Rogué pointed to average waits of two to three months—reaching four in cases requiring patient-provider scheduling alignment—citing factors like demographic expansion, population aging, disease persistence, age-specific treatments, administrative loads, and a gradual decline in CASS-contracted physiotherapists. While over 200 members are registered, only 137 maintain public health agreements amid intensifying caseloads.

The group highlighted years of static CASS rates, untouched by inflation, as a driver of contract withdrawals that threaten service breakdowns. COFA has long collaborated with the Health Ministry on revisions to ensure viability. Rogué sidestepped precise demands like a 30% rise, focusing instead on optimizing service structures for efficiency and standards, with realistic proposals to follow feasibility assessments. He noted health expenditure dipped 2% due to fewer contracts and challenged the value of cuts, given physiotherapy's role in reducing absences and operations.

In light of recent official comments, COFA's board is preparing a public stance to support members, challenge prevailing accounts, identify root issues, and advocate structural fixes through accountable planning and better pay.

Health Minister Helena Mas, speaking Thursday during a Salut app update launch, affirmed intensive joint work with COFA's new leadership on access, tariffs, processes, professional autonomy, and referral pathways. She described the sector as “difficult” due to treatment variability—such as differing shoulder cases for a young woman versus an older patient, or preferences for manual versus equipment-based care—and ruled out uniform rate hikes as ineffective. An IPC adjustment is forthcoming, paving the way for procedure standardization and comprehensive reviews, though no firm deadlines were given. Mas acknowledged some contract losses but emphasized they are not massive, offset by new accreditations, and urged patience for these intricate steps.