Health minister laments how “a good thing” has transformed into “bad news”
A €6 million plan to upgrade the gynecological and obstetric service at Lisbon’s Santa Maria Hospital has descended into an ugly war between doctors – seeing letters flying about, dismissals/ resignations and heated tempers.
Health minister Manuel Pizarro has lamented that “a good thing” has been transformed into “negative news” – but even this is too simplistic.
What appears to have happened is that a team of 34 doctors signed their names to a letter on June 15, highlighting their concerns about the overall workability of the plan.
The top signatory was head of Obstetrics Diogo Ayres de Campos who was promptly “removed” from his post on the premise that he was jeopardising the project (the ‘good thing’ that the health minister was referring to…)
Diogo Ayres de Campos was not simply the head of Obstetrics at Lisbon’s Santa Maria – a ‘hospital of reference’ – he is also the president of the European Society of Perinatal Medicine, and “one of the most reputable names in the area of obstetrics”, says SIC. For the Lisbon North Health Authority (CLHN) to have “removed” him for highlighting professional concerns smacks of political meddling.
The ‘new director of Obstetrics, Alexandre Valentim Lourenço – a recent contender for president of the general medical council (Ordem dos Médicos) – is quoted as saying he sees the plan as one that will make the hospital “more robust”. In other words, he does not share the 34 doctors’ reservations.
Today, however, those doctors (minus Diogo Ayres de Campos and a second director of service who was also ‘removed’ for supporting the concerns) have said they want them both back; saying they have “total confidence” in their former superiors, whose work, they say, is “unique”.
If this is indeed the case, then removing them suggests very negative news indeed.
WHAT IS AT THE ROOT OF THIS CONTROVERSY?
This is a plan outlined by the relatively new Executive Direction of the SNS health service – the second management tier of the State system, answerable to the health ministry. It centres on the closure of the delivery bloc at Santa Maria during the months of August and September – during which time services are to be concentrated at the city’s São Francisco Xavier hospital (HSFX), which will be open seven days a week as of August 1.
The doctors’ concerns, as outlined in their letter, centre on conditions of hospitalisation post-partum, as well as lack of professionals available for neonatal support.
As the letter explains, there are “only 11 delivery rooms (2 less than needed) and 38 Puerperium beds (16 less than needed). This should result in a greater number of periods of overcrowding of facilities, reducing the joint response in childbirth care by about 25%”.
Says SIC Notícias, the letter also shows doctors feel they are being pressured into collaborating with the plan (this has been further emphasised by the decision to remove Ayres de Campos for being its primary critic).
In their own words, the doctors said: “We would also like to express our displeasure at the way the team felt pressured to ensure collaboration with HSFX, even before knowing the facilities available, before having agreed on the clinical situations and the health professionals who would need to be moved, before having agreed on the works planned for HSM (Hospital Santa Maria)”.
The doctors stressed they were prepared to collaborate, but require a great deal more input and consideration.
Then came the ‘removal’ of Santa Maria’s respected head of Obstetrics, and the lament by the minister of health that a good thing had turned sour.
Now, we have to wait and see what comes next. Certainly, Ayres de Campos has said this kind of treatment of health professionals could see more of them deciding to ‘throw in the sponge’ and move to the private sector, at a point when obstetrics nationally is at a crunchpoint.
