Plan includes several measures to tackle “the most urgent problems”
In a bid to address the chronic insufficiencies of Portugal’s national health service (SNS), the Portuguese government has presented an emergency health plan.
Officially designated ‘Emergency and Transformation Plan in Health’, the document was approved on Wednesday by the Council of Ministers.
“Inequality in access to healthcare is a social injustice that affects the lives of many citizens and must be combated,” the government says in a statement, adding that the new plans “aims to implement urgent and priority measures that guarantee access to healthcare adjusted to the population’s needs, optimising and maximising the response of the SNS.”
The plan is also promising the “long-term and structural changes necessary for a better functioning healthcare system.”
“Valuing healthcare professionals is one of the fundamental principles of this plan, which aims to ensure the SNS’s mission as a pillar of the healthcare system. In exceptional cases, when the SNS’s response capacity is exhausted, the plan relies on partners in the social and private sectors as a complement in providing healthcare services,” the government statement adds.
The plan is broken up into several “immediate measures” which aim to tackle the “most urgent problems:
- Creation of a special regime for admitting doctors into the SNS with more than 2200 vacancies, of which about 900 are for new family doctors;
- Elimination of the surgery waiting list for cancer patients – currently, 1,299 people have already been operated on;
- Creation of a surgical program for non-oncological patients;
- Priority at A&E departments for the most severe cases and referral of less urgent cases to clinical care centres;
- Monitoring and referral of pregnant women through the SOS Pregnant line;
- Financial incentive system to increase the capacity for childbirth and strengthen existing agreements with the social and private sectors;
- Revision of the price list for agreed complementary diagnostic tests, particularly obstetric ultrasounds;
- Hiring of 100 more psychologists for health centres;
- Creation of a Mental Health program for Security Forces;
- Freeing up beds occupied in hospital wards mainly by social cases.
The full plan is due to be “presented in 60 days, which includes various measures to achieve these goals in a defined timetable, measure by measure, in 2024-2025”.
The presentation of this plan comes at a time when there have been changes to the SNS Executive Directorate (DE-SNS), an organisation set up by the previous government to manage the network of care for users, with the departure of Fernando Araújo, after around 15 months in office, and the appointment of a military doctor, António Gandra d’Almeida, to the post.
In addition to the changes in the coordinating team, the DE-SNS, a body provided for in the new SNS Statute, is expected to be reformulated and given a simpler organisational structure.
The emergency plan is also being presented after the health professionals’ unions and the government met to settle the terms of the career negotiations. The doctors rejected signing the negotiating protocol for the time being, claiming that it does not include salary scales.
Unions have warned that improving pay and working conditions is essential to retaining and attracting more doctors to the SNS. This constraint is also aggravated by the high number of expected retirements of doctors.
In the activity report it submitted to the Ministry of Health, the DE-SNS warns that around 5,000 SNS professionals are expected to retire this year, and it considers it “critical to be able to attract” new specialists and doctors working outside public units.
This year alone, the executive board estimates that 1,901 doctors, 699 nurses, 1,158 operational assistants, 171 senior diagnostic and therapeutic technicians, 794 technical assistants, 139 senior technicians, 37 pharmacists and around 198 professionals from other areas could retire.
According to data from the Medical Association, 45% of the 9,000 or so family doctors are over 65, and according to the SNS transparency portal, 1,565,880 users have not been assigned a general and family medicine specialist, when in August 2019, there were around 644,000.
Official figures indicate that, at the end of March, the SNS had around 21,400 specialised doctors at its service, plus a further 11,000 interns, more than 50,000 nurses and 9,800 senior diagnostic and therapeutic technicians.
