Portugal’s centre-right government has come up with a strategy to stop ‘losing doctors’ to agencies which then hire those doctors out to the state at ‘vastly inflated sums’.
The idea, still be to thrashed out with syndicates, is that newly-qualified doctors, and those breaking contracts with the SNS health service, will simply not be allowed to sign up with agencies that hire their services out to public hospitals, paying better rates than the doctors would receive if they were on the state payroll.
Expresso calls it the government “wanting to penalise doctors who don’t want to work for the SNS” but who nonetheless earn a living doing just that through a private agency.
The ‘bottom line’ here is that the government is paying out enormous sums to private agencies, when, if this was not the case, there would be more money to spend on salaried health professionals. To give an idea, because of the lack of salaried doctors, the SNS ‘just in 2024 paid out close to €231 million’ for agency doctors, writes Expresso. Every year, more and more doctors ‘leave the SNS because it pays badly, demands a great deal’ and thus the dilemma seems set to worsen – unless the government ‘thinks outside the box’ and comes down hard, as it is hoping, with a new set of requirements and restriction.
Doctors, however, are bound to see this as an erosion of their ‘freedom to choose’, to have a life with less working hours (and a lot more money!)
As SIC reports, “the draft bill has still to be discussed with syndicates, and opposition is expected”.
One aspect of the government’s plan is that it should guarantee an improvement in the quality of doctors working in the health system (by dint of giving doctors little choice of working elsewhere, unless they decide to ‘decamp’ to the private sector/ abroad, which a large part of them already do). But whether it can actually pass the ‘test’ of negotiations with syndicates is a whole different matter.
Another aspect of the draft bill is a setting of scales for agency doctors, making the pay they receive less attractive.
From the point of view of ‘health service users’ (the public, in other words), it will always be preferable to have a state health service staffed by permanent healthcare providers, as ‘agency staff’ are placed ‘when and where’ they are needed, without necessarily knowing the hospitals, or the staff and systems within them.
Source: SIC/ Expresso
