prime minister António Costa
What DOES the prime minister think about the SNS public health service? Costa responds (more or less), writes Miguel Esteves. Image: José Sena Goulão/ Lusa

All energies must be focused on reforming health service – PM

Article in Público makes no direct reference to state of crisis within SNS

Portugal’s prime minister has said today that all energy should be focused on the success of the reform of the health service (SNS) at a time when there are more financial and human resources.

In an opinion piece published in Público newspaper – and with no direct reference to the dispute between medical unions and the government that has hospitals in knots – António Costa responded to António Sarmento, professor at the Faculty of Medicine of the University of Porto, who on Friday, also in an article, addressed the prime minister, asking him “what he thinks about the SNS health service” and if he is aware “that we are on the verge of a catastrophe that could cause the loss of many lives“.

António Sarmento’s article listed six searing questions.

But as reports have pointed out, the prime minister may have responded in as much as he has written an opinion article in today’s edition of Público, but he certainly has not directly answered any of the professor’s questions.

For example, does the prime minister think that “the recent opening of dozens of private hospitals, already outnumbering the public ones, is due to a lack of response from the public sector or the State’s contribution to making these investments viable, or both”, elicited a reply in which the PS leader neither mentioned the opening of dozens of hospitals, nor the lack of response from the public sector.

The prime minister considered that “now that we have more financial resources and more human resources, it would be inexplicable if we didn’t focus our energies on successfully reforming its organisation. As always, with the active involvement of health professionals, whose careers and working conditions we are enhancing”.

Mr Costa went on to recognise that “with all the many problems affecting the SNS, the activity of its professionals is truly impressive”, exemplified in particular by the increase in the number of consultations and surgeries, with figures higher than in 2015, writes Lusa.

And then he listed the changes underway in the organisation of the health service, suggesting that “the revolution that is underway in the SNS” is the result of the decision to “strengthen resources, organise capacity management, optimise the care delivery model and qualify facilities and equipment“.

“I have no doubt whatsoever that the guarantee of having an SNS with the characteristics that we enshrined in our Constitution depends on the ability of all of us to mobilise to reform its organisation.” 

It was a very far cry from António Sarmento’s challenge to answer questions that, in his opinion, “millions of Portuguese would also like to see answered“.

The head of service and professor at the Faculty of Medicine of the University of Porto particularly wanted to know what the government’s plans are if, “due to the impossibility of competing with the private sector, the SNS becomes increasingly depleted of doctors, and its institutions lack scientific, training, clinical and human quality, knowing that millions of Portuguese have no alternatives“.

Are you finally aware that we are on the verge of a catastrophe that could cause the loss of many lives?” came his last question. 

Again, the response “was not clear”, say reports today. 

“António Costa continued to write (only) positive figures for the SNS – ‘by September the SNS had ensured 25 million consultations in primary healthcare, 9.9 million hospital consultations, 617,000 surgeries and attended 4.6 million emergency episodes. All figures higher than in 2015: +12.2 per cent of consultations in primary healthcare, +11.7 per cent of hospital consultations, +27.9 per cent of surgeries and +2.1 per cent of emergency episodes’ – giving the idea that the services are healthy”, explains Miguel Esteves for ZAP notícias (part of the AEIOU group) concluding: “According to the fourth paragraph of the letter, António Costa thinks the following: “The approval in 2019 of a new Basic Health Law was a clear and unequivocal affirmation of the public, universal and tendentially free SNS as the backbone of the health system, and I think that answers your direct question about what I think of the SNS”…

Certainly, Esteves is not convinced: “In conclusion: António Costa ended up failing to respond directly to the questions/”concerns” he set out to address.

“Did the ‘millions of Portuguese’ find out whether or not the Prime Minister is aware that Portugal is on the verge of a catastrophe “that could cause the loss of many lives”, questions Miguel Esteves.

Or did they read between the lines? ND