Marta Temido introduces new ‘SNS health service Statute’
As promised, the government has delivered what it calls its new health service Statute – a set of updated rules designed to improve public health in Portugal, which minister Marta Temido admits has been labouring under a ‘deficit of organisation’.
One of the chief changes appears to be a moving of responsibility slightly sideways by creating an “executive direction of the SNS”.
Critics will (and do) say this is just another ‘jobs for the boys’ type of structure, reminiscent of the practices of PS Socialists.
Marta Temido however has said it will be a hugely demanding ‘first dimension of the level of organisation’ within the service, that will “assume the coordination for all the SNS assistential response, assuring its functioning in a network”.
Today is “a very important day for the SNS, and particularly for its design on the future”, she explained at a session held at medicines authority Infarmed, to present not only the Statute, but investments under the Plan for Recovery and Resilience (backed by billions of euros of community funding).
The new ‘executive direction of the SNS’ will “distinguish itself from the function of the Ministry of Health” (…) “The executive direction has an operational function in the implementation of that which are political lines and choices”, said the minister. “The health ministry, on the other hand, has a function of execution but of defining health policies that are not restricted to the SNS…”
As always on these occasions, the overall message becomes a little bloated by verbiage.
On to the next major ‘change’. This comes in autonomy. Health centres are now to enjoy the same level of autonomy as hospitals when it comes to hiring.
Motivation is also a new ingredient. This third aspect of the Statute involves improving the motivation of health professionals, so that they can guarantee “better care, but also more humanised care”.
This was ‘the presentation afternoon’. It will take a bit of time for the dust to settle on what the Statute really means; what it doesn’t, and when it will come into effect (this has since been touted as October. In other words, the ‘deficit of organisation’ must continue through the summer).
What already seems clear is that the Ordem dos Médicos (General Medical Council) has a lot of issues with the government’s changes.
Under the headline “Unacceptable”, president Miguel Guimarães suggests new PS policy will involve “hiring doctors without any speciality to secure specialist functions in general and family medicine.
“This situation seriously violates the medical career, and the regulation of doctors acts. It can put the health of citizens and patients at risk.
“We do not want a Portugal with first and second class citizens”, he wrote in Correio da Manhã today. “Some who get access to a medical specialist, and others who do not. We don’t want that tomorrow a pregnant woman who cannot see an obstetrician is assigned a clinical pathologist; or that a cardiology patient who cannot see a cardiologist, is seen by a rheumatologist. The government has the obligation to guarantee that every Portuguese citizen has the right to a family GP. They exist (1400 operate outside the SNS) and can be hired.
“Placing doctors without specialties in health centres with a list of patients under their entire control and responsibility is neither wise nor acceptable. There are solutions that respect specialisation that can be activated. Let there be good sense”, he concluded.
Today’s announcements by Marta Temido will be analysed and commented on in the coming days. For now, the PS are taking credit for a ‘good change’.
The new Statute replaces one that has been in place since 1993, and “did not respond to the 2019 Base Law” brought in by PS Socialists, explained Ms Temido, while Prime Minister António Costa has also promised today an “organic fundamental reform of the SNS health service”, and affirmed that €1.240 billion will be invested in it from the PRR (‘bazooka’ of EU funds).
He said of the new executive direction of the SNS, that this is “essential, like it was absolutely essential to have a single point of command for the vaccination programme”.
Repeating very much the message from Marta Temido, the PM outlined how new direction would ensure that “every day, all establishments in the system“, from primary care to hospital care, passing through to continued care, can see “everyone work in a coordinated and networked way” … but not quite yet.
