Fundamental changes to health service hierarchy ‘done and dusted’
A picture says a thousand words - expressions at the press conference yesterday were grim

Fundamental changes to health service hierarchy ‘done and dusted’

Law approved ahead of time; without PM present, and without  addressing concerns of Marcelo

Yesterday’s Council of Ministers was distinctly odd. The faces of the ministers showed it. It failed to come up with the promised ‘energy saving plan’; it did not involve the prime minister (absent for health reasons, see briefly section) and it involved the approval of outgoing health minister Marta Temido’s plan for a new tier within the State health service hierarchy… one week ahead of schedule.

Perhaps more importantly, for Expresso, it meant that Marta Temido has now ‘gone’ without having answered the president’s very relevant concerns over the creation of an ‘Executive Direction of the Health Service’…

Something feels wrong about the way this “fundamental” reform within the health sector has been given whistled through; and those expressions on the faces of ministers tasked with holding yesterday’s press conference seemed to show it.

“The president agrees with the creation of this new direction, and with the position of an executive director of the SNS health service”, Expresso concedes. “But he has doubts about its articulation with ARS (regional health authorities) and the ACSS (central administration of health services). 

“Within the sector, there are many who defend the end of ARS – and this would be Marcelo’s preference. But Costa forced a compromise solution, which the head of State fears will lead to a duplication of structures. 

“These are the doubts the (outgoing) minister did not clarify. She also did not announce the name (of the person) taking over the new role.

“Marta Temido started by answering journalists questions but was sparing in her words…” the paper adds.

Oddly sparing, even. 

She said the choice of the person and the team making up the new direction was “a subsequent process” – meaning something that would take place after she had left. And on the subject of this abrupt exit, a full week ahead of what had been expected, she said she was “grateful for the opportunity” to have served within the government…

All in all, nothing felt very coherent. And that is before one realises the choices for the next health minister have also lurched in other directions.

Says Expresso, the name of Ms Temido’s substitute “will be seen as a sign of the capacity of attraction and traction of this absolute majority.

Fernando Araújo, the president of Porto’s Centro Hopitalar São João, desired by the sector, particularly when it comes to doctors, is being seen (suddenly) as an unlikely choice”. Other news sources have stressed the prime minister has not agreed with a number of (scathing) editorials written by Fernando Araújo on the management of the health service.

“In the last week, tips have pivoted towards Raquel Duarte”, the pneumologist who made up the government’s advisory team during the pandemic.

Raquel Duarte had a “brief passage” within the government (as secretary of state for health, between 2018-2019). It wasn’t a particularly successful one, says Expresso. She was seen as ‘good technically’ but not politically.

Other names still in the mix include Euro MP Manuel Pizarro (again nothing like as popular a prospect among doctors and nurses) and the recent health secretary and often ‘face of the pandemic’ António Lacerda Sales.

Expresso explains that if Lacerda Sales is indeed chosen in the end – after such a strange delay – it will be an extremely bad sign.  He has been in the health ministry for the last few years, and a secretary of State would be a logical choice. Thus having delayed such an announcement would just look somehow … odd – like the government had simply run out of alternatives that it deemed suitable, and fallen back on the convenient ‘spare’.

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