Queues are commonplace outside Portugal's health centres. This photo comes from Rádio Renascença and was taken in Greater Lisbon
Queues are commonplace outside Portugal's health centres. This photo comes from Rádio Renascença and was taken in Greater Lisbon

Health centres lack “almost everything”

Study reveals “unprecedented lack of essential material”

In a year in which the government promised “the largest ever budget” for Portugal’s SNS (State health service) lack of essential supplies to ensure the functioning of services reached levels never seen before.

This is the opening paragraph of a text in Expresso today, at a point where the ministry of health appears to be clambering back from the brink.

Last night, doctors syndicates were beginning a trawl through the small-print of the latest pay deal presented to them, while today prime minister António Costa is meeting with the CEO of the ‘Executive Direction’ of the health service – a man tipped to be on the point of resigning in frustration at the way nothing has been working as it should.

It is not simply that hospitals up and down the country are hampered by the work to rule by doctors syndicates’ over overtime, it is that health centres themselves are permanently under-equipped.

A study of the 615 national family health units (USF’s) revealed “that lack of basic material increased to the highest level in the last 13 years” (13 years being the last time such a survey was undertaken).

96% of those who answered the inquiry (and response was the highest ever, at 79%) attested to “lack of material considered basic for normal activity during the year.

“In half the units, insufficiencies occurred more than 10 times a year”(meaning essential material will have effectively run out 10 times during the year).

Expresso describes the kind of material that ‘runs out’ with most frequency: “otoscopes (to look into ears), scales, fridges, thermometers, serums, gauze compresses, syringes, contraceptives, vaccines, medication in general, paper, toner and office material”.

The study concludes there is a “lack in the capacity of regional health administrations (ARS), health centre groupings (ACES) and local health units (ULS) in resolving problems that have been aggravating.

“The consequences of the failings fall on users”, the study’s conclusions continue, adding that this can mean “users have to wait at least 48-hours to obtain the care they need due to lack of material.

“And when material isn’t lacking, computers and telephones are failing, compromising the response to the more than seven million Portuguese enrolled at USF health centres.

“No USF has its IT applications available at all times” and “this year IT failings occurred with even more frequency that last year. Almost 96.5% of (responses to the study) confirmed the negative impact in the quality of healthcare provided”.

Expresso’s report carries graphs on ‘ruptures of stock’ and ‘dissatisfaction’ levels recorded by the general public, and goes into the ‘inadequacy of premises’ which are either not sufficiently hygienic, or have other failings, like no heating/ air conditioning. The study also highlights professional difficulties faced by staff who feel that they are ‘overworked’ and ‘underappreciated’.

“The authors of the study blame the more central administration and that on the ground”, says the paper. They do however put some stock in the fact that the Executive Direction – created over a year ago, but hamstrung since then due to a lack of ‘statutes’ – may be able to turn things around now that statutes have been hurriedly published.

The authors of the study make 12 suggestions for changes in the running of the country’s health service, and these changes will be among topics under discussion between the prime minister and the CEO of the Executive Direction, Fernando Araújo, today.

Elsewhere, however, Expresso refers to one of its podcasts in which former PS parliamentary speaker Ferro Rodrigues says: “I do not know how the deep thinking of the President of the Republic is going, but what polls are saying is that there could be a dissolution (of parliament)” such is the level of general dissatisfaction, on so many levels, within the country.

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