Health minister resigns

Health minister quits; opposition demands “real change”

Health minister resigns after young mother dies in childbirth; Marta Temido’s replacement unlikely to be chosen before mid-September

Tuesday morning saw the first major casualty of Portugal’s ‘absolute majority’ Socialist government. Health minister Marta Temido threw in the towel following the third ‘suspicious’ death in obstetrics this summer.

By all accounts, it was the death of a young mother – following transfer from one ‘leading Lisbon hospital’ to another – that prompted her decision, albeit the writing has been on the wall for months. For all the billions of euros channeled into it, Portugal’s state health service is in desperate need of a reform.

Marta Temido’s announcement was simply that she “no longer had conditions” to continue at her post. Bizarrely, she has found herself forced to continue, in the short term at least, as prime minister António Costa ‘has no time’ to choose a successor…

That the country has arrived at such a surreal moment has seen all political parties in opposition demand “real change” and “action”.

President Marcelo Rebelo de Sousa has refused to comment until he receives Ms Temido’s formal resignation – and he stresses this must be accompanied by the naming of a successor.

And this is where it all becomes even more ‘clouded’: will the prime minister (once he has time) choose a successor to guarantee ‘continuity’ (which critics believe is the worst possible option), or will he be brave enough to choose ‘a leader’ – someone with real vision on how to resuscitate the ailing State health system?

Considering Marta Temido has been ‘at the helm’ through all three of António Costa’s governments, she has a long (and very chequered) history. For all the praise the PM has sought to heap on her for soldiering through the pandemic, the truth is the country has arrived at 2022 with the worst record for excess deaths in Europe. A record so much worse than the European average that it has been ‘news’ throughout global mainstream and social media. Add to this the absolute crisis in obstetric care, and Ms Temido leaves with no gold stars to her credit.

“A House on Fire” was the title of tabloid commentary on Wednesday, which blamed António Costa for the mess, suggesting it is all his fault that he maintained a minister in charge who failed to resolve fundamental issues.

Health minister resigns

Even in his reluctance to “comment on the case”, President Marcelo said, via videolink on Tuesday, that “an absolute majority means absolute responsibility” because the centre of power lies with the government, not parliament.

In his opinion, Marcelo says he would like to see the health service have more autonomy from the Health Ministry. This is key, as it means Mr Costa’s purported desire for ‘continuity’ may come up against the ultimate opposition, that of the president himself.

Three suspicious deaths

To recap, this summer, two babies have died due to constraints within obstetrics. Now, one young, reportedly previously perfectly healthy mother is dead.

The babies’ deaths are both under investigation by IGAS (the general health inspectorate). They occurred following the closure of obstetric units due to lack of available doctors.

In the third case, the baby survived (and is battling for life in neonatal intensive care, having been born weighing just 772 grams), but the mother died, last Saturday.

Husband Satgur Singh has told reporters that he doesn’t want to sue, he simply wants answers.

His 34-year-old wife entered Lisbon’s Santa Maria Hospital with all the signs of pre-eclampsia, but due to health service constraints, the neonatal unit had no space for her, hence the decision to transfer her to the capital’s São Francisco Xavier hospital.

During the ambulance journey – undertaken with a doctor and two nurses – the mother suffered cardiac arrest and essentially never regained consciousness. Her tiny baby was delivered by emergency Caesarean section at São Francisco Xavier.

Might this outcome have been the same had Mrs Singh been admitted to Lisbon’s Santa Maria and not transferred? Very possibly. But the fact that yet another obstetric tragedy has come in a year when a commission has been set up to try and discover why Portugal’s maternal death rate has suddenly leapt to the highest level in almost 40 years makes this moment a turning point – or in Marta Temido’s case, the full stop after five long, very challenging years.

Three (or four) possible successors

The media has wasted no time trying to pinpoint who might be the country’s next health minister.

The ‘name of continuity’ (which most agree is the last thing needed) is António Lacerda Sales, the face already very much associated with the pandemic, an orthopaedic specialist/politician and, surprisingly a very wealthy man in his own right (last year he was billed as the second richest politician in government, the first being the minister of economy at the time who has since returned to civic life).

Mr Costa is said to ‘favour’ António Lacerda Sales largely because he, with Marta Temido, has been integral in drawing up the new health service ‘statute’ – a so-called fundamental reform due to be formally adopted by the Council of Ministers on September 15 – but a document that elsewhere has been largely dismissed as more Socialist ‘hot air’.

It is because of this Statute – and his own packed agenda – that PM Costa is understood to want Ms Temido to continue at her post until September 15.

Other names in the air are Rosa Matos – currently presiding over the central Lisbon hospital board; Manuel Pizarro, a Euro MP, and, perhaps more ‘interestingly’, Fernando Araújo, president of São João Hospital in Porto and a fierce critic of government health policy.

Araújo is seen by critics and commentators as ‘the bold choice’: the man with vision to wrestle the health service back from the brink and away from ideological political control.

On the basis that health service syndicates complain they are never listened to, Fernando Araújo would be the first choice. But, for now, we have to ‘wait and see’.

The health ministry, meantime, is spending more money than it has ever spent before.

As the tabloid press proclaims: “Expenses rose by €3.1 billion under Marta Temido’s management” – meaning that no less than €13.321 billion is being spent this year – a year which “has never been so chaotic, with so many complaints over lack of personnel and closed services” and now three truly awful deaths in people who represented the future.


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