Decisions coming thick and fast ahead of parliamentary grilling of health minister
As opposition parties prepare for a parliamentary grilling of health minister Marta Temido tomorrow, Portugal’s government is suddenly announcing major policy decisions in a bid to stem the spiralling degradation of the country’s embattled State health service.
Today – the second Bank Holiday to fall in the space of less than a week – Lusa reports that the government has authorised the opening of 1,639 vacancies for specialist doctors: 432 in the field of general and family medicine, 25 in public health and 1182 in hospitals.
An order published in State gazette Diario da República has given the health ministry the green light to hire these doctors “on the basis of the respective career, through the conclusion of employment contracts in public service for an indefinite period … or open-ended employment contracts, in the case of health services and establishments integrated in the business sector of the state.
“This simplified selection procedure allows, as is intended, the swift recruitment of doctors, and both newly-specialised doctors in the corresponding final season of assessment of medical internship, and any other specialist doctors who, having carried out and completed medical internship, do not hold a legal employment relationship of indefinite duration previously established with any service, entity or State body, including the respective business sector, can apply to it,” it further explains.
Health minister Marta Temido, last night announced these plans saying, 50 of the newly-specialised doctors would be in the field of gynaecology and obstetrics.
She was speaking at a second press briefing in 24-hours to present the government’s response to a series of closures of emergency gynaecology and obstetrics services at hospitals throughout the country, due to difficulties in ensuring specialists are available at all times.
The order signed by the Health and Finance ministry states that, as there have been vacancies in hospitals to which no eligible candidates have applied, new intake may be considered with no existing link to the SNS State health service.
According to Marta Temido, this decision will allow the “solution of some problems” (like the shortage of SNS doctors) but also enable the beginning of “professional projects that are interesting for those who integrate them and useful for the country.”
It is not immediately clear what the above sentence actually means, but it is interesting that it comes as the government has opened the way to hiring workers from foreign countries and ‘doing away’ with immigration quotas.
Ms Temido’s second press briefing also saw her stress that the government is “committed” to reducing its unsustainable dependence on the use of agency staff, which has cost the Treasury millions without truly satisfying the ethos of a public health service..
Says Lusa, according to the latest report by the Public Finance Council (CFP) more than 4.9 million hours were “contracted with external service providers” in 2021. Most of these were for doctors, representing expenditure of €142.1 million.
In the first three months of this year alone, another €34 million was spent on agency medical services.
Meantime, talks are going ahead this afternoon with SIM, the syndicate of independent doctors, which has been critical of government response, even as far as it appears to be going, saying nothing will move forwards unless doctors’ salaries are increased.
Said SIM president Roque da Cunha today: “It is fundamental that we talk about salaries. When the health ministry signed an agreement with us 10 years ago it was on the basis that within two years this negotiations would take place. Since then purchasing power has reduced by about 30%. At a point where we have inflation running at 8% in this country, and when taxation has never been so high, it is essential to begin the process of negotiating salary levels…”
One development that has shone through in the last 24-hours is that the hierarchy is accepting agreements with the private sector, particularly when it comes to failings in services for expectant mothers.
Marta Temido has announced the creation of a commission to “accompany response” of obstetric and gynaecology emergency units, as well as delivery blocs. The commission will involve regional coordinators as well as a national coordinator, she said.
Tabloid Correio da Manhã has stressed that, in truth, a commission is the least important development. “Short term response for the lack of obstetric doctors cannot be the creation of a commission of accompaniment. It has to be the creation of conditions within the SNS health service to reinforce the hiring of these specialists”.
ALGARVE AT RISK OF BEING UNABLE TO CARRY OUT CAESARIAN SECTIONS
The Algarve has been hard hit by the crisis in obstetrics. Portimão Hospital is already referring all emergencies to Faro until next Monday. Now, Correio da Manhã reports that Faro’s surgical unit for Caesarian sections is so short-staffed (in terms of nurses), that it too may have to close. Says the paper, SEP (the Portuguese syndicate of nurses) says the bloc should have 70 nurses, when in reality it has only 40.
SEP is not the only unhappy syndicate. The southern region coordinator of SINDEPOR (the democratic syndicate of Portuguese nurses) has visited Faro Hospital, coming away with the impression that it is a “hospital of the Third World, and not of the European Union”.
Luís Mós opinion is one that will resonate with many and has sadly been voiced many times over the years – meaning that no improvements announced can ever really have been successful.
UPDATE: As this text went up online, the meeting between doctors’ syndicates and the ministry of health was reported to have come to an end, with no agreement in sight. SIM has talked of “total deception”, saying the health ministry’s plans are short-sighted and ‘inefficient’. The syndicate says it will be presenting a counter-proposal.