Lisbon hospital director warns of “serious risks of collapse of State health service this summer”

A&E closures have resulted in ‘system overload’ in departments remaining open

The head of São José’s integrated trauma centre in Lisbon, Dr João Varandas Fernandes, has warned today that the State health service (SNS) faces “serious risks of collapse” in the summer if there are no solutions for A&E departments.

“If solid and consensual basic solutions are not found, I think there are going to be serious risks of collapse during this summer period”,  he told Lusa. 

“They may be major or minor collapses, but there will be serious risks in terms of operation,” said the orthopedic surgeon, explaining that the increase in numbers coming into the CHUC (Lisbon central university hospital) A&E department results from closures of other emergency and inpatient units.

Dr Varandas (as he is known) listed the cases of Santarém, Loures, Santa Maria Hospital and Garcia de Orta (Almada) to explain the issues affecting CHULC – São José, arguing that “it is not possible to continue like this” and that there are not enough teams to deal with all the closures.

“On average we have between 52% -60% of patients assisted in the emergency services of CHULC from outside the area. We are in the front line to avoid failures; emergency teams have spared no effort, but if a solution is not found, the risks are very real”.

“This has been going on for a long time”, he added (remember the appeal last year from health director of the time Graça Freitas, “please do not get ill in August…”). Anyone could predict this crunch point “several years ago. The necessary measures have not been taken. 

“In recent years we have had a health system that was very ideologically tied up and it is necessary to find new forms of organisation and clinical management”, he said. “Closing emergency services due to a lack of human resources is an obvious move” but it can never be a solution.

Among possible answers, Dr Varandas used the example of integrated responsibility centres as a way to defend the SNS, a service he sees as “fundamental and indispensable” for Portuguese society.

“Professionals – all without exception – are paid at a base rate, but then have a complementary system of incentives based on indicators that are met, the production they have and the quality of care they demonstrate. This is one of the ways: to increasingly develop integrated responsibility centres in the country, centralising pathologies. This is something fundamental”.

The clinical health director challenged political powers and the Executive Management of the SNS, led by Fernando Araújo, for something to be done “quickly and sustainably” in order to avoid a drop in the response of care for the population.

“It is necessary to go further, deeper, have a great articulation and make choices by pathology and differentiation”, he insisted. “It is not possible to have everything everywhere; a more modern vision of the SNS has to be put into practice, if we want to keep it”, he concluded: “The Executive Board of the SNS has to go further (than it has already) and listen to professionals”.

Source: LUSA