Health secretary António Lacerda Sales says "no one will be left without answers"... even if they are 100 kms away. Image: José Sena Goulão/ Lusa

Outcry over shambolic crisis in obstetric care

Another weekend of mass maternity unit closures

PM António Costa will be returning from a short holiday break on Monday to face molten fury over the unconscionable crisis in obstetric care.

This weekend will see no less than eight maternity blocs up and down the country ‘closed’ due to lack of available staff; in Greater Lisbon hospitals of reference, including Maternidade Alfredo Costa, are slamming shut their doors (again!)

“Public obstetric services of MAC, S. Francisco Xavier and Garcia de Orta closed for the weekend. Put another way: pregnant women either have to go private or make do on their own… If this isn’t doing the job of the right and destroying the SNS health service, what is @antoniocostapm? Dyed-in-the-wool socialist and former MEP Ana Gomes tweeted earlier today.

The country’s leading tabloid Correio da Manhã has also put its boot in, in the form of a ‘director’s post card’ (comment piece), in which director Carlos Rodrigues alludes to the real elephant in the room of this ongoing drama: the government says it wants to encourage Portuguese to procreate. The population has been steadily declining for years – to the point that the Social Security system will rapidly become unsustainable. It is crucial that new citizens are born, and born in safety.

Says Rodrigues: “There is something that is not right in a country the obliges a pregnant woman to travel 100 kms when she has pain because the closest maternity bloc is closed due to lack of doctors. 

“There is something wrong when we live in a demographic autumn shrinking the population, and even so, we cannot guarantee the minimum conditions for our babies to come into the world.

“Something is happening that should shame us profoundly. 

“When we oblige one of our mothers to travel four times the distance she should, we are all failing.

“António Costa is on holiday. One of these days, when he wakes up in the morning, maybe he will take a deep breath and look into the mirror like President Sampaio did one day, to assess the record of the Government of Santana” (Lopes: a singularly unsuccessful PSD prime minister).

“What is happening in the health service simply cannot continue. It is too shameful”

Shameful too were the comments this week of health secretary António Lacerda Sales, who tried to make light of the extraordinary distances birthing mothers are being asked to undertake by saying that the fact that hospitals within the health service work as “a network” was one of the “great conquests of the SNS health service”.

The government and hospital authorities are “working on finding solutions, which could involve directing people to other health units”, he said. “INEM takes people to services that can offer better, faster, more secure response, so no-one will be left without answers”, he added, with the assertion “that INEM is a great institution whose image should be preserved even though there are exceptional cases that need correcting…”

This whole section of his comments to journalists at the opening of a new health unit yesterday actually needs correcting – or at very least putting into context: first the notion that “INEM takes people to services that can offer better, faster more secure response”. Better, faster and more secure than what precisely? The issue here is that ‘there is no response’ which is why pregnant women and others with obstetric/ gynecological emergencies are travelling up to 100 kms to see a doctor…

Second, “INEM is a great institution”. It may well be, but this week (and last weekend in Campolide, Lisbon) INEM failings have been brought to the fore, to the extent that Rui Lazaro, president of the syndicate of pre-hospital emergency technicians  employed by INEM says the service is 500 personnel down. “We don’t have the personnel”, he told CM. “Ambulances are shut down every day throughout the country. The other problem is that INEM also transports ‘non-urgent patients’ – and then, when ambulances are needed for urgent cases they simply aren’t available”.

Thus Mr Lacerda Sales’ assurances that birthing mothers ‘will have the response’ they need in one of the most significant moments of their lives cannot be taken on face value.

As if to underline this, a 41-year-old mother in the final days of her first pregnancy was this week forced to travel 100 kms when she started feeling pains (because the closest maternity unit to her home was closed), and when she finally reached a functioning Gynecological and Obstetric A&E, the medical team diagnosed ‘fetal death in utero’: her baby was dead.

At this point (today), the causes and circumstances of the baby’s death have not been established. An autopsy has to be undertaken – but none of this is a good look for a prime minister coming back from holiday whose governments have been running the country for the last seven years.

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