Portugal's doctors strike as state health service reels

Doctors claim the state-funded health service needs at least 600 extra professionals “as a matter of urgency”. In the Algarve, the lack of doctors has reached crunch-point, while the country’s three leading cancer institutes say they lack over 200 professionals in key posts.
In Porto last week, 66 department directors resigned in protest at “the progressive disarticulation between hospitals and health centres” – and topping the chaos, like a bitter cherry on a wobbly cake, come the words of former health chief António Correia de Campos, presenting his book ‘40 anos de Abril na Saúde’: “A government that is dying like this one has no conditions to effect reform”.
But is it really all this bad? How safe are we in Portuguese hospitals, or should we be heeding the warning that came from a top doctor in Britain not long ago, referring to the capability of the NHS in the UK: “Whatever you do, don’t get ill”?
In other words, Portugal is not alone when it comes to a state health service in tatters – and if Correia de Campos is to be believed, private hospitals should not be seen as any kind of great white hope. The former minister for health under the Socialist governments of José Sócrates and António Guterres stresses he “would never go to a private hospital”. What’s needed, he maintains, is reform.
No one would argue with him there – but that’s ignoring the issue of money.
As head of the doctors association José Manuel Silva said this week “drastic cuts and blind impositions on the financing of hospitals” have made it impossible for doctors to do their jobs, compromising patients in the process”.
This latest ‘crisis’ is basically another mini-tremor in an endless, ongoing quake. It started rumbling ominously last week when 66 clinical and departmental directors at Porto’s Hospital de São João resigned en-masse. Among the welter of reasons for their discontent was “the fact that the lack of professionals was putting the quality of healthcare to the population at risk”.
The doctors cited the “undervaluing” of the hospital, the loss of specialties that had earned São João its reputation as a centre of excellence and the government’s refusal to sanction “the hiring of doctors and other professionals, and the renewal of materials”.
As Correio da Manhã said in its report on the ‘walk-out’, “for the national federation of doctors, the measures implemented by the government have put the national health service at risk, which is the reason for calling the doctors’ strike announced for July 8 and 9.”
Since then, however, the situation has moved on rapidly.
In a bid to calm the outraged Porto health chiefs, the government agreed to “resolve the problems” and negotiations are underway.
But the health ministry’s valiant bid to paper over the cracks has left other hospitals in high dudgeon.
As SIC Notícias reported on Monday, Paulo Macedo is now faced with demands for as many as 600 health professionals in hospital units throughout the country.
In the Algarve, the southern section of the doctors’ association has warned that services are “at risk of rupture” just as hundreds of thousands of tourists arrive for the busy summer season. President Jaime Mendes claims the region needs at least 300 doctors – 200 in the three hospitals of Faro, Portimão and Lagos, and another 100 in the various health centres.
Into the mix has plunged the Association of Nurses (Ordem dos Enfermeiros) with its warning that Portugal “runs the risk of going back decades in its standards of healthcare”.
President of the regional board of the association’s central section, Isabel Oliveira, sounded the alarm in an editorial written for the magazine: Nursing and the Citizen.
“What is the point of having the best health care that science and technology can offer… the best health professionals in the world, if there is not enough of them, and the population has no access to them?” she queries.
And this shines another light on the whole subject. Portugal’s expertise when it comes to healthcare is most certainly not to be sneezed at. Endless testimonials will confirm that treatment under the state system, particularly when it comes to cancers, is second to none.
The Resident received another example of this this week when a long-term Algarve expat ended up in Lisbon at the IPO cancer institute for life-saving surgery.
“You couldn’t fault a thing,” his wife told us. “He is being looked after brilliantly.”
Algarve health chief Dr Pedro Nunes answered our questions on what the future might hold after coming out in print recently challenging Paulo Macedo to create incentives to attract health professionals to areas that are struggling most.
“I am not optimistic, nor pessimistic,” he told us. “The situation in the health service is very complicated – but we have survived up until now.
“The comments made by Correia de Campos, to my mind, would have been best left unsaid,” he added, stressing that the unsustainable debt that the health service inherited came largely from the policies initiated when the former health minister was at the helm.
So the reality is that Portugal’s health service is battered but not bowed. Nunes predicts that next year will see improvements to hospital budgets which will see all health units better equipped to cope. But, in the meantime, newspapers and websites are having a field day.
Only this week came the shock news that a health centre in Albufeira had “blood on the sheets and vomit on the floor” as the service struggled with a lack of medical auxiliaries.
In Évora and Caldas de Rainha, special emergency response vehicles were ‘paralysed’ due to a lack of doctors, in Cascais patients are waiting “up to a year” for colonoscopies and in the Alentejo out-patient surgeries are being performed in the in-patient ward – again due to lack of staff.
How things will fare in July, during the strike, is anybody’s guess, but health minister Paulo Macedo will be under no illusions after this week. The service he took over in 2011 is in urgent need of CPR.
By Natasha Donn [email protected]


More doctors and nurses for Algarve
As the Resident was going to press on Wednesday, health minister Paulo Macedo announced in Parliament that 45 nurses and a number of doctors – GPs, family doctors and other medical specialists – had been hired for the Algarve. He was answering questions from the opposition relating to the lack of human resources in the region’s health units. “Despite a crisis scenario, investment in the national health service has actually increased,” said Macedo.