State health service chaos: “Problem is not new”
Health minister Marta Temido during a press conference to address the chaos of Portugal’s state health service Photo: MANUEL DE ALMEIDA/LUSA

Portugal’s health minister resigns; replacement “won’t be quick”

Doctors syndicate says resignation was “inevitable”

Portugal’s health minister Marta Temido presented her resignation this morning, saying she no longer believes she “has the conditions” to exercise her mandate.

Coming as it has after months of chaos and discontent within the health service, the country’s independent syndicate of doctors has said the resignation was inevitable.

But it does nothing to improve the situation. If anything it has masked the latest ‘health service horror story’: that of a 34-year-old pregnant woman who died while being transferred from one of Lisbon’s best known State hospitals, due to there being no available beds for her in the neonatal ward.

As this ‘side story’ breaks, it seems the dead young woman’s child was delivered by C-section and has survived (see box story below).

It may be that this new catastrophe is what pushed Marta Temido towards the exit door.

Certainly, a replacement is not likely to be found easily. The expression ‘poisoned chalice’ hangs in the air.

A source close to the prime minister has been quoted by Lusa (State news agency) as saying: “The prime minister would like it to be Marta Temido to take the diploma regulating the new executive management of the SNS to the Council of Ministers” which is not scheduled until September 15.

The PM is described as “fearing that the replacement of Marta Temido will delay approval of the diploma” which he believes is a “central piece of health  service reform” – albeit many others have said it is fairly pointless.

Thus Lusa suggests “the replacement of Marta Temido will not be quick”. Mr Costa is fully occupied “completing preparation of the extraordinary meeting of the Council of Ministers next week” which will be presenting new packages of support for families struggling with rising inflation.

Tomorrow, the PM “will be on a plane all day to Mozambique”, where he is due to take part in a summit until Friday – only returning to Lisbon on Saturday night.

As the dust attempts to settle on this latest ‘bombshell’ for a government that appears more and more to be trying to keep running with its shoelaces undone, doctors syndicate leader Jorge Roque da Cunha has been quick to provide context:

“The Independent Doctors’ Union never demands the resignation of members of the Government because it is up to the Portuguese to choose the prime minister and the prime minister to make his choices. But in fact in recent months we have witnessed a disassociation from reality by Marta Temido when last weekend she still said that they have hired thousands of health professionals and doctors, not taking into account the recommendations made by the country’s national health authority (DGS) to the fact that there are 1.5 million Portuguese without family doctors, to the permanent problems of the obstetrics and internal medicine emergencies, and the incapacity to dialogue with the sector leaders”.

As Roque da Cunha prepared his syndicate’s statement, other sources within the health service have been compiling theirs – all saying much the same.

FNAM, the National Federation of Doctors has explained that Ms Temido showed “no willingness to address” some of the (fundamental) problems of the health service.

This “incapacity” has shown itself in an “undisguised way” over recent months, said FNAM’s Noel Carrilho.

Miguel Guimarães of the General Medical Council has said the obvious. The country can only hope now for a health minister who will, in fact, “make things happen” (by that he means implement necessary reforms to wrestle it back from the brink).It will not be easy: “There is a very big crisis in the National Health Service – a crisis which has been going on for a long time and which has had no solutions”, he stressed.

On this basis, one has to ask was it ‘just the ongoing crisis’ that pushed Marta Temido into her declaration this morning, or was it the truly awful death of a young immigrant mother in the process of being transferred between two of the country’s ‘leading State hospitals’?

The drama of obstetric care has blighted the last few months. It has plunged pregnant women all over the country into states of anxiety – and now this:

Pregant woman dies during transfer between hospitals

A 34-year-old Indian woman died on Saturday after collapsing during a transfer between two of Lisbon’s busiest hospitals.

Details emerging explain that the young woman only recently arrived in Portugal, “without any data showing medical vigilance of her pregnancy”.

She arrived at the A&E department of Lisbon’s Santa Maria hospital last Tuesday (August 23), manifesting high blood pressure and breathing difficulties. Once her issues had been stabilised, she was transferred to nearby São Francisco Xavier hospital “due to circumstantial lack of space in the neonatal department”.

According to reports, the young woman was accompanied during the transfer by “one doctor and nurses”.

“On the journey, the pregnant woman suffered cardiac arrest; reanimation efforts went ahead during transportation. On arrival at São Francisco Xavier a Cesarean section was performed, and the baby, which was born weighing 772 grams, was interned in the neonatal intensive care ward. The mother was admitted to intensive care, where she died on Saturday”, writes Correio da Manhã.

According to the Lisbon North hospital administration, ‘the network management of neonatology is current practice’. In other words, pregnant women are frequently transported between hospitals in emergency situations once they have been stabilised.

SIC television news has added on its website this morning that “due to successive stories of lack of obstetricians in A&E departments in various hospitals, the hospital stresses that the emergency obstetrics and gynecological team (on that day) was complete”. 

This story has found itself many items down on news pages today, due to the furore caused by Marta Temido’s resignation.

But it underlines the absolute crisis in maternity care.

Back in May, the State’s DGS health authority set up a multidisciplinary committee to study and monitor maternal deaths and serious maternal morbidity due to recent data showing how bad things had become.

The committee includes “experts in obstetric, internal medicine, anaesthesiologists”, one of whom – Diogo Ayres-de-Campos, director of gynecology and obstetrics at Lisbon’s Santa Maria Hospital – admitted outright: “Obstetric care, which has deteriorated, needs to be rethought”.

Opposition parties say resignation ‘should have come sooner’

Back to the central theme, political parties in Opposition have all agreed Marta Temido’s resignation should really have come a great deal sooner. But it does nothing to resolve the drama of how to fix Portugal’s broken health service, or how to restore citizens’ faith that medical emergencies will be in good hands.

natasha.donn@portugalresident.com