Portugal’s healthcare under fire

Austerity cuts in the health service are killing people. It’s the claim, coming from all quarters, that has literally taken the nation’s press by storm since Christmas. With presidential candidates, MPs and ministers all high-profile in their demands to “recover” the state health service before any more lives are lost, the truth is that what is happening in Portugal is very similar to what happens every day in other countries that still pride themselves on quality state healthcare. As one hospital administrator told us: “You think this is bad? Try getting ill in a holiday destination like Cuba, or the Caribbean…” In other words, the chaos being catalogued in Portugal today has to be put into perspective.

The bad news started rolling in before Christmas, leading to the resignation of three key hospital administrators in Lisbon.

Twenty-nine-year old David Duarte died in the capital’s Hospital de S. José because of the austerity-led policy not to have any neurosurgeons on duty over the weekends.

Arriving in hospital with a ruptured brain aneurism on a Friday (December 11) meant Duarte’s urgent need for an operation was put on hold till the following Monday.

He died hours before the surgeons who might have been able to save him came back on duty.

Duarte’s family are understood to be making a formal complaint but, in the meantime, the hospital boss who years ago supported the cuts brought in by the last government has admitted that they effectively caused the young man’s death.

“In recent years, with the cuts we have had in the health service, hospitals have not had the human resource possibility to respond to patients like these,” Luís Cunha Ribeiro told a packed press conference on December 22.

One of three administrators resigning over the issue, Ribeiro stressed that both the city’s hospitals with neurosurgical specialities would be reversing their weekend-cover policies forthwith, while an inquiry has been launched by the secretary of state for health Manuel Delgado into reports that four other patients may have died due to lack of neurosurgical cover at weekends at S. José.

But as the tragedy of David Duarte assailed the nation – prompting a visit to the hospital by presidential hopeful Marcelo Rebelo de Sousa as well as a damning outburst from fellow contender, Euro MP Marisa Matias – more horrors played out, bringing in the Algarve.

Late into the night on Christmas Eve a furious father almost came to blows with security guards in Faro after finding “nothing was happening” in the casualty department, despite urgent cases – like that of his young son vomiting blood – needing attention.

Mário Castro’s story was splashed over the nation’s tabloid and television screens – and the lack of medical cover, which hospital sources claim was short-lived, has led to three formal complaints.

Fortunately this time no one died. Castro’s son was treated at the nearby Hospital Particular, after his father stormed out of Faro state casualty in disgust, and all the other patients were eventually dealt with.

But then came a new disgrace. A septuagenarian who had been held up in Faro for six hours awaiting medical attention and who finally suffered a major stroke had to be rushed up to Lisbon for specialist treatment.

Sebastião Pereira, 74, did not get the care he needed. Yet again, Hospital de S. José was involved: this time refusing to admit the urgent case for treatment, which meant Pereira had to be transported by ambulance (as weather conditions precluded helicopter flight) to Coimbra.

He arrived in a coma, and died 10 days later.

Again, Pereira’s family are expected to launch an official complaint, though Faro hospital boss Pedro Nunes assures us that, in the Algarve at least, everything that could have been done was done.

With Faro launching its own inquiry into Pereira’s treatment and transfer to Lisbon, the nation’s presidential candidates launched into the maelstrom, all of them decrying Portugal’s deadly health cuts.

Euro MP and Left Bloc firebrand Marisa Matias claimed the last government’s health policies had “killed many people” and that this truth was “denounced in good time” but that no-one did anything about it. Her words were backed by fellow contender Sampaio da Nóvoa who confirmed that Duarte’s death “came from the many cuts to the national health service”.

Even former PSD leader and one of the favourites to replace Cavaco Silva, Marcelo Rebelo de Sousa declared that “making cuts in the health of Portuguese people is not a good principle for the construction of a just democratic state”.

The issue then got even messier, with politicians sniping at each other over who had supported cuts at the outset. But the real issue is that none of this, truly, is new. People have been dying as a result of austerity-led policies for years, and the ‘weekend phenomenon’ affects many developed countries.

A Global Comparators project reported in July on what it called “a weekend effect” that became apparent for deaths within seven days of emergency admission in UK, Holland, the US and Australia.

As Faro hospital administrator Dr Pedro Nunes told us: “Portugal still has a very good level of state healthcare. Yes, we have problems. Doctor shortages are among them, particularly in the Algarve. But as a country, this still has to be one of the most secure places for people to come to, with a health service that may not work miracles, but can and does look after hundreds of thousands of people every day”.

By NATASHA DONN natasha.donn@algarveresident.com