SNS State health service spends €34 million in agency staff in three months

Some A&E departments are 80% staffed by agency staff

Portugal’s State health service has spent €34 million in hiring agency staff (doctors/ nurses/ anesthetists etc) while prohibiting hospitals from contracting much-needed personnel.

The lunacy of the country’s health service management model has been laid bare in a report by SIC television news in which one head of department (with a contract) described how she was frequently in the position of being in charge of medical staff paid three times as much as she is.

This year’s health service expenditure on agency staff is double that of last year, says the station. The average hourly rate paid to doctors parachuted in is €31, “but there are hospitals that end up paying €90 just to keep their doors open…”

Three of these are in the ‘Hospital Centre of the West’ (taking in A&E departments in Torres Vedras, Caldas da Rainha and Peniche). “Every day these hospitals require 31 doctors to assure the 24-hour rosters. On the books working today (SIC report aired last night) were seven. The rest were hired through agencies, and paid by the hour”.

SIC explains that, on average, SNS doctors and specialists receive €20-an-hour (before tax). Agency doctors can find themselves doing the same work for sometimes four times as much.

As a head of department told SIC, it actually makes more sense for SNS doctors to ‘resign’ and then sign on the next day with an agency (and go back to work at the same hospital).

In April, the Hospital Centre of the West “desperately needed specialists in internal medicine to guarantee shifts over a six day period. The price offered was €90-an-hour).

Highlighting how lucrative agency work is, SIC adds that recent recruitment drives by the hospital centre, offering “a lot of jobs (…) were deserted”. Not one taker. “Even doctors who have only just finished training and have no particular speciality prefer to become agency doctors: they earn a lot more money (for the same work they would be doing if  full-time members of staff) and they manage more time with their families/ and for leisure activities”.

The eye-watering €34 million spent in the first three months of this year went in the main to hiring agency doctors. Says SIC, this reliance on agencies “is SNS practice, and increases year on year”.

In the last six months of 2021, 600 doctors rescinded the contracts they had with hospitals and SNS health centres. “Many were hired by private institutions”; others preferred to stay doing the jobs they had been doing before, but being paid a great deal more.

How can this make any kind of financial sense? SIC explains “costs of agency staff end up being masked by hospitals. They don’t get listed under personnel but under supply of external services, which also includes costs for laundry, food and the ordering of complementary diagnostic tests purchased from clinics outside the SNS”.

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