The National Health Service we want in Portugal | Opinion
For a long time there were hospitals and few doctors who cared for patients who came to their offices. However, we assume health as a collective social responsibility and created the National Health Service (SNS) as a guarantee of this right. It became possible for any citizen in Portugal to have access to the health care they need not only in hospitals, which are more distant by nature, but in proximity, with the installation of Primary Health Care health centers.
Proximity care is not long-term care or long-term care that concerns us with taking care of the person as a health environment for people, regardless of the health environment of diseases or that presents, framing them in their family and community, that resolves a wide variety of situations and that functions as a hinge of the system between the outside in which all health services are durable and the health services that we resort to permanently. This doctor is the specialist in General and Family Medicine, also known as a family doctor.
Rui Gaudencio
We went from an infant mortality rate of 55.5 ‰ in 1970 to 2.4 ‰ in 2021, from an average life expectancy at birth from 67.1 to 80.7 years and at age 65 from 13.5 to 19, 4 years. And the difference would be greater if we had lived with a disorganization that justified the health area, first by the need to respond to the non-imminent pandemic, then by the inertia in perceiving the evolution of the context and acting accordingly.
Access was the most affected accessory. The under-budgeting of the SNS, the congestion at peaks of affluence and the insufficient response of the hospital referral network already came from behind. With the pandemic, everyone felt that their family doctor was not there, despite being in a pandemic state, and that it would continue through the dawn, weekends and holidays, not as usual.
After the pandemic, the situation of the SNS is dramatic. Professionals are tired of the long-term (about 7.5 million extra doctors in 2021), the ridiculously low deadlines, the valorization of their careers, the placement of professionals without rules in individual employment contracts, by politically appointed managers and not due to merit, due to inadequate professional evaluation systems, poorly dimensioned equipment, the departure of retired doctors who were not properly taken care of, among others, in a disorganization that has not yet completely reversed.
These problems are not just for doctors. All of us, as SNS users, linger. And damage to health means illness, and death.
The solution is to place health as an investment of the country and not as an expense that burdens the State Budget. In Portugal, health costs 1982 euros per inhabitant (Eurostar, 2019), 36% less than the European Union average, but the proportion supported directly by citizens is 39% against the 20% in the EU27 average. We pay less for health, but more out of our pocket. If we want better health, we will have more investment, and if we want better SNS, we will have more investment.
The solution that the Government has found is the antithesis. The 2022 State Budget intends to fill the gaps in the system of hiring doctors without specialties, in precarious contracts that are discretionarily dependent on the supervision of the SNS, condemning a part of the Portuguese to have access to inferior quality medicine, without them guaranteeing the ability to choice or even reserve, as if they were second-class citizens.
As a family doctor, I feel informed with this proven and recognized decision that recognizes the levels of health in Portugal. While the citizen feels for a decision that may have the quality of medical care that I have when I go to my SNS taxes.
The author writes according to the new orthographic agreement