By Oscar Gaspar, President of the Portuguese Association of Private Hospitals (APHP)
In Portugal the month of August ended with the resignation of the Health Minister. Problems and failure to provide care in public hospitals filled the headlines and called for change.
The Portuguese health system had already no guaranteed sustainability, according to what OECD and the European Commission said at the end of 2019. With an aging population, chronic underfunding, and a poorly articulated system, the generous Portuguese NHS, created in the 1970s, was struggling to respond to current challenges. The pandemic affected all sectors including health, left professionals exhausted, left many non-COVID patients undiagnosed and untreated, made the shortage of health professionals more evident, and called for more attention in ensuring the necessary care.
In recent months there has been much discussion in Portugal about the shortage of doctors and nurses. In the case of doctors, we need more anaesthesiologists, obstetricians, paediatricians, psychiatrists, dermatologists, etc, and we will have to reinforce training capacity. In the case of nurses, the quality and quantity of graduates is very good, but they are still not being properly utilized and many emigrate to other European countries.
The problems of the Portuguese healthcare sector are very significant, and we still have to be able to provide access (universal coverage) and quality of life for the citizens. To this goal, it is absolutely necessary that the health system works exactly as a system: public, private and social sectors playing their different roles but with a defined and appropriate relationship. It is essential that the State distinguishes financing from provision and makes contractual arrangements that guarantee provision with a high level of efficiency, promoting quality and innovation and in which the citizen has freedom of choice.
This change of Health Minister in Portugal is taking place at a time when reality demands a health policy that focuses on the interests of the citizen and the sustainability of the health system.
September ended with the nomination of the new Health Minister, Dr. Manuel Pizarro. He faces great challenges and now is the time to act. We all hope that the system can be strengthened and progress towards sustainability.