The number of users without a family doctor increased by 29% in a year

The number of users without a family doctor increased by 29% in a year to almost 1.7 million due to retirement and the lack of capacity for the National Health Service (NHS) to attract specialists.

According to the transparency portal SNS, in April 2022, a total of 1,299,016 million users did not have an appointed family doctor, and a year later, this number increased to 1,678,226 people.

In view of this, according to official data, the number of users seen by these general and family medicine specialists has decreased from 9.1 million to just over 8.8 million over the same period.

Marches against the “degradation of social media” are planned for Saturday in Lisbon, Porto and Coimbra, called by several trade unions and with the participation of user movements an initiative requiring “serious investment” in this public service.

For the president of the Portuguese Association of General and Family Medicine (APMGF), this situation is connected both with the wave of resignations of specialists that has taken place in recent years, and with the lack of attractiveness of the SNA to save the family. doctors, recent graduates, and to attract those who are not currently employed in the public service.

Faced with these two factors, “the whole system that should be based on primary health care is shifting the focus to hospitals and emergency services, which also lack human resources and are not designed for this type of response,” he told the agency. Lusa Nuno Jacinto. .

The shortage of family doctors, Nuno Jacinto warned, forces users to access SNS “through a place they shouldn’t go” – hospitals, “perverts” the entire system, and generally overwhelms healthcare workers.

A study by Pedro Pita Barros and Eduardo Costa on the health workforce, published in February this year, shows that about one in four doctors is over 65, an aging class that will free up about 5,000 pensions. by 2030.

“Physician aging affects both hospital professionals and primary care physicians. According to 2011 estimates, about 75% of family doctors were over 50 years of age. This problem was exacerbated by the wave of early retirements that followed the austerity measures implemented after 2011.

This is an argument that has also been used by the government to justify an increase in the number of people without a family doctor, with Secretary of State for Health Promotion Margarida Tavares recently acknowledging that in addition to 2021 and 2022, 2023 and 2024 will also be years of great retirement. number of doctors.

The shortage of specialists in general and family medicine mainly affects the region of Lisbon and the Tagus, Algarve and Alentejo valleys, according to the executive, but the APMGF President warned that the shortage is already felt in the Center and even in the North, where “places where there is a lack of there were no doctors and now there are not enough.

The government has opened all 978 vacancies in general and family medicine to retain recent graduates as well as attract non-SNA professionals, but has already acknowledged that only 200 to 250 out of 355 physicians work in public health facilities, which are now their specialty.

“It is good that the government has opened all available vacancies. This is the first time this has happened and it is a good sign because it means that guardianship is taking on the true dimension of the problem,” Nuno Jacinto replied, noting that “there are almost a thousand family doctors” on social media.

The president of the ANMGF agrees that it would be “unrealistic” to think that all 978 vacancies will be filled, but he stressed that opening all available places “should be a measure that needs to be supported in the medium and long term so that it can stabilize” given that the real goal now is to hire more than 300 doctors who graduated in the last examination season.

“We are not going to say that we will look for a thousand family doctors at once, because there are none, but we must be ambitious and say that at least we want to hire everyone who has graduated,” said Nuno Jacinto, for whom physicians currently “look at the SNS with some sadness and disappointment”.

According to the head of the ANMGF, this was facilitated by the feeling of family doctors that “their work is not appreciated and respected.”

In practice, this is due to a “lack of investment in primary health care, primarily in the salary scale” as well as career stagnation, an inadequate evaluation system that should have merit promotion, and a “Very rigid contract model based on 40 hours , which does not give doctors the flexibility that exists, for example, in the private sector,” he said.