Doctors and government are seeking a deal that will return the NHS to normalcy

Doctors and the government return to talks this Friday, a meeting seen as crucial to reaching an understanding that will restore normalcy to several of the country’s hospitals that are facing restrictions and temporary closures of services.

At issue is the refusal of some 2,000 doctors to work overtime beyond the 150 hours a year they are required to do, with unions arguing that many of these health workers have already exceeded that legal limit, putting the quality of their care at risk. risk. the care they provide to users.

This situation has led to the temporary closure or restriction of operations of hospitals in various parts of the country in recent weeks. if the government and the two trade unions cannot reach an understanding.

The Department of Health acknowledges that the National Health Service is now suffering from the effects of declining doctor training in the 80s and 90s, as well as large numbers of doctors retiring, but unions believe the problem is more about the quality of the public service in order to retain and hire more health care workers.

Official data seen by Lusa shows that in August this year, SNS employed 21,691 medical specialists, 2,362 more than in the same month of 2020, as well as about 10,000 intern doctors in training.

Despite this growth of more than 12% between 2020 and 2023, the Medical Association states that there are 61 thousand doctors working in Portugal, a number that has doubled in the last 20 years, meaning that in practice only about half of the existing doctors in the country.

The same data also points to an increase in the number of hospital specialist retirements in the coming years, always exceeding the barrier of 400 per year until 2030, the year from which a significant decline in physician retirements is expected.

The years with the largest number of planned retirements will be 2025, with 560 physicians retiring, and 2026, with an additional 519 physicians retiring.

Added to this scenario are the difficulties that will be faced in the coming years in appointing a family doctor to the 1,653,424 users who do not have direct access to these primary care specialists, resulting in increased pressure on acute hospitals. given the lack of alternatives for users to access social networks.

This is exactly the scenario that meetings between the ministry and trade unions are taking place; the new negotiation process after the first, which began in 2022, after dozens of meetings ended without an agreement between the parties.

The Independent Union of Doctors (SIM) and the National Federation of Doctors (FNAM) do not want better working conditions and higher basic wages, arguing that doctors have lost about 20% of their purchasing power in recent years, with the health minister highlighting this. “huge evolution” of proposals presented by the government to trade union structures.

At the last meeting, the unions received a more detailed document on the proposal, which includes, for example, a new remuneration model and a bonus of 500 euros per month for emergency doctors and the option of 35 hours a week. but unions continue to refuse to accept the decision, which includes increasing wage bonuses and limiting overtime from the current 150 to 250 per year.

This Friday’s meeting comes three days after the SNS chief executive warned that unless doctors reach an agreement with the government, November could be the worst month in the public service’s 44 years.

Fernando Araujo’s warning was seen by unions as an acknowledgment of the seriousness of the social media situation and they held the minister responsible for the lack of agreement after 18 months of negotiations.

In parallel with the negotiations, executive management is ensuring that from next year SNS will undergo the “great reform” in its history with the creation of 31 local health units (ULS), which will join the eight already existing.

ULS, public for-profit enterprises, is an organizational model that promotes the integrated management of primary and hospital health care by bringing together in one facility hospitals, hospital centers, health centers and groups of health centers in a geographic region.

On Tuesday, the President of the Republic, with “many doubts and reluctance,” released diplomas confirming the full commitment of the SNS, the organization and functioning of family health centers and the creation of local health centers.

In 2024, the health budget will increase by 1,206 million euros, with total spending exceeding the 15 billion euro barrier, an increase of almost 10% compared to this year and which the government believes will allow the number of users to continue to increase. access to healthcare after years of enormous pressure that the social network has come under due to Covid-19.