Order of doctors asks to create a commission to monitor the reform of local medical posts

This Sunday the president of the Order of Physicians defended the creation of a committee to monitor the reform of local health services (ULS) and warned of a “failure” in the link between primary and hospital care.

“In some ULSs there has been a breakdown in the connection between primary health care and hospital care, which is a curious fact, but (…) this needs to be corrected quickly,” Carlos Cortes told Lusa.

Given that ULS reform “got off to a bad start” and was “not well prepared,” the president pointed to a number of problems with the model, but stated, “It is the position of the Medical Association to maintain development, reform, and correct a number of difficulties.”

“It is necessary to improve and improve what is being done,” he added.

Regarding the lack of monitoring of health facilities during this transformation, Carlos Cortes argued that the Ministry of Health should create a commission to monitor the ULS “to understand whether things are going well, and in those places where things are not going so well, to help overcome difficulties ” “

“Primary health care is under enormous pressure,” he said, recalling that “there is no guidance document for ULS.”

He said some autonomy was normal and desirable, but believed that the reform as implemented left the ULS “on its own”, arguing that “there must be guidelines for the whole reform”.

The person in charge also recalled the cessation of the activities of the regional health directorates, which has not yet entered into force since the President of the Republic returned the diploma to the government, and emphasized that many competencies belonging to these institutions were transferred to the ULS, but without any subsequent action.

Medical unions have reported cases where this error in the transfer of skills to APCs has resulted in non-payment of bonuses to teams.

The president of the Portuguese Association of General and Family Medicine, Nuno Jacinto, also pointed out how this reform has progressed on the ground, with “identical solutions applied to different realities.”

“Realities are different, and often we try to apply the same solution to all parties or the same solution. [de forma] in the same way, and in the end things don’t go very well,” he said.

The person in charge fears that “what has already been achieved in primary health care” will be lost: autonomy.

“This is dangerous,” said Nuno Jacinto, recalling that “one of the main principles of the primary health care reform was that these teams, these family health institutions, will have to have technical, functional and organizational autonomy.”

“In simple things, in internal procedures, in managing schedules, in managing vacation plans, in managing attendance, in determining the priority areas in which they want to work (…). It depends on the teams, and it should be up to the teams,” he stressed.

Nuno Jacinto also warned: “If we start to have elements outside the units who want to interfere in some way in all this, we will obviously limit their autonomy, and that cannot happen.”

He also said that there is “such a risk” with ULS at present, advising “to be careful” in applying this new model, “otherwise we risk jeopardizing something good that has already been achieved in primary care help.”