Experts from the local health department (ULS) of San Jose warned the government this Monday about the loss of autonomy of primary health care as a result of the reform of the National Health Service, which will lead to losses in responsiveness to the needs of users.
The warning is contained in a letter sent to Minister Ana Paula Martins by a group of coordinators of the primary health care functional units of the ULS in São José in Lisbon, to which the Lusa agency had access this Monday.
As part of a reform that consolidated the ULS in a country where there are now 39 such units, the Central Hospital University of Lisbon began to function as the ULS of San José in January, concentrating the hospitals in the same model of organization and management. . and medical centers.
In a letter sent to the minister, health experts believe that vertical management has led to an “effective loss of autonomy for primary health care” (PHC).
“In practice, this management model, which centralized services and resources in the ULS, increased bureaucracy and reduced the decision-making ability of CSPs, preventing them from responding quickly and tailored to local needs,” the document warns.
According to the signatories of the letter, given that functional units are structures with autonomy, “unilateral” decision-making without consultation and participation of primary health care specialists leads to their demotivation and can negatively affect the efficiency and effectiveness of the assistance provided. .
These National Health Service professionals, who carry out coordinating functions in the functional units of the former groups of health centers (ACeS) of Central Lisbon and Loures Odivelas, now integrated into the Local Health Unit (ULS) of São José, express “their deep concerns about the current management model.” primary health care.
“We also agree that the generalization of the ULS model being applied suddenly and across the country, in addition to jeopardizing this entire journey and the future of social media, does not benefit users, professionals or management,” he says Also. letter.
Because of this, the 11 signatories believe that this is a “key moment to signal” that they do not agree with the model, which they consider “a real failure for SNS, in particular for CSPs.”
In their arguments, they refer to “complex language” because the ULS governance structure has introduced multiple layers of decision-making, “which makes communication difficult and reduces the CSP’s ability to respond, negatively impacting the care provided to users by bankrupting schemes not tailored to circumstances of the PSC, and the abolition of those already existing in the previous management model.”
In addition, according to the letter, there is a “risk of depersonalization and dehumanization” of health care with the creation of “gigantic institutions” that “contradicts the basic principles” of general and family medicine and CSP.
It also said that the centralized management of ULS has integrated ACeS with different organizational cultures, demographic and social realities, there is a “lack of knowledge of local realities” that makes it difficult to meet the specific needs of CSPs, and there is a “risk of insufficient allocation of resources.”
“There is no plan for the integration of shared care, and no known initiatives in this regard,” further lament healthcare workers, who advocate the adoption of a model with greater autonomy for primary care, in which “resources will be shared on equal terms.” at the regional level, which provide economies of scale and in close cooperation” with the reference hospital center.
Subscribers emphasize that the document does not represent any value judgment regarding the current board of directors of ULS San Jose or the relevant board of primary care.
The area of direct influence of the ULS São José covers 13 parishes in the municipality of Lisbon and four in the municipality of Loures, corresponding to more than 440 thousand registered in primary health care departments.
Author: Lusa
Source: CM Jornal
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