The Health Regulatory Authority (ERS) has initiated administrative proceedings against the Lisbon North and Central Lisbon Hospital Centers for violating the user’s freedom of choice when scheduling a first consultation in the specialty of Plastic and Reconstructive Surgery.
ERS has become aware of several user complaints involving the Santa Maria Hospital, part of the Centro Hospitalar Lisboa Norte (CHULN), for refusing requests for referrals to the hospital for plastic and reconstructive surgery consultations.
After reviewing the situations, ERS found that referral requests submitted by users (all residents outside the Santa Maria referral area) through the “Time and Hours Consultation” for the first consultation in this specialty were rejected for general reasons: “[…] CHULN Plastic Surgery Service is currently not equipped to respond to requests for consultations in a timely manner.”
The hospital center also said that “having LIC [Lista de Inscritos em Cirurgia] hundreds of patients cannot maintain TMRG [Tempos Máximos de Resposta Garantidos] to carry out surgical operations, checking access to the agreed system of patients under their care”, namely to the hospital at the place of residence or to the corresponding central hospital.
“Now, in the light of the facts stated in the case, it can be concluded without any doubt that the right of access to medical care of the users (…) to the first specialist consultation in the hospital that they needed was not protected by CHULN.”
“By refusing a request for a first consultation at a hospital in the manner described, CHULN is establishing a genuine access barrier for users by preventing them from registering on the consultation waiting list, preventing the regular functioning of the access matrix that the LAC [sistema de Livre Acesso e Circulação de Utentes] strived to implement,” says the ERS report on the results of the fourth quarter of 2023.
ERS has also issued instructions to the Central Hospital and University Center of Lisbon (CHULC) with the same purpose – to ensure at all times that the provision of health care respects the legitimate rights and interests of users, namely the freedom of choice of health care provider.
According to ERS, after the user’s request for a referral to Santa Maria Hospital was denied, her family physician made a new request for a referral to San Jose Hospital, which is part of CHULC, which was also denied. inability to respond within medical waiting times for consultations and surgery due to extensive waiting lists”
The regulator emphasizes that CHULC also did not guarantee the right to access medical care that the user lacked, “in fact, it assumed this failure by expressing its willingness to make an appointment that had previously been denied.”
On the other hand, he adds, there have been other situations in the specialty of ophthalmology where requests for consultation were denied for non-clinical reasons, assuming that at the time the hospital had a procedure for screening requests for consultation based on priority criteria and referral/follow-up area from this supplier.
“On top of this problem, such denials of requests were sometimes made months after primary health care consultations were requested,” meaning that, in addition to users not being guaranteed access to the care they needed, they it was forbidden to receive them elsewhere. SNS Hospital,” reports ERS, emphasizing that the hospital cannot establish eligibility criteria for access to specialized ophthalmology consultations such as those it claims to have adopted.
Hospitals are subject to administrative offenses punishable by fines ranging from 1,500 to 44,891 euros.
Author: Lusa
Source: CM Jornal
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