Fernando Araujo says he carried out the biggest reform of the SNA in 45 years in 15 months

The chief executive of the National Health Service (NHS), who announced his resignation on Tuesday, said his 15 months in office had seen the biggest organizational reform in the NHS’s 45 years.

“In these 15 months, despite external restrictions, the largest organizational reform has been carried out in the 45 years of the existence of the SNS,” says Fernando Araújo in a statement in which he announced that he would present, together with his team, his resignation to the new Minister of Health Ana Paula Martins.

At the end of 2023, the current Minister of Health resigned as president of the board of directors of the Centro Hospitalar Universitário Lisboa Norte, denying at the time that her decision was based on “any disagreement with the executive management of the SNS” (DE-SNS).

In a statement on Tuesday, Fernando Araujo stressed that reforms in any area are difficult, in the health sector they are “particularly complex and demanding”, but that since January 2023 it has become possible to implement legislative changes, introduce new economic models, and plan strategies. and organize processes, involve teams from different institutions, create external mechanisms to monitor and evaluate the reform and “truly change the social network.”

Among the “most important aspects to be implemented”, the doctor highlighted clinical integration, the creation of an “effective network of social insurance institutions that worked clearly and complementarily,” risk-adjusted capitation financing, supplemented by funds that pay for patient flows between local health care facilities (ULS).

In terms of ensuring the sustainability of social networks, Fernando Araujo assured that the creation of value-based health programs has begun, focusing social networks on user outcomes, primary health care and intimacy, “finally, prioritizing effective disease prevention and strengthening health.” “.

“Our goal was to simplify the management of social networks by increasing the autonomy of institutions in relation to other levels of decision-making (sometimes called verticalization, but the scope of which is to reduce decision-making levels, increase the speed of response and bring decisions to the floor) . providing care), as well as reducing the number of facilities to less than half (from more than 100 to less than 50) and related administrative positions,” said the outgoing executive director.

According to the doctor, the protection of human resources in the “vision of motivation and recognition for excellent work done”, investments in the modernization of structures and equipment of the SNA were among the “most relevant aspects, the work of which still matters.” the path to be taken.”

“At the same time, a program to reduce bureaucracy was implemented,” Fernando Araujo said, pointing to examples of self-declaration of illness, certificates of temporary disability in private and social services, as well as in the emergency services of public hospitals and the renewal of prescriptions for drugs for chronic diseases. available in pharmacies.

In addition, the validity period of prescriptions and additional diagnostic and treatment products was extended to 12 months, pilot projects of the Centers for Medical and Psychological Expertise were implemented to issue medical certificates for obtaining a driver’s license and other purposes, vaccinations in public pharmacies and access to doctors from social security boards to electronic clinical process.

“These measures, some of which were proposed decades ago, have a common characteristic: administrative simplification, making life easier for users, reducing bureaucracy in the work of health professionals and increasing satisfaction with the use of services,” Fernando Araujo assured in a statement summarizing 15 months of work .

The chief executive announced on Tuesday that he and his team would hand in their resignation to the health minister, saying he did not want to be an obstacle for the government in the policies and measures it considers necessary to implement.

“Respecting the principle of institutional loyalty, I, together with the team I lead, will submit a request to the Minister of Health to resign from the position of chief executive of the National Health Service,” said Fernando Araujo.