2023 will be a year of health challenges in Portugal. This year, which marks a new beginning after the pandemic, there is a need to respond to the weaknesses that I have highlighted. As things return to normal, it is essential to strengthen structural investment measures in the National Health Service (SNS), rather than specific responses.
SNS budget promotion
In Portugal, only 6% of GDP is allocated to public spending on health, in contrast to other EU countries, where investment reaches close to double digits. Lack of investment in health contributes to the intensification of existing gaps and the emergence of new problems. Divestment in health puts the SNS at a disadvantage, as it presents deficiencies in the safety and quality of care provided to users.
About 40% of the SNS budget corresponds to the expenditures of the Special Foreign Services; In 2018, more than €473 million was spent on complementary diagnostic tests alone. Spending during the pandemic has been more visible and has added to the vulnerability of the system. Can this part not be invested in the social networking services themselves in order to address some of their weaknesses and improve access to healthcare?
Valuing and investing in human resources in SNS.
It is not possible to talk about the SNS without talking about health professionals, because they are the strongest foundation for it. Although Portuguese health professionals are important to the world due to their exemplary training, they are among the lowest paid health workers in the European Union.
A national study, carried out in recent years on 7,000 Portuguese nurses, concluded that 60% had already considered changing occupations due to working conditions.
The working conditions granted to nurses are still not sufficient to keep these professionals in the country. According to recent figures from Ordem dos Enfermeiros, since the start of the pandemic, more than 3,300 nurses have emigrated, which translates to an increase in nurse emigration compared to previous years.
The doctors’ reality is equally disturbing. The share of doctors available to work in the SNS is decreasing. Immigration, retirement and the continued exit of the private sector are the main factors responsible for the event. Recently, controversy with obstetric emergencies across the country has highlighted the shortage of physicians in various SNS specialties.
The need to connect nurses and doctors to the SNS, with attractive employment contracts and competitive salaries with those in the private sector and with Northern Europe, is acute. Investing in the employment of health professionals in order to enable compliance with schedules that reconcile professional and personal life is fundamental to the assessment of Portuguese health professionals. Conditions conducive to investment in continuous training of physicians and nurses has proven to be an effective measure to keep them informed and satisfied and to continuously improve care. It is essential to value health professionals, end injustice in their professional lives, provide decent working conditions for those who care for us, and continue to invest in SNS.
Primary health care (PHC) promotion
CSP is the main gateway to the SNS and an essential area for monitoring all users throughout the lifecycle, and it is critical to finalize the hospital-centric perspective.
Investing in health promotion and disease prevention is the transformation needed to provide better health care but also to improve the efficiency of the SNS and end the difficulties in terms of its financial sustainability. Concrete measures are needed to handle the user in a comprehensive and preventive care-based manner. Interventions focused on reducing the prevalence of major risk factors for Portuguese, such as poor diet, physical inactivity, overweight and addictive behaviors, are the best approach, not only for the health of the individual but also for the health of all. Serious monitoring of plans and interventions should be prioritized and analyzed on a regular basis, with a view to promoting their reformulation or adaptation, if necessary.
SNS does not need an unlimited budget and hence, proper distribution of available resources plays a prominent role in its effective management. It is necessary to deepen these assumptions to confer greater stability and to strengthen the SNS. In this year that is just beginning, stronger and more resolute measures are expected to protect the health and well-being of everyone.
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