Sick health

Without the ability to respond to citizens and with increasingly high costs, the National Health Service (SNS) continues to collapse. This is despite the fact that, in theory, there are more resources, more doctors, more nurses, and fewer emergencies.

The total value of health spending in Portugal represents 10.6% of GDP in 2022, which is a higher weight than what was recorded in the pre-pandemic year (2019), which amounted to 9.5%, and in the current year 2023 it recorded growth. By about 6%, the 2024 budget expects another increase of 1,206 million euros, which represents an increase of 9.8% compared to the initial budget for 2023.

Clear signs of wear and warning. We have long known that an aging population is putting pressures on the NHS, that the middle class itself is mostly over 50, and that only 42% of all doctors work exclusively in the country.

This reality, on top of two years of pandemic, translates into a brutal increase in overall SNS spending, growing year over year and always reaching historic highs. In the first six months of this year, emergencies increased, but are still below pre-pandemic levels, so it is not clear how this breaking point was reached.

It is urgent to implement structural reforms, and not isolated navigation on the horizon, to stop the rise in budget expenditures, a gap that worsens from year to year by hundreds of millions of euros, which increases the accumulated debt obligations to suppliers, that is, commercial debts. Debts. Since 2017, accumulated capital injections to settle overdue liabilities, without debt reduction, have exceeded €4.5 billion.

It makes no sense for the government to continue trying to frame short-term issues, with little more than zero rhetoric, because it is structural reforms that create the sustainability our health services need.

This comes in conjunction with recent events, which highlight the utter chaos and decline in our public medical services, which is evident in a sector of this importance, which is linked to birth rates and the need for more children, in what should be seen as a national determination.

These are clear reflections of the state of the SNS. Long waiting times for surgeries, specialties, service closures and emergencies are unsustainable. In the context of these risks and uncertainties, and the unfortunately expected disruption of public health services, it is time to intervene to ensure more and better health for the Portuguese. Before it’s too late.