About 40 years of the Hospital of Faro, which opened in December 1979, also during the 40 years of my practice at the institution, I thought of making some remarks about the anniversary, especially since the discussion about the need to build a new hospital seems to have returned to the order of the day.
With a project that dated back to the sixties, the opening of the then designated District Hospital of Faro it was a major leap in the quality of medicine then practiced in the region.
Qualitative leap because we started to have decent facilities, and qualitative leap because the incorporation of more professionals, including new technical careers, many nurses and physicians from different specialties, allowed for a medicine similar to that practiced in large centers, albeit that the hospital had never been equipped with the technology required to make it a state-of-the-art hospital.
However, in the last 40 years, medicine has evolved a lot, gigantic steps, both in the scientific and technical fields, so the hospital of Faro, always financially strangled, was getting strangled in his facilities, conceived 50 years ago, when, in order to practice medicine, little more was enough than a penknife, a stethoscope, an X-ray machine and some analyses, so that, gradually, it became obsolete, cramped, dysfunctional, despite the constant effort to adapt.
This is the current situation, a corseted hospital, without the capacity to properly install the technology it needs, which offers poor reception conditions and in which clinical areas are generally mediocre, and to make it current, it would have to build from scratch, because even other infrastructure, electrical, water and sewage, parking and internal accesses, are outdated.
Anyone who understands hospitals and their functional needs, and knows the hospital of Faro, you know that this hospital is no longer able to fully fulfill the mission of a differentiated hospital, which is required of it. It has large wards, narrow corridors, small waiting rooms, no interventional radiology, no scintigraphy, no PET, no place to put them, there is a meager operating room and sterilization, etc, etc.
The obvious conclusion is that the hospital of Faro it dignifiedly fulfilled its cycle, with effort, with limitations, much better than public opinion might think, but, like everything else in life, it now needs to give way to whoever succeeds it, as the science and technology of our days impose.
It is more than evident that the Algarve needs a new large hospital, with a minimum size and differentiation not inferior to the projects already prepared for the Parque das Cidades.
One wonders, and will there be money for such an undertaking?
Allow me to answer that the cost of a new hospital, fully equipped, will be around 300 million euros. If we divide this amount, to amortize over 30 years, as projected, this will represent around 10 million euros per year, plus interest (currently low), say 15 million/year, an amount that should not greatly exceed the investment that is required do in the current hospital, in renovations and equipment, to keep it minimally functional.
If we consider that the annual budget of the Centro Hospitalar do Algarve exceeds 220 million euros, assuming that the hospital in Portimão will still hold up for a few more years, we are talking about a 5% effort, something that seems to me to be justified, face the contribution of the Algarve to the State budget and the predictable increase in population, enriched by the strong migration of new people, Italians, French, Brazilians, etc.
If what I said above already supports the construction of a new hospital, there are still strategic reasons that, in my opinion, are as important, or more, than the previous ones.
Firstly, it is necessary to close ranks around a large hospital unit, which is the anchor of the health system in the region and, secondly, it is necessary to understand the relevance of the union with the University of Algarve, in order to keep it here teaching and research in the health field.
If we do not have a large hospital, if we choose to disperse investments, without creating an unifying pole, hospital, or hospital centre, we run the risk of being imposed an organizational model, similar to that existing in Alentejo, for example with two units places of health, each one of them with a little differentiated hospital unit, not attractive to the professionals, nor capable of offering differentiated care.
The consequence will be technological disinvestment, the restriction of differentiated care and the consequent corruption of patients to central hospitals, as happens in Baixo Alentejo or Litoral Alentejano.
I don't think this is the model that best serves the region and the health of its inhabitants. It may divert some more patients to private hospitals, but they don't need that to grow and prosper.
The connection with the University, which I believe is also celebrating its 40th anniversary, is the other key point. Health research is a very dynamic sector, with gigantic international expression, since it involves very diversified scientific knowledge, from mathematics, information technology, biology, pharmacology, physics, etc., and involves huge financial resources, whether in investment , either in the return of that investigation.
It turns out that some of these are areas of knowledge in which the University of the Algarve has recognized work, and in which it has the potential to do much more, as long as it is connected to a good hospital. That is, a differentiated hospital, a partner of the University, can contribute a lot to the vitality and development of the University itself.
On the other hand, the University, offering health professionals opportunities to become involved in teaching and research, will provide a strong incentive to attract increasingly differentiated personnel to the region, which will obviously increase the quality of health care. The hospital/university partnership is a positive synergy, which must be preserved and developed.
It would be good if the Algarvians, understanding those who want to live here as such, understood well the local reality and the implications of what is at stake, and did not get distracted by demagogic conversations, nor let themselves be carried away by village rivalries. We cannot allow the leeward/windward dispute, petty views, or private interests to distract us from the essentials.
I am convinced that if we do not move towards building a new hospital, we will all lose out. The professionals lose, the user population loses, above all, the Sotavento loses and the Barlavento loses.
I very much hope that, whoever is responsible, does not focus on his farm, does not just look to his immediate interest, and understands that this is a structuring issue for the entire region. It's a fight for all Algarveans.
More than defending the municipality, or the parish, it is necessary to defend the Algarve, its economy and its people!
Author Horácio Guerreiro is a doctor
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