I write this article after reading the piece that the Sul Informação published titled “Manuel Pizarro came to the Algarve to meet mayors in a desperate situation”, describing the difficulty that exists in some municipalities in the Algarve in terms of access to health care.
This issue has been raised for a long time in the region, but are the conditions currently the same? Can nothing be done? We then analyze the problem and propose some solutions.
Why is it difficult to attract doctors to some municipalities in the Algarve?
The Algarve is a region of beauty and unquestionably favorable living conditions, a situation that has led to the settlement of many residents from other countries and even from other regions of the country. Doctors are no different from the rest and this is certainly not why they will not settle in the region.
There are difficulties in the region in terms of affordable housing and also other conditions for the family of doctors. This is one of the problems, but it will not be the only one, so only by analyzing what can lead doctors to settle in the region can we solve the problems.
The reasons usually given by doctors are:
• Costs and difficulties in finding housing;
• Difficulty and costs associated with placing children in crèches and schools (I would like to point out that with regard to crèches, the current measure of bearing the costs of social security is an important help in the Algarve, a region where public provision is limited);
• Lack of health center conditions, including computer equipment;
• Absence of perspectives of professional differentiation and participation in training and research activities;
• Absence of differentiating financial incentives for its fixation.
Can proximity access to health care not be achieved in other ways?
Technological evolution currently leads to the existence of several other solutions for easy access and proximity to health care.
In Portugal, the Shared Services of the Ministry of Health (SPMS) launched the SNS24 Counter, which allows scheduling appointments and exams, renewing prescriptions, consulting results of exams carried out and even carrying out consultations via teleconsultation.
It would be expected that there would already be many SNS24 branches available to the population in the municipalities of the Algarve, however it is surprising that, in the region, there are only 3 branches in prisons in the region.
What's going on with the Algarve not to be using this offer (yes, I said it right, offer!) that SPMS makes available?
I now leave the challenge to the Algarve mayors to make these counters available in their parish councils, municipal offices, in conjunction with their IPSS or other institutions, to the population.
SPMS is available and interested and it is not understood why this solution is not available and widespread throughout the region. I am available right now, if you consider it necessary, to help establish contacts with SPMS, so that the Algarve does not miss this technological train.
What can Algarve mayors do to help retain doctors in primary health care in the region?
I emphasize that the availability shown by Mr. Minister of Health to positively differentiate the conditions for hiring health professionals for primary health care in the Algarve, although they were excluded from the conditions given for the interior regions. The Algarve is not inland, but in the setting of health professionals it has to be positively differentiated given its distance from Lisbon or Porto.
In order to secure the health professionals, the mayors can and should maximize all the benefits that exist in the region and contribute to solving in every possible way the accessibility of their citizens to health care.
Here are some possible solutions:
• Install, immediately, SNS 24 Branches in all parishes and, above all, in locations farthest from health services;
• Provide support for the residency of doctors who intend to work in your municipality, regardless of the type of contract they have;
• Support for the travel of doctors who do not reside in the municipality, provided that they mostly work in the municipality;
• Ensure the existence of conditions for household members, including nurseries and schools;
• Carry out the works and make the physical environment of the health center attractive for professionals and the population (there are even funds from the PRR for this!);
• Ensuring the existence of computer equipment with optimized functioning;
• Ensure professional development opportunities for physicians, namely:
• Agree with the Faculty of Medicine of the University of Algarve (FMCB of the UAlg) conditions for access to a PhD;
• Supporting research and carrying out doctorates at the FMCB of the UAlg that benefit the county's population;
• Agree with the FMCB of the UAlg on the possibility and support for the participation of physicians in the training of medical students;
• Agree with ABC on participation in postgraduate training, access to scientific information platforms and support for research;
• Consider assigning a surcharge to doctors according to the number of users they handle, in addition to their base contract
It should also be added that, immediately and until the measures take effect, the mayors must demand the operation of the SNS network and that the ACES guarantee the availability of doctors from other health centers on a rotating basis, with travel expenses paid by the municipalities , in order to reduce absences and guarantee the equal access required to the SNS.
This network operation, with the sharing of resources has been defended, and very well, by the CEO of the SNS, Fernando Araújo, with due support and political support from Mr. Minister of Health. Well Hajam! Let's do this now on the finer mesh of the net!
With the excellent mayors we have, creative and willing, and with the unique availability shown by national health decision-makers, solutions will certainly be quickly found and implemented!
The Algarve, regardless of where they live, deserve the best health care!
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