In 2013, the decision to merge the administration of the Algarve’s public hospitals was presented as a way to attract more health professionals to the region and facilitate access to care for patients. Eleven years later, the region’s hospitals are in an unprecedented state, especially that of Portimão, where the constant closure for several days of the maternity, obstetrics and pediatric emergency departments has left expectant parents in a constant state of anxiety.
Amid reports of expectant mothers in the western Algarve being rushed to Faro hospital – and at least one having to give birth in an ambulance on the A22 motorway – the situation at Portimão hospital led concerned citizens to stage a protest on 30 August. Only about 20 people showed up – a small number, but one that must be put into perspective, given that the protest took place at 11am on a weekday in August, when most of those affected by the hospital’s failings are likely to be working.
For more than a decade, Dr. Batalau has expressed his “total disagreement” with the merger of hospital administrations, the results of which, he says, are “visible to all of us, except for those who are blind or who have personally benefited from these measures.”
“Unfortunately, most of these measures in Portugal are implemented without any prior study, neither in terms of the care to be provided, nor in financial terms. I would be very happy if someone could prove to me that with the CHA/CHUA (administrations), all types of health care have improved considerably and that there has been a saving/reduction in the funds invested,” says the septuagenarian.
Dr Batalau is convinced that the merger of hospitals in the Algarve has brought a series of negative consequences for the region’s health system, one of the most significant problems being the reduction in the number of health professionals, who “have moved to the private sector or left the country altogether”.
Photo : Michael Bruxo/Open Media Group
The situation is further compounded by the low nurse-to-patient ratio in various departments, he explains, which results in many nurses being forced to work excessive overtime without pay. This overtime is often placed in time that is theoretically supposed to be used as vacation days, but with such a low staffing ratio, these breaks “are never taken.”
The career progression of health professionals has also stalled, while the lack of adequate human resources has even led to the closure of services, including the maternity and pediatric and obstetric emergencies of the Portimão hospital, explains the doctor.
He also warns that if this trend continues, Faro hospital could be next, leaving only private health facilities available for those who can afford them.
The effects of the merger are also felt in the increase in waiting times for emergency services, consultations and surgical procedures, with only a few medical specialties managing to maintain acceptable levels of service.
In addition, costs associated with the health system in the Algarve have increased dramatically, particularly due to the high fees paid to doctors hired on a service-based basis, sometimes reaching up to €100 per hour. This financial pressure is further compounded by payments made to private health companies for outsourced services, Dr Batalau points out.
Another major problem is the reluctance of health professionals, especially doctors, to move to the Algarve, mainly due to fear of being assigned to the Faro hospital. This reluctance has led to an alarming trend of doctors resigning from their contracts due to the pressure to work in the emergency department, including at night and on weekends, in Faro, explains the former hospital director.
Added to these problems are the difficulties in replenishing supplies of medical supplies, essential products and medicines, particularly at the Portimão hospital.
Finally, Dr Batalau criticises the management of health facilities in the Algarve, which he says has been entrusted to “incompetent individuals lacking in health knowledge”, with appointments often based on “political connections rather than expertise”.
“I could continue to list other problems/complications that have arisen after the merger of hospitals and now with the creation of the Algarve Local Health Unit – ULSA – a health institution with great management difficulties, or worse,” he says.
“If a single hospital is already difficult to manage, imagine an institution with three hospitals (Faro, Portimão and Lagos), five basic health emergency units, a physical medicine and rehabilitation center with hospital care (São Brás de Alportel), a hospitalization unit (Loulé) and 15 health centers with 152 functional positions,” emphasizes Dr. Batalau.
Par Michel Bruxo
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