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Since the beginning of the covid-19 epidemic in Portugal, in March, until October, the National Health Service (SNS) lost 842 doctors, between specialists and interns. Data from the SNS Transparency Portal reveals the extent of this negative balance at a time when the needs of doctors soared due to the pandemic. Although it is largely explained by the high number of retirements registered in this period, the decrease is not justified solely by retirements.
Data collected by the Independent Physicians Union (SIM) in the Caixa Geral de Aposentações lists and to which the PUBLIC had access indicate that 476 clinicians left the SNS due to age limits or early retirement in these eight months. Compared to the figures on the Transparency Portal, there are still close to three hundred doctors who have not stayed on the NHS. Where will they be? Some will be doctors who have finished their internship and have not been hired in the meantime or who have chosen not to fill vacancies in competitions, others will have gone to work in the private sector or abroad, reflects Mário Sardinha, from SIM, responsible doctor Of the investigation.
There are several factors that explain this phenomenon, he emphasizes. It is not just salaries that make the NHS “unattractive”, some doctors who finish the specialty prefer not to stay in the public sector “because of working conditions,” he explains. “An example: an orthopedic contest is opened for a hospital service in the Algarve that has a staff of 10 specialists, but only two are in operation. Someone dares to compete, knowing that they are going to a service where only three doctors can stay doing the work of 10 [o próprio e os outros dois, na hipótese, provável, de mais ninguém concorrer]? “
Others “do not want to leave their family and prefer to wait for the competition next year” and, sometimes, the competitions are also delayed and, although they do not happen, some do. That is exactly what happened this year when due to the pandemic, the bids for the hiring of new specialists were long overdue.
The year is being “atypical”
Given these data, the Government has preferred to highlight the increase in the number of doctors in recent years and, in September, the Minister of Health insisted that the decrease in the total number of specialists since the beginning of the year would be compensated with bids for hiring of doctors who finished their internship in October.
But even that was not possible. The data provided to the PUBLIC by the Central Administration of the Health System (ACSS) indicates that 471 physicians withdrew during these eight months and that 378 specialists were hired in the same period. A negative balance of 93, therefore. Without wanting to comment on the data on the Transparency Portal, ACSS assumes that inmates do not enter these accounts and recalls that “this year is being atypical”, with 911 specialists in the hospital and 39 in the health sector yet to be concluded. public.
The ACSS also adds these figures to the 435 vacancies in the general and family medicine competition to affirm that the total of “1,385 jobs” represents “an increase of 13% in relation to the number of doctors who recently completed their training (1,227), thus seeking to attract more doctors to the SNS ”.
“The Government assumes that all these vacancies will be filled, which will not happen, taking into account the history of competences in recent years,” disputes the deputy of the Left Bloc, Moisés Ferreira. In fact, in the competition for general and family medicine, which recently concluded, a third of the vacancies were vacated (146 out of 435), and in hospital specialties “the same should happen,” the deputy calculates, recalling that the percentage of Jobs that remain deserted has fluctuated between 30% and 35% in recent years. “In a good scenario, of the more than 900 places for hospitals and public health, about 600 should be occupied,” he estimates.
The Left Bloc has also invoked the negative balance shown by the data from the Transparency Portal to insist on the need for greater investment in the SNS and to demand measures that allow to captivate and convince doctors to remain in the public sector , such as the possibility of remaining in the public sector. Exclusivity regime. “The truth is that, in this year of pandemic, the SNS is losing doctors”, concludes Moisés Ferreira, who foresees that this negative balance will worsen even more until the end of this year.
“This Government has been totally incapable of creating attractive conditions because it does not invest, currently the best equipment is in the private sector. It is not with a whip that people are forced to stay on the NHS. As there are fewer, the doctors get tired more and are more willing to leave ”, criticizes the general secretary of the SIM, Jorge Roque da Cunha, who wanted to go further and take stock of the retired doctors who, in these eight months of pandemic, they returned to the NHS. , under a regime that has existed since 2010, but was extended in March due to the pandemic.
The balance indicates that 130 retired doctors were hired again on the NHS from March to October, but they return temporarily, some for only four months, others for a year. This regime, which was created ten years ago to be exceptional and transitory, although it was not possible to make up for the shortage of new specialized doctors, has been renewed every year and, in July, it was extended again, this time until the end of 2021 .
“The Government has transformed a temporary situation into an almost definitive one,” laments Roque da Cunha, who considers that there is a perverse effect on the measure: “Retirees are stealing the place of newly specialized doctors.”
