Lack the long-term strategy on health policy
Posted on June 19th, 2009 in Uncategorized
Management reform does not alter the performance of hospitals, with private partnerships have been launched to breach the rules of good governance and improvement in the waiting lists and in primary care are inadequate.
The conclusion is the Center of the Portuguese Health Systems (OPSS), the Spring Report versa this year on the evolution of the Portuguese health system in the last decade.
Despite being coordinated by Constantine Sakellarides, former Director General of Health and current consultant of the Ministry for primary care, the body does not spare criticism of the evolution of health policies. It is particularly negative with regard to partnerships with private (PPP) for building and managing hospitals and the chronic lack of an analytical basis for assessing the evolution of the results of health policies.
Ana Escoval, one of the authors of the report, cites the example of the politics of medicine, specifically referring to the use of antibiotics. No information or analysis on the situation in the country, knowing that Portugal is just abusing the prescription of these drugs and leads the ranking of the use of quinolones.
As the PPP – a “stark situation” – the OPSS regrets that it has opted for a solution “without parallel international” without starting a pilot project and that, after seven years, still no results in sight. The government earlier decided to build ten hospitals in this scheme – the private building for thirty years and managing a unit integrated in public, which comes after in the state. The current government stopped them for five to have decided, recently, to withdraw from the clinical management of private power.
The advances and setbacks – which also have been targets of the contract (see sheet below) – are proof of the absence of a center for intelligent analysis and strategic direction in the governance of health “that Ana Escoval regrets. “A policy takes years to implement, so it can not depend on changes of direction. Health needs of a pact of regime? “Almost … not like the political system of pacts. But these things are fundamental,” says the researcher, lecturer, National School of Public Health.
The long-term strategic planning “is essential to ensure the availability of human resources for health”, says the report. And its absence results in problems such as inappropriate use of nurses (many are unemployed or employed the term) and the absence of a sustained training of doctors: the medical population is aging. The same lack of strategy was behind the closure of services (hospitals, emergency and health centers at night) because they were made “out of a local integrated planning based on specific needs of each region.”
While admitting it is a complex issue, by its very nature, OPSS highlights the challenge of financial sustainability of the health system. And advocates raising the priority of health policy in relation to other sectors. To be willing to do more and better with existing resources and create value. Sustainability can not be seen as only a financial problem, the researchers warn.
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