In a discussion with a full room about decentralization in health, users, doctors and nurses expressed different concerns to different participants in the session, including Fernando Araujo, Executive Director of the National Health Service (SNS). A resident of Murica do Fuga, Bjuida, complained that he had not had a family doctor for half a year; A doctor from Hospital de Aveiro lamented the lack of investment in social networking services and warned that decentralization would lead to the “fragmentation” of the health system and lead to “the spread of chiefdom and influence”; A family doctor in Ujeda noted that the structure of the sector is “hospital-centric”, that is, it is very much centered around hospitals.
These and other concerns were heard during a symposium promoted by Centro Hospitalar do Baixo Vouga at Aveiro University (UA). Fernando Araujo hypothesized that Portugal is a “highly centralized country” and that the current management model has “losses of effectiveness” that must be corrected. Local Health Units (ULS) – with many more in the process of being installed – are one of the parts of the new machine, which has a “greater ability to get things done”, independently and without relying on super licences.
Better management of social networking services is crucial for the proper functioning of this sector, which has seen spending increase by “40 to 50 per cent” without envisioning tangible gains in the provision of care. He asked, “Are people more satisfied?” Spending should be controlled, he said, but HR is “poorly paid”.
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