The Portuguese Observatory of Health Systems (OPSS) points out the lack of strategic guidance in health and says that it is necessary to respond with intelligence to emerge from the crisis exacerbated by the pandemic with greater resilience.
In the Spring Report 2022, the OPSS sets out the biggest challenges of the National Health Service (SNS), points out the “recent and ambitious” response attempts contained in the Statute of the National Health Service (SNS) and the Recovery and Resilience Plan. (PRR), but insists on the need to define a structural strategic orientation for the sector.
“What is the structural strategic orientation that we intend to follow in health?”, ask the authors of the Spring 2022 Report – “What now?”a document in the form of a question that also makes some proposed answers.
The document immediately points out the three major challenges of the SNS – access to health care, human resources and public health -, also listing the “response attempts”, such as mental health reform, health digitalization, the Basic Health Law and the SNS Statute, full dedication “only for some professionals” and the creation of Local Health Systems.
Taking digitalization in health as an example, experts ask on what basis the care model will be developed, how it will drive transformation and how it will contribute to the three fundamental principles: the centralization of care in the person/family, integration and continuity of care.
They recall that the work of re-founding the SNS and the health system has not yet been carried out, also assuming some blame for the lack of proposals during the height of the pandemic, but admit: “Perhaps the time was too noisy, too demanding, necessary of answers to the most pressing and immediate, without time to think”.
“Perhaps the foundations for this response should have been laid earlier, at a quieter time”
As for the Basic Health Law, the observatory says that it remains to be seen what architecture is intended for the future of the Portuguese health system. “If, in fact, the private and social sectors are intended to be complementary, there is a lack of clear indications on how the SNS will respond to the greatest needs, preventing recourse to the private sector, with serious financial implications for families, from continuing to be indispensable”, underlines.
The authors of the Spring 2022 Report also insist: “And there is a lack of indications on the proper management of this complementarity, ensuring the quality and value of care in the social and private sectors, which are generally not transparent and whose control seems to completely escape the State”.
In a document full of questions, they also recall that it remains to be known what strategy will be adopted “for a healthier and more well-being population, regardless of economic and social status”.
Another question that is said to be unanswered is how to attract, motivate and retain health professionals: “How will full dedication, central point in the new SNS Statute, be implemented, and will the model be applied to all professionals?” .
What will change with the impact of PRR on health?
For the authors, there are also many doubts about the innovations that the pandemic has promoted, remembering: “It remains to be seen how the digitalization of health, central and promising point of the PRR, will be developed”.
“How can digital health effectively be a central contribution to the integration and continuity of person/family centered care? Will digital health be the instrument that allows us to increase our response capacity, in the present and in future pandemics?”, they still question.
Regarding health care at home, they say that it is also unclear whether it will be “a way to increase and improve responses” and whether informal/family caregivers will be given better conditions, which they consider “essential for the home care strategy”.
Finally, they argue, it remains to be seen “what fate will be given to other innovations from the hardest times of the pandemic”, such as proximity access to medicines, mechanisms to support the development and rapid evaluation of tests and vaccines and the adaptation of processes to that this innovation is accessible to everyone.
The Portuguese Health Systems Observatory is made up of a network of researchers and academic institutions dedicated to the study of health systems and annually produces a summary report on the evolution of the Portuguese health system.