“The Right Funding is the Key for Better Health”

The demand for healthcare will continue to grow in the next years and “the right funding is the key” to improve the management of resources and obtain better results for patients, defended Isabel Vaz, during a debate about the future of the sector, broadcasted yesterday at RTP3 channel.

Luz Saúde CEO was an invited guest in the TV show “Fronteiras XXI”, organized by RTP channel in partnership with Fundação Francisco Manuel dos Santos, together with Francisco George (former director-general of Health and current president of the Portuguese Red Cross), Rui Vaz (director of the Neurosurgery Service from Hospital de S. João, in Oporto) and Tânia Bonifácio (specialist in General and Family Medicine at Unidade de Saúde Familiar da Baixa, in Lisbon).

“Who takes care of our Health?” was the motto for a debate of about one and a half hour, where topics such as the National Health Service financial sustainability, organization, human resources and politics were discussed.

“The issue of sustainability arises, today, in all countries with a welfare state. In Portugal, although the public health system and the private sector are growing, the demand is so high that the current capacity is no longer enough, with a subsequent rise in costs.

On the other hand, the aging situation and lifestyles don’t help: patients are more complex and have more diseases, which puts a huge pressure on healthcare providing”, explained Isabel Vaz.

Questioned if it is easier to do management in the private or public sector, Luz Saúde CEO stresses that the key point is how funding is obtained.

“There is general consensus, from left to right, on the fact that the National Health Service is underinvested. To clarify, it is not truly an underinvestment of the public sector, because at some given point funds emerge, which generates a certain unaccountability from the perspective of hospital managers, who realize they are dealing with impossible budgets”, she said, adding: “This is straightaway demotivating. But they also know that, at some point, the funds will have to emerge – and this, in my opinion, is the wrong way to do management, that is not followed in the private sector”. “A critical rise in the demand for healthcare is expected and the right funding is, clearly, the key to promote better attitudes and results”, she also stated.

As for the negotiations still in course about the revision of ADSE charts on the co-payment of healthcare provided by the private sector to public workers, Luz Saúde CEO stressed that the problem, in her opinion, is to know “if the way that co-payment is done is efficient, so as to promote better results in the patient’s perspective”.

“The private network has today an equal capacity to assist any state of seriousness and using the best technology”, also referred Isabel Vaz, defending that, in the future, “the assessment of the results obtained will be fundamental”.

And she gave the example of national registries (namely the registry of oncologic diseases), considering them “fundamental to learn and identify the best practices”.

“Portugal in the forefront”

On his turn, Francisco George stressed that “the health of the Portuguese people improved a lot in the last 25 years”. “There is a concept that the National Health Service has no solutions, which is not true; Portugal is on the forefront”, he stated, giving examples. “We had a 25% recovery in what concerns premature mortality and there are ever more Portuguese people celebrating their 70th anniversary”.

The former director-general of Health recognized that “there are management problems and the quality of managers training has to be improved”, but he argued that “the future is guaranteed”.
“For as long as there is Welfare State, there will be a National Health Service. It simply needs to be adjusted. Having the private sector as complementary and with a significant activity, but that cannot limit the National Health Service to the service of the poor. Their calling is distinct”.

As for Rui Vaz, “beyond underinvestment, the key points are the lack of autonomy” of NHS units (impeding them from hiring directly the necessary resources, for instance) and “the accountability of managers in costs”.
But he agreed that “our NHS, with all its flaws, is good and a reference, giving people security”. Among its advantages, the director of the Neurosurgery Service from Hospital de S. João gave the example of the creation of reference centres, and among its “defects”, “the delay in funding technological innovation, that has allowed the private sector to stay ahead the public sector, in several areas, such as robotics.

The physician Tânia Bonifácio insisted on the priority of primary healthcare, that is at the basis of the whole system”. “We must start planning at medium and long term, in what concerns topics such as smoking, diet, sedentarism and sleep disturbances”, instead of simply focusing on “emergency services and overcrowding”.