After analyzing “the excerpt” of the diploma sent by the Government regarding Centralized External Emergency Services of Regional Scope, SIM regrets that does not contain “specific incentives for providing work outside the usual unit, limiting itself to mentioning cost and transport allowances, already provided for in any trip in the Public Administration”.
Garcia de Orta Hospital, in Almada
Ana Baião
In analyzing the document, to which the Lusa agency had access, SIM also points out the “lack of definition of the maximum distance between the place of origin and the destination hospital, allowing unlimited travel”.
Contacted by Lusa, on the eve of a new meeting with the Ministry of Health, the secretary general of SIM, Nuno Rodrigues, regretted that the Government had only sent “excerpts from the diploma” without the incentives previously presented at the meeting with the guardianship for professionals.
“That incentive has disappeared, the kilometer limit has disappeared”he said, pointing out as a possible explanation the Ministry of Finance’s lack of availability to create these incentives.
The SIM also identifies as negative aspects the existence of “legal standards that conflict with the Collective Labor Agreement in force since July” and the lack of reference on whether the population in the area of influence of the new emergencies will serve as a basis for calculating the minimum standard team, which it says compromises “the analysis and definition of the appropriate number of doctors”.
There are also no procedures foreseen for situations of saturation of the hospitalization or delivery block, “despite the fact that the hospitals that house regional emergencies are not sized for the population they will respond to”.
As positive points, the SIM highlights the formal definition of regional urgency, legally framing those that already exist and the creation of new ones, the “apparent applicability to the entire country and to all specialties” and the “possibility of adapting responses to the resources available in each region”.
SIM states that it will present a counter-proposal with the changes it considers essential to ensure that “the reorganization of regional emergencies is operationally feasible, legally sound and clinically safe”.
“Incentives must be provided”
Nuno Rodrigues argued that “incentives must be foreseen” and there must be “a limit of kilometers up to which the doctor has the perception that he can be mobilized”.
“It can’t be a blank check”he warned.
The union highlights in the document that, “in view of the legal insufficiencies, the lack of incentives and the lack of guarantee of complete teams”, it rejects the presented components of this diploma and considers that, with the current wording, “it will not achieve the objectives expected by the Government”.
SIM also analyzed the diploma that creates the High Performance Centers in Obstetrics and Gynecology, considering that it could constitute “a useful instrument if the identified gaps are corrected”.
Among the positive aspects, it highlights the recognition of multidisciplinary teams and differentiated organization in critical areas, the creation of incentives based on productivity and quality, the possibility of gradual implementation through pilot projects and the voluntary adherence of professionals.
Negative aspects include a lack of guarantees for those who do not join, a lack of clarification on hierarchies and responsibilities between ULS and the Executive Directorate of the SNS, omission of essential specialties such as Pediatrics and Immunohemotherapy, undefined productivity criteria, lack of supplement for training advisors and lack of reference to strengthening training capacity in Gynecology/Obstetrics.
According to Nuno Rodrigues, the diplomas may have been approved on Wednesday by the Council of Ministers, but with “text reservation”still subject to change.
For the union, this is “an unacceptable working method in a serious negotiation process and which prevents rigorous evaluation of proposals”.
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