The Ministry of Health has decided to incorporate the recommendations of the Winter Contingency Plan for managing medical shifts into legislation. This will be done through a dispatch that will be published soon. The aim is to “avoid” situations similar to those experienced this summer.

However, unions and administrators are contesting this decision. They argue that the issue is not about resource management, but rather a lack of human resources.

Winter Contingency Plan Recommendations

The document that arrived in August at the hospitals of the National Health Service (SNS) outlined the preparation of the Winter Contingency Plan. It recommended that medical shifts be organized to ensure the functioning of services, given the expected increase in demand for care during certain critical periods.

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At that time, officials explained to the media that this would require better management of doctors’ holiday shifts. This summer, some emergency services in the country had periods where only one doctor was on duty, leading to the unfortunate result of having to close the emergency service to outside patients.

New Shift Management Rules From The Ministry of Health

The Ministry of Health has decided to make it obligatory by formalizing it in legislation. As reported in yesterday’s edition of Público, hospitals will have the authority to adjust doctors’ holidays whenever there are conflicts that do not meet operational needs.

A source from the ministry, who also confirmed to us the existence of a dispatch on the matter, explained that:

“The objective is to raise awareness among boards of directors about the management of emergency shifts during doctors’ vacation periods, ensuring in time that there are no gaps in these”.

On the professionals’ side, the president of the National Federation of Doctors (FNAM) has reacted strongly, stating that this ruling is absolutely unacceptable and will further alienate doctors from the National Health Service (SNS).

Joana Bordalo Sá emphasized that the document would create discomfort among teams already working exhaustively. She accused the ministry of unilaterally implementing changes to the rules that adversely affect doctors.

Criticism Over Lack Of Investment In Hospital Management Careers

We also gathered the perspective of hospital administrators on the issue. According to Xavier Barreto, managing shifts is already mandatory for hospitals, and he emphasized that this management is being carried out in the vast majority of cases.

The president of the Portuguese Association of Hospital Administrators (APAH) even said that:

“The work shifts already take into account doctors’ holidays, which are already staggered and distributed throughout the year in order to ensure the schedules are met. It is natural that there may have been problems with work shifts in one or another hospital this summer, but we cannot confuse one case with the majority of hospitals in the NHS.”

He further said that he understands the concern of the supervisory authority and its need to remind hospitals that they have to ensure the shifts, but, in truth, this is already being done.

Xavier Barreto pointed out that the problem with the NHS’s emergency services is not due to doctors’ shifts or holidays, but rather the lack of professionals. He stressed this is the real issue, so let’s not lose focus on what’s essential.

He further commented

“The priority now is to ensure there are more doctors in the NHS by improving their working conditions. Additionally, we need to move forward with creating a concentrated emergency network, redefining teams, and increasing investment in management.”

Barreto took the opportunity to criticize the repeated rhetoric about management, often mentioned by the minister, and posed the question:

“What investment has this and other governments made in the management of the NHS? There has been a career to review for many years and, at the moment, many hospitals do not even have management structures.”

He further elaborated saying:

“When a service director makes a roster, who is there to review whether the law is being complied with and whether that is the most efficient way to allocate resources throughout the year? It should be the hospital manager, responsible for that service, and not the board of directors, but in most hospitals this manager does not exist, precisely because governments continue not to invest in hospital management or in the career of hospital administrators.”