HEALTH-PORTUGAL:
Latin American Doctors
Fill the Breach
By Mario de Queiroz
LISBON (IPS) - Portugal
is trying to fill the
vacuum left by the
departure of many of the
2,000 Spanish doctors
who have been
contributing to the
normal functioning of
hospitals and clinics in
the interior of the
country, with Argentine,
Cuban and Uruguayan
doctors.
Many Spanish doctors who
spent years in Portugal
weathering the storm of
a lack of health posts
in their own country due
to an excess of medical
school graduates are now
responding to a call to
return to Spain, issued
by the government of
socialist Prime Minister
José Luis Rodríguez
Zapatero.
As the Portuguese
National Health Service
(SNS) acknowledged,
medical services,
especially in border
areas, are already
suffering from the loss
of Spanish personnel.
The most likely solution
"lies on the other side
of the Atlantic," Dr.
Rui Sousa Santos, head
of the Beja Hospital in
the capital of the
southern region of Baixo
Alentejo, one of the
areas most affected by
the exodus of Spanish
doctors, told the local
press.
In July, Uruguayan
doctors are due to start
working in Medical
Emergency and
Resuscitation Vehicles (VMER)
under a cooperation
agreement signed by
Lisbon and Montevideo
last year during
Uruguayan President
Tabaré Vázquez’s
official visit to
Portugal.
The solution to medical
staff shortages in the
VMER, which are part of
the National Institute
of Emergency Medicine (INEM),
were 100 Uruguayan
doctors, according to
local press reports in
August 2007, quoting
then Health Minister
Antonio Correia de
Campos.
However, Pablo Porro, an
adviser to the Uruguayan
Embassy in Lisbon,
denied the figure
reported in the
Portuguese press, and
told IPS that "from Jul.
1, only 15 Uruguayan
doctors will begin
working for INEM, in
accordance with the
agreement signed in late
September."
In addition to the
emergency personnel,
"two or three teams of
specialists, totalling
some 10 doctors, will be
coming to Portugal," the
diplomat said.
The Portuguese medical
profession, jealous of
its privileged status,
was for once obliged to
face the reality of a
possible total collapse
of the public health
system if they continued
to object to foreign
doctors working in the
country.
Poland and Ukraine have
a surplus of doctors,
but they are being
absorbed by Germany,
which offers more
attractive salaries and
is closer to their
countries.
Sousa Santos predicts
that Latin American
doctors will provide the
most viable solution,
because medical schools
in many countries in
that region train
thousands of good
doctors, many of whom do
not find work, "which
makes it easy to hire
them," as was the case
of Spanish doctors a
decade ago.
In the late 1990s,
Spanish doctors began
migrating to Portugal,
especially in border
areas and particularly
in the northern
Portuguese regions of
Minho and Trás-os-Montes,
which border on the
Spanish regions of
Galicia and Castilla,
and the southern region
of Alentejo, which
borders on Extremadura
and Andalusia.
Carlos López Salgado,
deputy head of the
Association of Spanish
Health Professionals in
Portugal (APSEP), told
the Lisbon newspaper
Publico in an interview
on Jun. 19 that he moved
to Ponte de Lima, in
northern Portugal, nine
years ago because he was
"fed up with the arduous
task of practising
medicine in Spain."
There were so many
medical graduates that
most of them could not
find work in the public
health service, so many
young doctors,
especially Galicians
whose language is very
similar to Portuguese,
came to Portugal where
they could find stable
employment. In 1999,
nearly 20,000 candidates
applied for 3,000 posts
for doctors and nurses
in the Spanish health
services, whereas in
Portugal that year, 900
people applied for 800
posts in the national
health service (SNS).
However, Portugal now
has a crisis on its
hands, as Madrid has
called on Spanish
doctors to return, and
is offering much more
attractive salaries. In
addition, according to
the Portuguese doctors’
union, 800 doctors left
the SNS between 2006 and
2007 for the private
sector, where they can
earn over twice as much.
The former steady flow
of Spanish doctors into
Portugal, especially
from Galicia,
Extremadura and
Andalusia, "has
virtually come to a
halt," said López
Salgado, who explained
that "now Spanish
doctors are seeking job
opportunities in their
home regions."
APSEP statistics
indicate that in 2002
there were 3,000 Spanish
health professionals
working in the Norte
region of Portugal, most
of them at polyclinics.
By 2007 their number had
fallen to between 800
and 1,000. In the
southern Alentejo
region, where five years
ago 400 doctors from
Extremadura were
practising, there are
now under 150.
At present, although
there are no official
figures, APSEP estimates
that there are about
2,000 Spanish health
professionals in
Portugal -- 80 percent
doctors and 20 percent
nursing staff.
Pedro Nunes, the head of
the Portuguese Medical
Association, raised the
alarm level by pointing
out that in some areas
of the Trás-os-Montes
region, nearly half of
all health professionals
were Spanish.
Nunes painted a gloomy
picture of the
vulnerability of
Portugal’s SNS if the
contribution of Spanish
doctors is withdrawn,
citing as an example the
emergency service at
Ponte de Lima, where 14
out of the 16 staff
doctors are Galician.
The north is the region
that will suffer most
when Spanish doctors
return to their country,
as there are high
numbers of Galician
doctors at health units
in Chaves, Montalegre,
Boticas and Miranda do
Douro.
In other areas, too, the
situation is worrying.
Out of the 103 doctors
in the Baixo Alentejo
region, 38 are Spanish.
In the southern Algarve
region, 20 percent of
the doctors are Spanish,
as are 24 percent in the
northern port of Viana
do Castelo.
Why are doctors coming
to Portugal from
Argentina, Cuba, Uruguay
and possibly other Latin
American countries not
yet named, rather than
from Brazil, which seems
the logical choice from
the point of view of
language and a degree of
shared culture?
The Medical
Association’s reply is
that it considers those
countries to offer an
excellent university
training, in contrast to
many Brazilian
universities.
Nunes called attention
to the risk of hiring
health professionals
whose training is not up
to Portuguese standards.
He said that Brazil, for
example, has close to
130 medical schools, but
only 25 are of high
quality, some of them
being "even better than
Portugal’s."
However, while on one
hand the Medical
Association cannot
ignore the crisis that
would afflict the health
system if foreign
professionals are not
hired, "on the other
hand it is always eager
to safeguard its
privileges," a young
doctor who is also a
civil society activist
told IPS.
Speaking under condition
of anonymity for fear of
reprisals from the
Medical Association, he
said that "the idea that
Portugal has the best
doctors in the world has
been generally accepted
by the public for
decades," because in
order to be selected by
the medical schools,
grades of 19 or 19.5 out
of 20 are required.
However, "having been a
good student in high
school, and having a
good memory in order to
pass admission exams,
does not make us the
world’s best doctors, as
can be seen from the
high number of deaths
due to medical
negligence that occur
every year in Portugal."
|
|
|
|
|
|
