The death of a pregnant woman who could not be treated at Lisbon’s main hospital due to a lack of capacity has sparked outrage in Portugal, where a months-long health crisis has shut down hospital services. emergency across the country and put maternity care under extreme pressure. .
The 34-year-old was admitted to Santa Maria Hospital in Lisbon on August 23 with respiratory problems and high blood pressure. Due to lack of space in the neonatology ward, she was transferred to another hospital, but died of a heart attack in the ambulance.
Her baby, born at 30 weeks and weighing 772g (1lb 11oz), survived.
Health Minister Marta Temido, in office since 2018 and throughout the Covid pandemic, resigned this week after the affair came to light. She said in a short statement sent to the Guardian that she “no longer had any conditions to remain in office”. Prime Minister António Costa said the woman’s death was “the last straw” for Temido.
Santa Maria Hospital said the patient had been stabilized and described transfers between regional hospitals as a “frequent procedure”. He told CNN that the woman’s death was “not foreseeable or expected in this situation.”
An investigation has been opened. The government’s General Inspectorate of Health Activities (IGAS) is also examining the death of a baby on June 9 in Caldas da Rainha, north of Lisbon, after there were no obstetricians to help the mother during childbirth. On August 22, another pregnant woman had to be transferred from one hospital to another twice, traveling a total of 95 miles (150 km) during labor.
Newspaper front pages branded Portugal’s once highly rated National Health Service (SNS) the ‘national disease service’ and the health ministry the ‘ministry of simulation’ after shutdowns left thousands of people without access to care in the practically free public health system.
The crisis is the result of decades-long structural problems, including low salaries, outdated equipment and inefficient bureaucracy, said Dr. Gustavo Tato Borges, president of the National Association of Public Health Physicians.
Salaries have not changed since 2009. A medical specialist has a monthly starting salary of €1,853 (£1,603) and a nurse €1,200. “There is not a lack of doctors to meet the needs of the SNS, but rather a lack of doctors willing to submit to work in the SNS,” Borges said. “The SNS does not have the ability to attract doctors and keep them staying for long.”
While the number of doctors in Portugal has almost doubled over the past 20 years, almost half work in the private sector. An estimated one-third of the population has health insurance, an increase of almost double over the past 16 years, as waiting times have increased in the public health system.
Infant mortality is at its highest rate since 2018 and the third highest in the past decade. Portugal has an excess mortality rate of 23.9%, four times higher than the EU average.
The Ministry of Health has announced a “thorough” investigation into the death rate.
Before stepping down, Temido had announced 1,600 vacancies for medical specialists in fields such as gynecology, obstetrics and public health, and approved a new model for the SNS, with a different management structure, greater autonomy decisions for hospitals and measures to increase productivity.
However, health workers say the new model, along with the minister’s resignation, fails to address structural problems that plague the public health system.
Costa said there would be no change in health policies, saying replacing Temido would be purely a change in “personality, energy or style”.
“Those who want a change in policy will have to overthrow the government,” the prime minister said on Tuesday.
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