Statement by Jorge Pires, Member of the Political Committee of the Central Committee, Public Hearing “Strengthen the NHS. Guarantee access to healthcare”

“Strengthen the NHS. Guarantee access to healthcare”

“Strengthen the NHS. Guarantee access to healthcare”

More than 40 years after the adoption of the law that created the National Health Service on September 15, 1979, the NHS today faces a gigantic operation led by private groups in the disease business, their political representatives and the usual propagandists that have done everything, over the years, to have these groups replace the public service in providing healthcare and thus see thousands of millions euros entering the coffers of their companies, public money that should be used to strengthen the NHS.

The Constitution of the Portuguese Republic appointed the SNS as an instrument for the materialisation of the primary responsibility of the State in guaranteeing the right to healthcare for all Portuguese, regardless of the social and economic conditions of everyone.

With the creation of the NHS, and despite being systematically attacked and discredited, it was possible for the country to emerge from a position of great backwardness in terms of health, and in a short time to take a prominent place worldwide in the main indicators, such as the rate of infant mortality, life expectancy at birth and vaccination. In 2000 the WHO even ranked it as the 12th best in the world.

But the life of the NHS has always been very difficult. The so-called “health-based” interests have always been against it, namely the medical right-wing, the dominant private groups in the production and distribution of pharmaceutical products and equipment, and the private groups with the respective insurance companies.

Over the years, through the political intervention of the PSD, CDS/PP and the PS on many occasions, it was possible for this conglomerate of “installed interests” to prevent the articulation and exploration of the full potential of the NHS, parasitizing it and using it as a tool to transfer public resources to private accumulation.

Government after government, the representatives of these interests, by party nomination, depending on the party in government, in the different instances and services, over dozens of years of right-wing policy, particularly between 2011 and 2015, led the NHS to a situation which did not enable it, on many occasions, to fully fulfil its mission with obvious losses for the interests of the people and the country.

If we consider the period between 2012 and 2017, the real underfunding reached about 20% on average/per year; 4 500 beds were closed between 2005 and 2015; hospital facilities were closed and transferred; proximity healthcare units in primary care were closed; maternities and emergency services were closed. These are just some of the wrongdoings against the NHS.

A process of devaluation and discrediting of the NHS that had above all in the social, professional and wage devaluation of health professionals, one of the central aspects of the offensive.

The wager on an atmosphere of unstable employment relationships, great dissatisfaction due to low wages, discouragement resulting from the lack of working conditions, has been part of a strategy that aims to lead thousands of healthcare professionals to leave the NHS for private groups or for early retirement, many of them being fundamental for the functioning of services, while many others stopped having full-time schedules in the public service and began dividing working hours between public and private systems.

A process that has created great difficulties in the organisation of services and for training new doctors.

Without motivated and valued professionals, it is not possible to guarantee a National Health Service with the nature and characteristics of what we have in our country.

It is not possible for the NHS to fully fulfil its responsibilities, when the levels of promiscuity between the public and the private systems reach the dimension that exists, or when the full capacities of the NHS units are not used and are transferred to private groups: thousands of surgeries; diagnostic tests and treatments; the management of large hospital units under a PPP regime, with significant benefits for private groups and which cost more than 400 million euros a year.

About 40% of the NHS budget is transferred annually to private groups to pay for conventions, contracts, pharmaceutical products, PPPs, money that should have been invested to a great extent in strengthening the NHS.

As a result of the right-wing health policy, while thousands of beds in public hospitals, proximity services, namely in the area of primary healthcare, maternity hospitals and emergencies were closed, new private hospitals grew like mushrooms all over the country. At the same time, a concentration process was developed with the four large private groups buying dozens of clinics and small hospital units. Four large groups whose share capital is today mostly held by foreign capital.

Today, the majority of the Portuguese people acknowledge the irreplaceable role of the NHS in responding to the epidemic outbreak, and it became clear that it is the only response capable of guaranteeing the right to healthcare, particularly in the most difficult moments. The more than 130 000 professionals - doctors, nurses, senior health technicians, operational technical assistants and all those involved in providing aid to the Portuguese contributed in a very significant way, as well as Medical Emergency professionals, fire fighters, officers of the Security Forces and Civil Protection.

As we have said the build-up of the operation against the NHS, under the pretext of delays in the treatment of other pathologies, emerges precisely when the myth of the advantages of private management and business has fallen flat, with private groups hiding from the virus and seeing their activity reduced significantly.

If it was possible to adopt an emergency plan to respond to the impacts of COVID-19, it is also possible to implement an emergency plan to strengthen the overall response of the NHS in the hospital, primary care and public health fields, catch up delays and ensure regular activity.
What is needed today is not questioning the capacity of the NHS to respond to the needs of the people in providing healthcare, but implementing the necessary and long-identified measures to strengthen the public service.