The report “Ready for the Next Crisis? Investing in Health System”, by the Organization for Economic Cooperation and Development (OECD, to which Portugal belongs), analyses “the lessons” of the pandemic and includes recommendations for policies so that countries are better able to face the next crisis.

The pandemic, declared by the World Health Organization in March 2020, constituted “the biggest health crisis” in the last century and showed “three major vulnerabilities” in the system: it was not properly prepared, it lacked personnel and investment.

The OECD advocates that the increase in investment that it recommends for its members be aimed at personnel (half of the total), prevention and infrastructure.

“More than 6.8 million deaths due to covid-19 were reported worldwide in January 2023. Excess mortality analysis suggests that up to 18 million people may have died worldwide from the pandemic by end of 2021", underlines the report, adding that "life expectancy has decreased in many OECD countries in 2020 and 2021", in addition to having "widespread disturbances in society and education" and GDP having fallen "4.7% in 2020 in the economies” linked to the organization.

The study recalls that “pre-existing inequality and chronic diseases worsened the results of the pandemic”, noting that the fact that health systems spend “less than 3% of total health spending on prevention” left “many members of the population vulnerable”.

The lack of personnel, in turn, “has limited effective responses to the pandemic and continues to do so”. “Sufficient and well-trained” staff are needed for “agility in times of crisis, as well as to deal with the backlog of care” and respond “to the substantial increase in mental health needs”.

In Portugal

The number of doctors in Portugal per 1,000 population in 2019 (or the last year for which data are available) was just above the threshold of 3.54, the OECD average being slightly lower, while the number of nurses was slightly below the OECD average.

The lack of health professionals in the country - whether doctors, nurses or assistants - had a medium level of impact on Portugal's ability to deal with the pandemic, according to the organization.

To increase the supply of professionals during the peaks of the pandemic, Portugal resorted to extending working hours and increasing their workload, as well as relocating them to “localities or establishments with greater needs”, reducing activities not related to the covid-19 and the mobilization of more workers, such as students and pensioners from the sector.

Portugal was one of the countries that resorted to digital consultations, as well as “private providers”, to “increase the volume of non-urgent care” by the National Health Service.

Regarding information and knowledge, the pandemic led to changes in Portugal in terms of “new technologies to improve the availability of health data, accessibility, sharing or privacy (…) and security protections” and the necessary legal reforms

The report insists that "smart targeted investments" in the resilience of the health system will benefit societies by ensuring that "foundations are in place for the next crisis".

"Without these investments, the costs and impact on people will be greater."