In a statement sent to Lusa, Carlos Cortes, the regional president, accuses the CHUC of devaluing mental health, saying that patients "spend several days” in accident and urgency department because there is no space for them on the wards and that "they only eat biscuits, soup and milk or juices” while there.

“There are even patients with criteria for compulsive internment who remain for several days in the emergency room," while others are transferred to other wards, "without the due specialised care," he said, adding that patients "spend days on end with difficulties in satisfying their basic hygiene and food needs, since there are no conditions to intern them.

"This is a warning cry for an inhumane reality, as it results in serious consequences for patients,” the statement goes on. “The CHUC had a leading centre nationwide in the area of psychiatry that is gradually being destroyed. The management board should value the excellence of the work done by professionals in the field of mental health and not be jeopardising the dignity of patients.”

The statement is based on a document submitted "in the face of the seriousness of the situation" to the CHUC board by about 40 doctors working in the psychiatric service, which outlines the existing "shortcomings and deficiencies", in particular relating to the shortage of in-patient places and the danger that patients are in A&E, where they are "more vulnerable" and develop complications from hospital infections.

In the document, dated 26 June, which Lusa has seen, the signatories warn the hospital management that "so long as the safety and quality conditions for the practice of medical acts are not met [they themselves] refuse any and all liability deriving from the shortcomings" cited, in particular accidents and incidents that may occur as a result of the "anomalies" in the conditions of the service.

The signatories stress the "urgent need to increase the number of places for in-patients in the psychiatry for acute patients CRI” – the Integrated Responsibility Centre – to "at least … what existed" in September 2018, when there were 54 for men and women, against 48 at present, before the "untimely" closure of the women's psychiatric unit, in Celas.

At the end of 2018, the internment vacancies were "provisionally moved" to the ground floor of the central building of the University of Coimbra Hospitals, where the male internment unit exists, and to the first floor of a building at Sobral Cid Hospital, 10 km away.

As a result, the doctors allege, "many patients with criteria for hospitalisation and without conditions of discharge as out-patients" are, due to the absence of places, left in A&E "long beyond the time defined" in the norms of the psychiatric service, and with inadequate conditions in terms of food and hygiene.

In a note sent to Lusa, the hospital management states that before the establishment of the CHUC, the central psychiatric emergency ward for the Centre region was created in 2009 in the Coimbra University Hospitals and that, a decade on, with in-patient treatment now "essentially centralised" in the CHUC, the earlier set up ceased to make sense.

It states that since June it has been turning the situation around, ensuring that patients are not kept for more than 24 hours in this area, with the goal of ensuring there are no patients awaiting hospitalisation in A&E.

On the doctors’ allegations, the CHUC states only that "situations of constraints with place are resolved with the improvement of internment times, which is happening."