The conclusion emerges from an analysis made in the Spring 2019 Report by the Portuguese Observatory of Health Systems, a body made up of researchers and representatives of academic institutions.
The document stresses that SNS "is much better than many want to believe", but states that, where the current Socialist government is concerned, "little has been added to the legacy of the previous administration", as it has chosen to cope with “lack of money" with a tactical approach involving "current management of the sector".
In its analysis of governance in healthcare, the report cites the opinion of three prominent figures in the sector, with distinct ideological positions: Cipriano Justo, Leal da Costa and Ana Jorge, the spokesman for the document’s coordinators, Rogério Gaspar.
The report suggests that the health sector today would be in "worse conditions than when it was inherited from the previous government" if it were not for civil society and sectorial movements, independent from the Ministry of Health. It states that "what is left for posterity is manifestly little", both in terms of reform of the SNS and the Basic Health Law, which has not yet been approved.
The funding of the SNS in the near term has dominated the political concerns and orientations of the current government, "to the detriment of technical, structural, human and financial sustainability in the long term,” the report states.
"When the Prime Minister realised what was going on, three years had passed and his government’s health team did not show leadership capacity to manage health policy," it quotes the doctor and researcher Cipriano Justo in the first chapter, alluding to the substitution of former minister Adalberto Campos Fernandes with Marta Temido, who took over in October last year.
Campos Fernandes had already decided to appoint a committee to propose a new Basic Health Law, but it was already late, the report notes.
"With one year to go before elections for parliament and a particularly turbulent inheritance, the new team [at the ministry] lacked time to ponder and adopt the measures that had not been taken or considered at the due time,” he states there. “He could only resolve the labour conflicts and manage politically the review of the Basic Health Law.”
In the same chapter on governance, Leal da Costa, a doctor and former member of the preceding right-of-centre government, argues that "the SNS is worse", because demand is "far superior to its responsiveness", largely due to an older population.
However, he adds that the state of the SNS is almost certainly "still better" than many believe: "The state of the SNS, probably even better than they want to make us believe at any moment, whether the opposition – in particular when it is the left – the media or individuals’ opinions in isolated cases, but surely worse than governments and ministers imagine; it needs continuous care and constant improvement."
Ana Jorge, another doctor and former minister, in a previous Socialist government, acknowledges in the report that "the SNS is in a major crisis", citing human resources as the main challenge. Health professionals, she stresses, “have to be proud to work in the SNS," expressing concern about the disappointment they feel at the state of public service.