The warning that the pediatric emergency room at the Hospital de Loures would close this Friday at 9 pm and over the weekend was made on Monday by the medical unions. Hours later, the Minister of Health rejected the idea, referring that a reorganization of emergencies was underway, to be prepared by the Executive Board of the SNS. “You can’t say that the pediatric emergency room is going to close,” he began by saying on Monday. But this Tuesday, once again faced with the issue, he assumed that the closure at night will actually happen because of the lack of professionals.
“What I said yesterday and I reiterate is that next week a plan will be announced for the regular operation of pediatric emergencies throughout the Lisbon metropolitan area, namely in the Setúbal peninsula, but also in the part around the capital. This does not mean that there are not, however, some constraints”, began by saying Manuel Pizarro, on the sidelines of the visit he made this morning to the Hospital Amadora-Sintra, together with the president of the order of doctors, but later assumed: “And yes, it is true that in the case of Hospital de Loures the closure of part of the services will occur earlier, just because there is no availability of professionals.”
Speaking to journalists, broadcast on television, the minister explained that the lack of resources “is one of the reasons that led to this reorganization measure, which will be announced next week and which is anticipated in the case of urgent pediatrics in the country. Loures Hospital, which will in fact stop working at night”. The solution, in the face of this closure, is for parents to resort to pediatric emergencies that will remain open. “The pediatric emergencies remain open at Hospital de Santa Maria, at Dona Estefânia, at São Francisco Xavier. The SNS network continues to ensure that people’s needs are met.”
Manuel Pizarro recalled that the Executive Board of the SNS “is working on the organization of a metropolitan care model” for emergencies – not just pediatrics – that “allows people to be predictable and responds to the availability of professionals we have”. “At the moment, there are 12 pediatric emergencies in operation throughout the entire Lisbon metropolitan area. I think we can better organize the services, guaranteeing a number of emergencies that correspond to the needs, with the geographic proximity possible, but that at the same time corresponds to the availability of the professionals that exist to guarantee these services”, he added, stressing that the “essential” is to guarantee “quality and safety” and in other areas of the country similar models already work successfully.
Next week, the Executive Board will meet with the 12 hospitals to discuss the reorganization of pediatric emergencies. In a response to PÚBLICO, sent on Monday, the organization led by Fernando Araújo said that “different reorganization scenarios” of the network are being discussed and said that before the meeting a decision will not be taken on “the model that best defends the users”. In addition to representatives of the 12 pediatric services, the meeting will be attended by the Lisbon and Tagus Valley Regional Health Administration, INEM, the SNS24 line, the operational technical unit and the executive committee appointed to study the reorganization of the pediatric emergency network
There is a lack of child psychiatrists in the SNS
The Minister of Health was also asked about the situation of children’s mental health. PÚBLICO reported this Tuesday that the SNS has a shortage of child psychiatrists, with a very pronounced deficit of specialists in the Algarve – with only one part-time doctor in the public service – and in Alentejo, which has only two doctors.
Manuel Pizarro assumed that there is an embarrassment. “We have less child psychiatry doctors in the SNS in relation to needs. We estimate that we would need around 200 and we have 132. We are training more doctors”, he said, referring that at the same time it is necessary to ensure the attractiveness of these doctors.
Noting that mental health issues are not only dealt with by specialists in child and adolescent psychiatry – “these are needed for the most serious and complex cases” -, the minister noted that “there are many other cases that can be treated by doctors family and by psychologists, which we have to increase in health centres”.
“We are increasing the recruitment of psychologists, which is still not enough, but in the last three years 90 psychologists have entered the health centers and in the last six years a thousand psychologists have been admitted in schools”, he said, also referring to the investment through the Recovery and Resilience Plan, which has made it possible to increase community mental health teams. “Ten new teams were created in 2022 and ten additional teams will be created in 2023”, he said, assuring that the ministry is aware of the problem and “the need to respond to it”.
As part of his visit to Amadora-Sintra Hospital, the minister highlighted the efforts of professionals in that unit, who admitted working in difficult conditions. “The emergency observation room at this hospital has the capacity for about 40 patients and currently has 108 patients hospitalized. New physical spaces were arranged with a lot of imagination, but still the working conditions are very difficult ”, he acknowledged. “We are going to speed up the discharge of people who no longer have a clinical indication to remain in the hospital, this will help alleviate it, and we imagine other solutions, namely resorting to other hospitals that can provide support”, he pointed out as an immediate response to relieve the pressure.