If all goes well and quickly, next year the population will have easier access to psychologists and nutritionists in the Local Health Units (ULS), which bring together health centers and public hospitals, and where it is currently necessary to wait months on end to get an appointment.
The National Health Service (SNS) has around 1110 psychologists and just over 500 nutritionists, which is manifestly insufficient to provide an adequate response in a country where one fifth of the population has mental health problems and two thirds have excess weight or is obese. Just see that, last year, there were less than 317,000 psychology consultations and 197,000 nutrition consultations on the SNS, according to the Transparency Portal, which recently started to make this data available. Everyone recognizes that it is necessary to recruit more psychologists and nutritionists, but the hiring of these professionals has been residual, bureaucratic and slow.
The first step to increase access to these professionals, facilitating their hiring, was taken this Thursday at the headquarters of the Executive Board of the National Health Service, with the presentation, by the presidents of the Order of Portuguese Psychologists and of the Order of Nutritionists, of guidelines for the creation of integrated services of psychology and nutrition in the Local Health Units.
In a discreet way, the SNS Executive Board has already started the process of multiplying these units that integrate and include in the same management model the health centers and hospitals of the same municipality. When the body led by Fernando Araújo started, at the end of last year, there were only eight ULS and the model had been stopped for more than a decade, but it was revived and is being rapidly expanded.
In an advanced stage of implementation, there are now 12 more ULS, in the North, Centre, Alentejo and Lisbon and Tagus Valley regions, and from April “a new wave” will start, announced the executive director of the SNS, Fernando Araújo.
The new ULS will be different from those that already exist – the first of the eight was created in Matosinhos in 1999 and the last one in 2012 – and will, it is expected, have these integrated psychology and nutrition services. Fernando Araújo has no doubts that this “care integration reform”, although not very visible, “is one of the most relevant for the SNS”. Also because the hiring of other professionals, not just doctors and nurses, will be a decisive step to advance in the always promised but little practiced commitment to disease prevention.
Having more psychologists and more nutritionists in the SNS will allow “saving money”, emphasizes the executive director, who gave the example of the potential savings with the reduction in the consumption of medicines that a preventive and timely intervention will imply, by preventing people from getting sick.
Also to convince hospital administrations of this financial added value, in terms of referencing program contracts for 2024, psychology and nutrition consultations will be valued, he revealed. It may seem like a detail, but it will make a difference, because so far this has only been planned for medical consultations, he explained, stressing that hospital administrators will realize that this will result in “the ability to generate income for the institutions”, which will help “to unlock “the hiring process. “Today is a symbolic day of the beginning of a path”, he concluded.
“This model of organization of an integrated service in a ULS facilitates the hiring of professionals” and will allow “to give an adequate response” to people, preventing them from being lost” in the institutions of the SNS, corroborates Fátima Fonseca, responsible in the Executive Directorate for the area of primary health care and the ongoing ULS multiplication process.
“This is the first step to facilitate access” because “it simplifies hiring”, believes the president of the Order of Portuguese Psychologists, Francisco Miranda Rodrigues, who recalls that people wait today on the SNS “many months for a first consultation, more many months for a second consultation”.
There are currently just over 1100 psychologists in the SNS, 300 of whom are in health centres, he lists. “There is a serious lack of professionals”, but it took “almost five years to hire 40” in the last public tender, regrets the president, who hopes to see “some results” from the measures now announced as early as next year.
As for nutritionists, there are “a little more than 500” in the SNS, around 400 in hospitals and 150 in health centres, estimates chairman Alexandra Bento. “It was necessary to double this value”, she stresses, admitting that the ULS model now presented “is more facilitating in terms of hiring, with organized services” and that they will have “a strong commitment to health promotion”.