«What if the Ministry of Health was led by a nurse?»

Specialist in Community Nursing. Invited Assistant Professor at the Institute of Health Sciences / School of Nursing at the Catholic University of Portugal

Posted on September 8, 2022

A challenging question, the title of this September’s “Nursing Diagnosis”. September is a month of usual renewal of challenges, of returning to work after the holidays, of returning to schools, in short, of planning a new cycle of developments in active life.

2022, particularly with regard to the Ministry of Health, represents a milestone of change with the departure of Minister Marta Temido.

The management of the Ministry of Health is, perhaps, one of the most complex in Portuguese politics. A Health System that articulates a National Health Service with scarce resources that aims to offer excellent care to Portuguese citizens and a network of private organizations, which in a commercial relationship, are an important resource in the promotion of positive competition and often a resource to respond to the shortage of the SNS.

Health professionals of the highest quality compared to the rest of the world, but who find difficulties and discouragement associated with a financial gear that has not allowed an investment in careers and, consequently, in the appreciation of professionals and their bond with the SNS, finding answers many times times more satisfactory in private organizations.

On the other hand, I would say that, since the creation of the SNS, we have experienced some disorientation in the meaning of the SNS, namely with regard to Primary Health Care. The beacon that guides the management of the SNS is illuminated by a philosophy more oriented towards the disease and endowed, therefore, with a medicocentrism that inevitably values ​​the disease, hospitals and indicators associated with the treatment of the disease, hospitalizations, surgeries.

However, since Alma Ata, with its declaration published a year before the birth of the SNS, where investment in Primary Health Care is foreseen (attention, I reaffirm that it is for “Primary Health” and not for “Primary Diseases”) and in promoting reaffirmed in the letter from Ottawa, published 7 years after the creation of the SNS and with a different guideline from the management that Health has had throughout these 43 years of the SNS.

The lobbies installed in a corporatist culture of health, more oriented towards the disease, the disinvestment in community-oriented care and in the enhancement of health literacy, people’s firmness and transdisciplinarity, using evidence (of enormous quality, even produced in Portugal ) to apply it in the clinical and health management context.

Evidence, which demonstrates, for a long time, the non-use of transdisciplinary skills, namely of nurses, as the Minister Marta Temido herself demonstrated in her research, and the non-investment in effective accessibility to health care, which would not overload the limit care of the diseases (in particular emergency services).

Pedro Melo

The statement attributed to Einstein that “Insanity is always doing the same thing and expecting different results” would be a good motto to innovate in the management of the Ministry of Health.

If the Minister of Health were a nurse or a nurse, I have the perfect conviction that he would know how to orient himself better than anyone else to the uncertainties of Health in Portugal, promoting an autonomous, mature and articulated SNS with a robust Health System, with positive competitiveness, which enhances Benchmarking and, above all, is oriented towards People and not diseases.

What if the Minister of Health was a Nurse or Nurse? It was so interesting to have a Prime Minister capable of guiding innovation.

I still believe that one day we will see the difference. Until then, Nurses and Nurses will continue to be local ministers promoting the defense of the Right to Health of every Portuguese citizen, even if silenced by all this pathogenic cover that has covered the history and stories of Health management in Portugal.


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