The Socialist government has promised more Family Health Units (USF), with the hope that it will bring doctors and patients closer together. In this model of primary care management, everyone will have a family doctor.
But the truth of the matter is that there are thousands of Portuguese citizens who don’t have an assigned family doctor, and adapting to this new model will push the country’s health service to its limits. What happens to patients who have no family doctor? They cannot be seen at Family Health Units, they have to go to a health centre, sometimes outside of their area of residence.
This is what is happening to individuals across the country. In one particular case in Lisbon a health centre was replaced by a Family Health Unit back in June, which left 2903 healthcare users without a health centre nearby. The consequence of this replacement left a neighbouring health centre with an overflowing waiting room.
"In principle, having more Family Health Units has improved primary care and there is proven evidence. We are on the right track, the concept is correct. Transiently, it may raise some problems, but it will be acceptable if some people are transient and for a short time. There must be conditions to minimize the problems, " argues Rui Nogueira, president of the Portuguese Association of General and Family Medicine.
The model, inspired by the English system, was introduced in Portugal back in 2006 by the then Minister of Health, António Correia de Campos, and is one of the pillars of the primary care reform, which has been a target of investment for years.
And officials seem set on fully adopting this model, despite the stress it is putting on leftover health centres. By the end of the year, another 20 Family Health Units will be in operation, the prime minister has said, at a debate on the presentation of the government's program for this legislature back in late October.
"I do not think it is possible to find solutions in the current framework, it can not only be with the creation of more units. More clinical management experts are needed, but we think we will be able to solve this problem by April” claims Mr. Nogueira.
Meanwhile, there are around 600,000 Portuguese people who have been left without a family doctor, despite the promise to give a family doctor to all citizens being repeated endlessly.
