São João da Madeira's Hospital Passes to the Local Misericórdia From Today Under a 10-Year Deal Worth 13.85 Million Euros a Year, and Stays in the SNS
From 1 November the Santa Casa da Misericórdia runs São João da Madeira's hospital for the SNS: referred consultations in 15 specialties, a basic emergency service and day surgery, for 13.85 million euros a year over 10 years. Doctors' union says the benefits are unproven.
The hospital in São João da Madeira, a city of the Aveiro district, is run from today, 1 November, by the local Santa Casa da Misericórdia, a Catholic charitable institution that built it in 1966. It stays inside the Serviço Nacional de Saúde (SNS, the national health service), and the State will pay the Misericórdia 13.85 million euros a year to run it, according to Lusa, reported by Notícias ao Minuto.
The hospital joined the SNS in 1975 and has been run since 2009 by what is now the Unidade Local de Saúde de Entre Douro e Vouga (ULS EDV, the public body that manages hospitals and health centres in the area). Its management and buildings now pass to the Misericórdia under a cooperation agreement signed on 28 July by the SNS Executive Directorate, the central health administration (ACSS) and the Misericórdia's head, in the presence of Prime Minister Luís Montenegro and Health Minister Ana Paula Martins, the SNS Executive Directorate said.
What the agreement covers
The government says the agreement runs for 10 years, has a monitoring committee and binds the Misericórdia to SNS rules. According to the text seen by Lusa, care at the hospital is limited to:
- outpatient consultations on referral;
- a basic emergency service (Serviço de Urgência Básica);
- day surgery;
- diagnostic tests and therapies.
Consultations are planned in 15 specialties, including cardiology, internal medicine, neurology, paediatrics and pulmonology; general surgery, gynaecology, ear, nose and throat, ophthalmology, orthopaedics and urology also have operating-theatre time. The Misericórdia must meet the SNS's guaranteed maximum waiting times and is responsible for all clinical staff and equipment.
The first-year payment, which includes 5 percent in incentives, covers a planned 50,000 consultations, 591 surgical admissions, 4,000 day operations and up to 37,000 emergency episodes, Lusa reported. The amount is to be reviewed every year.
The cost question
The SNS Executive Directorate says the deal cuts the SNS's overall costs by more than 25 percent compared with providing the same services in the public sector, and that patients will get local services that were not available before. Some ULS EDV staff told Lusa the State had been spending only "five to six million" a year on the hospital.
The Northern Doctors' Union (SMN) said on 30 October that the minister had not shown the benefits of the transfer, and asked who will staff the services and whether doctors keep their contracts, careers and pay, Lusa reported. Asked by Lusa, neither the Misericórdia nor the ULS EDV said how many staff moved across or who is now clinical director.
What it means for you
- The hospital is still an SNS hospital: you reach its consultations through a referral, as before.
- The basic emergency service remains part of the agreement.
- Day-hospital cancer treatment, a service that used to run in São João da Madeira, is getting a new unit under construction at the Hospital de São Sebastião in Santa Maria da Feira, the union notes; it is asking for details of that building contract.
The handover comes as the government plans more outside management of SNS hospitals: the health minister promised another wave of hospital partnerships on 31 October, and a building-only partnership is being studied for Barcelos and Esposende.
