The guardianship remained silent, not sending any comments until the time of publication of this work, about the flaws identified in the program approved by the previous Minister of Health, Manuel Pizarro, starting at the Local Health Unit (ULS) Póvoa do Varzim/Vila do Conde, but whose extension to 27 of the 39 ULS in the country has already been approved by Ana Paula Martins.
In the only response sent to DN, DE-SNS refuses to comment on the flaws and justifies itself with the following argument: “The biggest difficulties identified in the Health Regulatory Entity (ERS) report are related to the beginning of the Ligue Antes, Salve Vidas Project and that, since then, a lot has been done by SPMS, the SNS Executive Directorate and the Local Health Units (ULS) to overcome them, especially with the introduction of the Master Data System, a system of information that collects, stores, organizes and distributes reference information about the health system”.
More. In relation to cases of “the most serious situations, of lack of access, DE-SNS is not aware of them having happened again since that time” and that “DE-SNS is in permanent coordination with the ULS in order to identify additional problems and resolve them”.
Now, the cases of slow service, lack of access or incorrect information to users reported in the ERS report are from the end of 2024, November and December, and the beginning of 2025, January and February.
DE-SNS says it is not yet aware, but DN knows that the report of this latest ERS assessment reached the office of minister Ana Paula Martins, the executive director and the SPMS.
And, on one of the pages of the document, the ERS even reminds DE-SNS, as a body with competences in planning the management of the SNS, that it is responsible for “continuing to provide the targeted health units and the SPMS, in a programmed manner and integrating the various scenarios, with strategic guidelines on the plan and the procedures to be adopted when there are temporary constraints, scheduled and unscheduled, of responses in the expected areas, in order to guarantee permanent coverage and equity of all regions of the country, It is up to interlocutors with access to the SDM (Master Data System) to carry out their respective records in accordance with the local reality at all times”.
According to the report to which the DN had access, published in its edition this Friday, the 5th, the ERS is very clear in the recommendation it makes: “A user who goes to a service or establishment of the National Health Service (SNS), legally bound to ensure the protection of individual and collective health, cannot be denied access, without further ado, even if it is concluded that the type of care sought is not appropriate or that the establishment in question does not have the care profile or capacity to provide treatments”.
The document states that ERS received 389 complaints from users since the beginning of the Ligue Antes, Salve Vidas program until April 30, 2025, most of which were due to constraints in guidance for primary health care, denied care and constraints and guidance for hospital care.
SPMS assumes that it “received and accepted all ERS recommendations”
In its response to the DN, DE-SNS also includes the response from SPMS, the body that manages the SNS24 Line, which, in essence, materializes the program, and about which the ERS document highlights that it is “overloaded” with functions, without “investment” and “without resources”, recommends to the guardianship and DE to guarantee such situations in order to “operationalize” the program.
But, in its response to the regulator’s conclusions, the SPMS assumes that it “received and accepted all the recommendations of the ERS which, in the report in question, covering the years 2023, 2024 and until April 2025, warns of the need to respect the fundamental right to complain that assists all users of the health system. The SPMS has already improved the circuit and reinforced the department where user complaints are received and dealt with, in order to ensure that everyone has a timely response. In order to reinforce the SNS 24 Line, in order to respond to all user requests, SPMS took measures both in terms of human resources, organizationally and technologically.”
SPMS also admits that, in terms of human resources, “the pool of professionals will have an unprecedented reinforcement, to 3700 professionals, this winter”, with the total number of professionals at SNS24 expected to exceed more than three thousand. But not only. With the aim of “retaining professionals and increasing capacity and clinical preparation: incentives were created for professionals to remain (in training and remuneration), the recruitment process was streamlined and extended to faculties and the training period was extended”.
At the organizational level, he also states, “we continue to optimize the service circuits, by forwarding administrative tasks to non-clinical professionals. This optimization of the circuits allows health professionals to be freed up for triage and clinical counseling functions.”
At a technological level, SPMS explains that “a bot to identify signs of emergency before clinical triage. This month, an artificial intelligence solution will also be implemented to assess acute respiratory symptoms and propose referral, as well as a mechanism for call-back (callback) and digital screening via the SNS 24 App for acute respiratory problems.”
This last measure had already been proposed by ERS in the first evaluation carried out on the program.
As for numbers, the SPMS recalls that the SNS24 Line, with the resources it has, has already scheduled 970 thousand consultations in primary health care, around three thousand people who stopped going to a hospital emergency every day.