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Ensaios da Fundação #33
Pela Sua Saúde
Que sistema de saúde queremos ter? Qual o lugar do Serviço Nacional de Saúde (SNS)? O que significa ter um SNS? Que princípios podemos usar para o organizar e melhorar?
Partindo de uma leitura da situação actual, e dos elementos que caracterizam o sector da saúde, discutem-se alguns mitos correntes. A intenção é levar ao conhecimento do leitor o que são as principais dificuldades e as possibilidades de evolução do SNS. A organização do sector depende de quem nele trabalha, mas também do comportamento dos cidadãos enquanto doentes e como contribuintes que o financiam. Não se apresentam soluções perfeitas, mas um convite à participação cívica. Cidadãos informados contribuirão melhor para a construção do sistema de saúde português. Pela sua Saúde.
Partindo de uma leitura da situação actual, e dos elementos que caracterizam o sector da saúde, discutem-se alguns mitos correntes. A intenção é levar ao conhecimento do leitor o que são as principais dificuldades e as possibilidades de evolução do SNS. A organização do sector depende de quem nele trabalha, mas também do comportamento dos cidadãos enquanto doentes e como contribuintes que o financiam. Não se apresentam soluções perfeitas, mas um convite à participação cívica. Cidadãos informados contribuirão melhor para a construção do sistema de saúde português. Pela sua Saúde.
- GenresPoliticsNonfiction
95 pages, Paperback
First published January 1, 2013
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Displaying 1 - 2 of 2 reviews
September 7, 2020
The History of Public Health in Portugal is long, but we can base it with the creation of the Directorate-General for Health in 1899.
It is not, therefore, a Public Health of only 40 years! However, it is still true that these 40 years of the National Health Service (SNS) reinforced the performance of Public Health in some of the recent decades. The achievements in the health level of the Portuguese population were mostly the result of public health interventions such as housing, access to drinking water, sanitation and better education, vaccination, the provision of screening in different areas or control transmission of diseases such as HIV / AIDS, hepatitis and tuberculosis.
But, let us think about Public Health in the coming years framed with the challenge of meeting the Sustainable Development Goals that translates into thinking and acting in health in all policies. In fact, in much of what achieved of health and well-being in Portugal over 40 years, without this same designation.
The object of Public Health is by nature the space of the population and its territory, so we can think that it can restrict to subpopulations such as the school, the hospital, the workplace or the neighbourhood. It turns out that Public Health today has a much more global perspective. Moreover, it is not surprising that in a not too distant horizon it is called Global Health, so what sought is to manage the available resources to improve the state of health and well-being -being of the populations, with a view to better levels of equity. The aim is managing efficiently and with a better impact, the resources available in a given territory and a population residing or passing by. Working in Public Health usually means creating coordination and planning mechanisms for the use of available resources by public and private entities, including those of a social nature.
In the discussion on the possible creation of a Public Health Law, new challenges were identified for the times to come:
1. Climate change with effects on citizens' health;
2. Uncontrolled epidemics of chronic diseases;
3. Increased resistance of pathogenic microbiological agents to antimicrobials;
4. Progression of marked inequalities, inequities and imbalances between communities.
To these four challenges, we can add, certainly some more, such as the potential impact of widespread use of unconventional treatments or disbelief in the protection of vaccines.
In this context, I would quote, "it recognized that health could not be the exclusive responsibility of the state of health services, but of the whole of society, in a concerted effort by the central power, municipalities, companies, the social sector, non-governmental organizations and citizens". The reorganization of Public Health Services, at the local level, is considered urgent, since it will allow, by modernizing its infrastructures, to contribute in a very significant way to face the new challenges.
Unfortunately, the new Basic Law on Health was limiting in what was described in Base 8 on Public Health, referring only to the observatory action, the identification of areas of activity and the promotion of literacy. A feeble description! Where is the reference to the three major areas of Public Health: Protection, Promotion, Prevention?
Much written about this Law and the press, like the Newspaper Médico, has made its contribution as it has done in the themes related to Public Health systematically and prudently.
At a time when the temptations of multiple promises on the part of different actors in civil society and politicians are practically impossible, and we run the risk of seeing health always in monothematic mode - disease x, determinant y, service z and patient w. A problem here, a disease there (often associated with new therapies that envisioned) are distracting us from the grave and responsible discussion we need. We can put the sustainability of the NHS at risk and increase the gap between the health levels of the most fortunate compared to the less fortunate. Elites are always shaping society.
We can and must promote a health system integrated into the different sectoral policies (all), viewed from a perspective of responding to health needs valued in terms of equity.
We can and must find a Virtuous Balance by looking at the bottom and not the top of the sides, to see what needs we have in terms of healthcare provision and what their value is.
We can and must invest in reducing inequalities, improving the health of the population in general, intensifying the improvement of the health of those who are in a less favourable situation compared to those who have better health levels.
Public Health services in our country have had a history of innovation since 1899. They could be an effective and sustainable response by developing a Virtuous Balance in improving health in our country. Public Health services can be the balance between the provision health care - hospital, primary, continuous and palliative health care - and the implementation of health policies at different levels, in particular with municipalities, social and educational agents, public and private.
As in other areas of knowledge in the country, Public Health today has the potential of professionals from a generation of gold in terms of training in multiple sizes: nursing, epidemiology, environmental and health, epidemiology, information systems, communication, social work, sociology, psychology and medicine.
Therefore, let Public Health Be part of the systemic solution and not fix individual health problems. The opportunity is now visible. May Public Health contribute to a passionate and simultaneously rational definition of priorities. The Virtuous Balance for our National Health Service for 2030. May the faithful of the scales fulfil their mission.
Source: https://www.jornalmedico.pt/opiniao/3...
It is not, therefore, a Public Health of only 40 years! However, it is still true that these 40 years of the National Health Service (SNS) reinforced the performance of Public Health in some of the recent decades. The achievements in the health level of the Portuguese population were mostly the result of public health interventions such as housing, access to drinking water, sanitation and better education, vaccination, the provision of screening in different areas or control transmission of diseases such as HIV / AIDS, hepatitis and tuberculosis.
But, let us think about Public Health in the coming years framed with the challenge of meeting the Sustainable Development Goals that translates into thinking and acting in health in all policies. In fact, in much of what achieved of health and well-being in Portugal over 40 years, without this same designation.
The object of Public Health is by nature the space of the population and its territory, so we can think that it can restrict to subpopulations such as the school, the hospital, the workplace or the neighbourhood. It turns out that Public Health today has a much more global perspective. Moreover, it is not surprising that in a not too distant horizon it is called Global Health, so what sought is to manage the available resources to improve the state of health and well-being -being of the populations, with a view to better levels of equity. The aim is managing efficiently and with a better impact, the resources available in a given territory and a population residing or passing by. Working in Public Health usually means creating coordination and planning mechanisms for the use of available resources by public and private entities, including those of a social nature.
In the discussion on the possible creation of a Public Health Law, new challenges were identified for the times to come:
1. Climate change with effects on citizens' health;
2. Uncontrolled epidemics of chronic diseases;
3. Increased resistance of pathogenic microbiological agents to antimicrobials;
4. Progression of marked inequalities, inequities and imbalances between communities.
To these four challenges, we can add, certainly some more, such as the potential impact of widespread use of unconventional treatments or disbelief in the protection of vaccines.
In this context, I would quote, "it recognized that health could not be the exclusive responsibility of the state of health services, but of the whole of society, in a concerted effort by the central power, municipalities, companies, the social sector, non-governmental organizations and citizens". The reorganization of Public Health Services, at the local level, is considered urgent, since it will allow, by modernizing its infrastructures, to contribute in a very significant way to face the new challenges.
Unfortunately, the new Basic Law on Health was limiting in what was described in Base 8 on Public Health, referring only to the observatory action, the identification of areas of activity and the promotion of literacy. A feeble description! Where is the reference to the three major areas of Public Health: Protection, Promotion, Prevention?
Much written about this Law and the press, like the Newspaper Médico, has made its contribution as it has done in the themes related to Public Health systematically and prudently.
At a time when the temptations of multiple promises on the part of different actors in civil society and politicians are practically impossible, and we run the risk of seeing health always in monothematic mode - disease x, determinant y, service z and patient w. A problem here, a disease there (often associated with new therapies that envisioned) are distracting us from the grave and responsible discussion we need. We can put the sustainability of the NHS at risk and increase the gap between the health levels of the most fortunate compared to the less fortunate. Elites are always shaping society.
We can and must promote a health system integrated into the different sectoral policies (all), viewed from a perspective of responding to health needs valued in terms of equity.
We can and must find a Virtuous Balance by looking at the bottom and not the top of the sides, to see what needs we have in terms of healthcare provision and what their value is.
We can and must invest in reducing inequalities, improving the health of the population in general, intensifying the improvement of the health of those who are in a less favourable situation compared to those who have better health levels.
Public Health services in our country have had a history of innovation since 1899. They could be an effective and sustainable response by developing a Virtuous Balance in improving health in our country. Public Health services can be the balance between the provision health care - hospital, primary, continuous and palliative health care - and the implementation of health policies at different levels, in particular with municipalities, social and educational agents, public and private.
As in other areas of knowledge in the country, Public Health today has the potential of professionals from a generation of gold in terms of training in multiple sizes: nursing, epidemiology, environmental and health, epidemiology, information systems, communication, social work, sociology, psychology and medicine.
Therefore, let Public Health Be part of the systemic solution and not fix individual health problems. The opportunity is now visible. May Public Health contribute to a passionate and simultaneously rational definition of priorities. The Virtuous Balance for our National Health Service for 2030. May the faithful of the scales fulfil their mission.
Source: https://www.jornalmedico.pt/opiniao/3...
December 11, 2013
A Fundação Francisco Manuel dos Santos tem publicado nesta colecção "Ensaios da Fundação" trabalhos interessantes sobre temas relevantes para pensar e repensar Portugal de uma forma informada. Fiquei logo com vontade de ler alguns, de várias áreas, com algum destaque para a saúde, a economia e o estado social. A Daniela ofereceu-me o Pela Sua Saúde, pelo que foi por este que comecei a explorar a colecção. O autor - Pedro Pita Barros - é um economista, professor catedrático e investigador nessa área e editor de revistas de Economia da Saúde, pelo que se propõe a olhar para o Serviço Nacional de Saúde analisando os seus problemas, as possíveis melhorias, os caminhos para a sua evolução tendo particularmente em conta a limitação de recursos do estado português.
A leitura deste pequeno ensaio foi bastante enriquecedora, mesmo tendo em conta que já parti com bastante informação sobre o tema. O autor aborda de forma lúcida e relativamente isenta as principais questões de relevo na discussão da dita "sustentabilidade" de um serviço de saúde financiado pelo estado. O livro começa por uma descrição geral do SNS, segue para a análise directa da sua sustentabilidade financeira, examina a organização e funcionamento do SNS e por fim a relação entre o cidadão e o SNS, terminando com algumas considerações gerais.
Como ensaio curto, este não é um livro em que os temas são explorados à exaustão, com bases científicas e ideológicas explicitadas e bem destrinçadas. Um exemplo disto é a sua abordagem das taxas moderadoras, que discute tendo em conta o seu aumento e aplicação diferencial mas nunca analisando as provas (ou ausência delas) da sua eficácia como factor redutor de desperdício em saúde ou dos seus efeitos de criação de desigualdade e potencial impedimento de acesso a cuidados que se querem universais. No entanto o autor consegue atingir o seu objectivo: fornecer ao leitor as bases e os pontos fulcrais para que possa pensar sobre o assunto, informar-se mais detalhadamente e participar activamente na sua discussão.
Assim sendo, recomendo a leitura de "Pela Sua Saúde" como ponto de partida para quem quer participar activamente na discussão eterna sobre o SNS, sabendo desde já que terão que progredir de seguida para outras leituras no sentido de criar e fundamentar opiniões. Pretendo ler mais livros desta colecção e agradeço recomendações a quem já tenha lido alguns.
Opinião originalmente publicada no meu blog.
A leitura deste pequeno ensaio foi bastante enriquecedora, mesmo tendo em conta que já parti com bastante informação sobre o tema. O autor aborda de forma lúcida e relativamente isenta as principais questões de relevo na discussão da dita "sustentabilidade" de um serviço de saúde financiado pelo estado. O livro começa por uma descrição geral do SNS, segue para a análise directa da sua sustentabilidade financeira, examina a organização e funcionamento do SNS e por fim a relação entre o cidadão e o SNS, terminando com algumas considerações gerais.
Como ensaio curto, este não é um livro em que os temas são explorados à exaustão, com bases científicas e ideológicas explicitadas e bem destrinçadas. Um exemplo disto é a sua abordagem das taxas moderadoras, que discute tendo em conta o seu aumento e aplicação diferencial mas nunca analisando as provas (ou ausência delas) da sua eficácia como factor redutor de desperdício em saúde ou dos seus efeitos de criação de desigualdade e potencial impedimento de acesso a cuidados que se querem universais. No entanto o autor consegue atingir o seu objectivo: fornecer ao leitor as bases e os pontos fulcrais para que possa pensar sobre o assunto, informar-se mais detalhadamente e participar activamente na sua discussão.
Assim sendo, recomendo a leitura de "Pela Sua Saúde" como ponto de partida para quem quer participar activamente na discussão eterna sobre o SNS, sabendo desde já que terão que progredir de seguida para outras leituras no sentido de criar e fundamentar opiniões. Pretendo ler mais livros desta colecção e agradeço recomendações a quem já tenha lido alguns.
Opinião originalmente publicada no meu blog.
Displaying 1 - 2 of 2 reviews