“I never had access to what doctors earned in additional bonuses. I only became aware of it when it appeared in the news. And I didn’t need to, because I was just a mid-level clinical manager,” said Paulo Filipe at the Health Committee in Parliament.
The clinician is being heard at the request of the IL and Chega regarding the additional production of surgeries, a regime that provides incentives to pay healthcare professionals to reduce waiting lists, in the dermatology department of ULS Santa Maria.
The focus is on the alleged exploitation of the Integrated Surgery Enrollment Management System (SIGIC), which reportedly allowed a doctor to earn hundreds of thousands of euros by operating on patients on Saturdays.
Paulo Filipe explained that he didn’t have access to the surgery coding.
“I don’t have anything to do with the coding. You need a course to do the coding, and it’s also a responsibility of the Medical Association. Each surgery generates a code. Furthermore, the diagnosis of patients involves more than being benign or malignant. There are also other criteria that lead to other diagnoses, such as comorbidities, other diseases the patients have, the degree of comorbidities,” he observed.
The former director of the dermatology department emphasized that he learned from the press that “audits on coding found a compliance rate of 99.5%”, representing “a correct coding of patients.”
“This compliance, which was found internally, is now going to be reviewed again by IGAS [General Inspection of Health Activities]. There is an ongoing process of IGAS investigations. I am also interested in knowing if there was any fraud or a significant deviation in the production or profitability of the service in clinical terms,” he noted.
IGAS has initiated a disciplinary inquiry process with no known conclusions yet.
Additionally, the general inspection has opened an audit process on the surgical activity performed as additional production in the National Health Service, covering the 39 ULS and the three oncology institutes, which has already collected and processed the data sent by all hospitals.
Paulo Filipe recalled that in 2020, he proposed to the board of directors of ULS Santa Maria to carry out additional surgeries due to “huge waiting lists,” in a “proportion of three regular or conventional to one additional.”
“During the pandemic, only young people with benign lesions came to the hospital. Additional surgery at that time was mainly for benign lesions. But there was an evolution, and a proportion of malignant and benign was established. (…) We have given preference to malignant ones in recent months because there has been a clear ‘boom’ and explosion after the pandemic of malignant skin lesions,” he said.
The doctor stated that “additional surgery became the norm” both at ULS Santa Maria and “other hospitals nationally.”
Regarding the reasons for his resignation, the former director explained that it was related to his appointment, by public competition, as a professor at the Faculty of Medicine of Lisbon.
“Having obtained the position through public competition and considering the significant responsibilities involved, my resignation was anticipated because I could only remain in the National Health Service for 10 and a half hours. And that’s not enough to run a department,” he indicated.
