The proposed closure of the neonatology unit at Hospital de Dona Estefânia in Lisbon has sparked widespread concern. Even though Health Minister Ana Paula Martins assured that the closure “is not planned,” she acknowledged that there is a “project” to reorganize the service.
In response, a public petition titled “For the future of our babies — no to the closure of the neonatology unit at Hospital D. Estefânia” has been launched.
In just two days since its creation on November 18, nearly 9,000 people have signed the petition.
“The closure of the Neonatal Intensive Care Unit (NICU) at Hospital D. Estefânia (HDE) is more than just an administrative decision. It’s a decision that impacts lives, affects families, and puts at risk the most fragile babies of our country — those fighting to breathe, to survive, to have a future,” the petition states, emphasizing that for decades, Dona Estefânia has been “a safe haven for newborns with severe, complex, and unexpected illnesses.”
“Deeply worrisome”
“Half of all neonatal surgeries performed in Portugal take place there. And they are conducted safely because the NICU and the operating room are next door to each other, on the same floor, separated by mere meters. In life-decision seconds, this proximity saves children. The proposal to transfer these services to other units is deeply worrisome,” wrote the petition’s authors.
It should be noted that the Local Health Unit (ULS) of São José is considering reorganizing the neonatology unit and consolidating it into a single center, potentially closing the service at Hospital Dona Estefânia due to a shortage of specialist doctors.
The ULS might thus centralize the neonatology service at Maternidade Alfredo da Costa (MAC), which, according to the petition authors, “does not have an operating room for newborns, a CT scanner, or an MRI. Each baby at risk would need to be transported by ambulance, unstable, fighting for life, when every minute is precious. It is unacceptable to force newborns into such journeys because the hospital lacks necessary resources,” they critic.
Petition signatories emphasize that “the NICU at HDE is much more than an intensive care unit.” “It is a center where newborns with rare, metabolic, neurological, or gastroenterological diseases receive multidisciplinary care by teams working together alongside reference pediatric specialists. Whenever a baby at MAC requires such specialized care, they are sent to HDE. That says it all. Yet, the hospital will continue to have an operating pediatric emergency — but without neonatal support in case of resuscitation. How can a pediatric emergency function without the capacity to save a newborn in distress? It cannot,” they stress.
Pediatrician from D. Estefânia: “A disaster for national neonatology”
One of the petition’s signatories is pediatrician Pedro Garcia, who shared a lengthy post on Instagram discussing the lack of resources and the significance of Hospital Dona Estefânia’s neonatology unit.
“I don’t like and don’t want to bypass hierarchies and the institution I represent, but unfortunately, this news is having the impact we all anticipated! For a long time, we have been warning about the human resource shortages in HDE’s NICU, sacrificing greatly, along with our families, to cover schedule gaps. Unfortunately, we’ve reached the point of not being able to cover the schedule next month and foresee the same for the following months,” the doctor wrote on his Instagram page.
Pedro Garcia indicated that a “solution” was proposed, which “seems easy but is fictitious.”
According to this pediatrician, about 46% of newborns with surgical pathology in our country are operated on at Dona Estefânia, so closing the neonatology unit there could put many babies at risk.
“Santa Maria cannot accommodate all newborns with complex congenital pathology. The peri-operative care for surgical patients is very specific, highly specialized, and multidisciplinary. It is not possible to maintain the quality of such services at the other neonatology center of ULS São José, which is MAC.”
Additionally, should the discussed closure proceed, it would mean losing, according to the specialist, “a uniquely skilled team of doctors and nurses with over 40 years of experience.”
“A disaster for national Neonatology! For Neonatal Surgery! For Prenatal Diagnosis! For training new professionals. Moreover, Hospital Dona Estefânia, with an open emergency to the public, will be left without a single neonatologist to support the resuscitation of a newborn arriving at the emergency (as so often happens). This is all very sad! And the responsibility? Will it again be left in the void? We won’t let it happen!” concludes Pedro Garcia.
The Democratic Nurses Union of Portugal (Sindepor) has also warned that closing the neonatology service at Hospital Dona Estefânia puts newborns who need specialized care at risk and threatens the continuity of a highly experienced team.
