The ‘Current Moment of Primary Health Care Reform in Portugal 2024/2025’, developed by the National Association of Family Health Units (USF-AN) and released today, reveals that only one in three units reported having adequate clinical equipment, highlighting a “failure in the supply system of primary health care.”
Among the 90% of USFs reporting shortages in basic supplies—such as vaccines, screening kits, dressing materials, and printer supplies—30% encountered these issues more than ten times this year, with 77% experiencing replenishment delays exceeding two days.
The study’s authors advocate for “a new mission” for Primary Health Care (CSP), stating that problems persist year after year, ranging from “clinical integration” (referring patients to hospital specialties) to digital (lack of interoperability), including service contracts (incentives) and workload (patient list size).
“After 20 years since the mission for primary health care that led to the creation of USFs, and with significant success, we believe it’s time for a new mission,” remarked USF-AN President André Biscaia, proposing the establishment of a mission unit involving CSP elements, unlike previous groups.
“The aim is to establish a new management structure, which can remain under the current administration [of the Local Health Unit], focusing solely on primary health care.”
The “absence of this focused management” on CSP is evident in issues like supply shortages, IT problems, and system integration failures that complicate hospital referrals (sending patients to specialties), he added.
This year’s study is based on responses from coordinators of 538 USFs, representing 77.6% of the Family Health Units existing at the start of the study.
Regarding facilities, 44% deemed them inadequate, with similar issues in air conditioning systems (49%) and cleanliness (27%).
The reform of Local Health Units did not fully address the needs of USFs, particularly concerning logistical support for health centers’ operations.
The study reports that 99.6% of USFs experienced “IT availability issues”: 8% one to two times; 37% three to ten times; 39% 11 to 50 times; and 15% more than 50 times.
Findings also indicate that only 7.3% of USFs prefer a system prioritizing remote consultations, despite over half of the teams (58.2%) lacking necessary materials for video consultations.
“I had to buy my own camera and microphone,” stated André Biscaia to Lusa.
USFs suggest creating a National Maintenance and Equipment Plan with targets and deadlines set by ULS, with annual public reporting.
As for innovation, only 7.6% of USFs can conduct rapid tests, which would enhance problem-solving capability at this care level, reducing emergency visits.
Just a quarter of coordinators acknowledge health improvements in populations with the creation of ULS, and less than 40% recognize “real progress” in service coordination or quality of care.
More than half (55.3%) of USFs say the ULS respects their autonomy. However, authors express concern that nearly half of the teams feel their autonomy is limited, calling for more financial and management autonomy in primary health care.
