Decentralisation of health without means can “enhance inequalities”

A president of the Regional Section of the Center of the Pharmaceutical Order today warned that the decentralisation of competences in the area of health without the appropriate means does not offer solutions to citizens and can create new inequalities between territories.

“First, decentralizing skills without the means to exercise them does not bring the solutions of citizens closer: it brings the problems closer to those who cannot solve them. Second, decentralizing cannot create new inequalities between territories with financial, technical and organizational capabilities that are very different from each other,” Lúcia Santos said.

During the opening session of the First National Forum on Local Health, which takes place throughout the day in the city of Coimbra, Lúcia Santos stressed the need for “national policies that guarantee common rights and local responses that recognize different needs”.

“ Therefore, the National Health Plan needs municipalities and municipalities need their own health planning tools,” he added.

According to the president of the Regional Section of the Centro da Ordem dos Farmacêuticos, Coimbra took this first step with its Municipal Health Strategy 2021-2025, “built from the health determinants of this territory”.

“This cycle is over. Therefore, it is now important to know the results and define the following priorities”, he said.

For this person, the municipal health report cannot be just a document that identifies problems and lists operations.

“ It must be an instrument of decision, of mobilisation of resources and of accountability for the results. And this is not done without health professionals, institutions, social organizations and citizens themselves”, he said.

During her intervention, the pharmacist also showed the proximity that these professionals maintain daily with the populations, particularly in the monitoring of chronic diseases, in the identification of problems related to medication and in the recognition of warning signs.

This proximity allows them to know the difficulties of those who live alone and those who cannot perform therapy because they have to choose between buying a medicine and going to the supermarket.

“ Those who work in this proximity know that health is built in the street, in the parish, in the house where you live, in the school where you learn, in the place where you work”.

Lucia Santos said that “poverty favors disease and disease deepens poverty” and defended policies capable of acting on the social factors that condition health.

The participants also reported that the Coimbra Municipal Health Strategy identified parishes without pharmacy and without primary health care units.

“ This is in a county that supports some of the most important hospitals in the country. If these asymmetries exist in Coimbra, what will they mean in low density territories, where distance, aging and isolation accumulate?”.

In the same session, the representative of the Municipality of Coimbra, Alberto Barreira, highlighted the importance of the articulation between the Local Health Unit, pharmacies, private institutions of social solidarity, university, schools and other entities in the promotion of health and well-being.

It also acknowledged the challenges posed by decentralization to municipalities, including the need for maintenance, modernisation and improvement of the conditions of the equipment transferred, to ensure the functioning of the services and the work of health professionals.

The 1st National Forum on Local Health, which takes place throughout the day in the city of Coimbra, is organized jointly between the Regional Section of the Center of the Order of Pharmaceuticals and the Portuguese Association of Young Pharmaceuticals (APJF).

Under the theme “The Local Power in Health Construction”, this initiative brings together political leaders, mayors, health professionals and representatives from various institutions.