The lack of doctors in primary health care in municipalities outside the large urban centers is a reality that has forced camarison measures to encourage those health professionals, some successfully.
Salary complements, financial support for renting houses and moving or housing are some of the measures directed to family doctors, to provide services in health centers and extensions, the Center agency told the center of the Center, Alentejo and Algarve.
In Alcoutim, one of the municipalities in the Algarve most affected by population aging and desertification, although the municipality was announced last August to the fixation of clinicians in its territory, only kept keeping in service the only doctor who was already performing duties .
“With two doctors, the county would be well served,” said Paulo Paulino, noting that the difficulty in attracting doctors to this municipality of northeastern Faro district is not new, but worsened after the creation of health facilities Family members (USF) Type B -where professionals are paid based on their performance -since Alcoutim does not have enough users to have such a USF, contrary to what happens in neighboring municipalities.
In the far west of the Algarve, the Monchique Chamber approved, by 2023, a regulation that provides for doctors to have a support in the lease or acquisition of housing at the maximum monthly amount of 80% of the minimum wage, which also applies to those living in its own residence.
In the county benefits from the incentive program two full -time doctors and, over the weekend, the service is done by a doctor sent by the Local Health Unit (ULS), said Mayor Paulo Alves.
However, there are still users without a family doctor and the mayor estimated that it would be necessary “at least another doctor”, but this claim bumps into the racings by inhabitant determined by ULS.
About 600 kilometers (km) separate Monchique from São João da Pesqueira, in the end of the district of Viseu. There, the Municipal Regulation of Acting incentives for the fixation and maintenance of doctors came into force in 2024 and was the only way to avoid the closure of the Health Center, said Mayor Manuel Cordeiro.
The situation, for now, is resolved, as USF Heart foresees five doctors and the municipality has managed to attract four doctors (two of whom have settled with family and children), who join three doctors, although the center of Health is “far from meeting appropriate quality requirements, revealing unacceptable weaknesses,” he said.
“This is not even a won bet. It is the implementation of the only feasible solution to preserve the service in the county and return some tranquility to the population, ”said Manuel Cordeiro.
In Figueiró dos Vinhos, in the interior of Leiria district, there are support for the lease or construction of their own home, others to move from resident doctors (between 150 and 500 euros monthly), as well as free access to sports equipment or the cultural initiatives promoted by the Municipality.
The president of the municipality, Jorge Abreu, argued that, although the picture of doctors is filled, the creation of incentives was justified why all clinicians reside outside the municipality and the regulation, rather than attracting new doctors, aimed, above all, Being able to keep the current clinical picture by loyal to the county.
In Fundão, where a year ago half of the population of that municipality in the northern district of Castelo Branco had no family doctor, municipal incentives to attract professionals did not have the expected results.
The councilwoman with the Health Pelro, Alcina Cerdeira, said that the situation was eventually attenuated with the possibility of retired doctors to return to service, a solution that the mayor considered “a palliative”, as it is uncertain to the more time these professionals are available to give this response to the population.
In Abrantes, in the Tagus Middle region, the lack of clinicians is also felt, but the panorama is less serious: the municipality costs about 12,000 euros, 12 doctors responsible for managing two USF, which ensure health care Regular primaries to about half of the 30,000 council users.
With a third USF in Constitution, to be possible to cover the entire territory, the municipal investment, according to Councilwoman Raquel Olis, is not only financial, but also in the “construction of high quality health equipment”, considered a factor of attractiveness for health professionals.
In Mação, to the limit between the district of Santarém and Alto Alentejo, the data made available to Lusa point to 75% of the population – very aged and dispersed by a territory with more than 120 villages – without a family doctor.
The municipality of just over seven thousand inhabitants ‘waves’ with a salary bonus of 2,500 euros per month to those who want to provide health care, measured after, in 2023, two of the three doctors then existing to reach when they hit the age of reform.
Currently, the municipal regulation supports two doctors of the local health center, one of which, as it has also reached the age limit to have a bond to the National Health Service, is at the service under the “Bata Black” government program, which Provide assistance to those who do not have a family doctor, said mayor Margarida Lopes.
Next door, already in the district of Portalegre, in Gavião, was the inland to the interior that led to the departure of the only doctor in full -time service at the local health center, said the mayor, José Pio.
Despite the municipal support in housing and payment of expenses, doctors who have passed by Gavião do not fix themselves, preferring places where they can do more services, namely in clinics or hospitals.
“Right now, we have zero [médicos a tempo inteiro]we have a doctor to do 20 hours and who is retired and two hired doctors, with services to the Health Center. The extensions are more discovered, ”he lamented.
Further south, in Reguengos de Monsaraz, the panorama is now more laughing, due to the camarrary incentives, having, in four years, the number of doctors increased from two to seven, one of them in half a time.
The president of this autarchy of the Évora district, Marta Prates, specified that the municipality pays a salary complement of 1,000 euros per month and attributed ‘houses of function’ to the families of three doctors who exercise full time, while the remaining three receive more 250 euros for support in travel or lease expenses.
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