According to a delegation of powers dispatch published this month in the Diário da República, the top bodies of establishments and services integrated into the National Health Service may, "in duly justified exceptional situations", apply a payment of value/hour higher than that foreseen, up to a limit of 40%.

The National Federation of Doctors (FNAM) warns, in a press release, that this increase "accentuates the imbalance that already exists between the salaries of NHS doctors and service providers", will discourage the establishment of doctors in the NHS and contribute to the departure of professionals from one regime to another, to the detriment of public health services and the capacity to respond to the population.

In statements to the Lusa agency, the general secretary of the Independent Union of Doctors (SIM), Nuno Rodrigues, also criticized this measure, considering that it will create discomfort among professionals.

"In fact, this possibility already existed. What is being dealt with in this case is an acceleration for the Local Health Units (ULS) to be able to obtain this authorization more quickly. The problem continues to be a question of equality", he stressed.

For Nuno Rodrigues, it is unacceptable that two doctors are working "side by side", one with an employment contract with the NHS and the other a service provider, and that one receives more than 70 euros per hour and the other, for example, an assistant doctor at the beginning of his career, receives 18.93 euros per hour.

If the specialists who have been waiting for a month and a half for a competition to open to remain in the National Health Service see the hourly value that is currently offered in the medical career and the hourly value for service providers "they start to think that, perhaps, it is really not worth staying in the NHS, he explained.

For the union leader, it is necessary that the Government, at the next negotiation meeting, give "a strong signal that it wants to make a structural change", not only in salaries, but also in the speed of competitions, the hardship and the number of emergency hours that doctors have to do every week.

The FNAM adds in the statement that, although the plan for emergencies in the summer is not yet public, "even less so for the winter", the Government's decision "involves continuing with a policy of patching up".

Therefore, instead of presenting "strategic and future solutions to establish doctors in the NHS", the executive only contributes "to accentuating the structural problems of the NHS", considers the FNAM.

For the federation, the increase in the hourly value paid to service providers leads to the reinforcement of the outsourcing of services that the NHS should be able to ensure, "since an increase of this proportion is an explicit invitation for doctors, poorly paid and without working conditions, to exchange their place in the NHS for the provision of services".

It also emphasizes that this policy has "proven results in the medical field", such as "broken and unstructured teams", "imbalance between professionals who, for the same work, receive very different values" and "lack of capacity and predictability in the construction of scales, which, despite the increase in costs, will keep the NHS with a shortage of doctors".

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