"This idea of integrating care, of having our health professionals discussing the paths of our patients without barriers and jointly, which are the best responses (...) is a kind idea", considered Xavier Barreto.

In practice, the ULS integrate in the same entity the care provided by the health centres and by the hospitals, concentrating the management of human, financial and material resources.

"Primary care, hospital care, municipalities, associations, the social sector and the private sector" join at the same table, specified the president of the Portuguese Association of Hospital Administrators (APAH), adding that the ULS are doing their work throughout the country, although there are always problems, "some more serious than others".

According to Xavier Barreto, what "went wrong" in the reform of the sector, which included the creation of the ULS, "was the transfer of the competences of the Regional Health Administrations (ARS) to the rest of the National Health Service (SNS)".

"Several of the competences of the ARS that were set out in laws were not conveniently transferred to other entities and this created problems", he added.

He gave as examples the cases of people from the ARS who were not transferred to the hospitals or to the ULS, the Central Administration of the Health System (ACSS) or other organisations and of doctors who complain that the incentives of the Family Health Units (USF) were not well calculated or were not paid.

"I would say that this was the most difficult part (...) of this reform, but the Government is in time to cut this issue short, to clarify this lack of definition left by the previous government and to distribute the competences of the ARS very quickly" and the people who worked there, indicated Xavier Barreto.

In the last week, some criticisms have been made of the existence of the ULS, with the president of the Order of Doctors (OM) having warned on Wednesday that their recent creation resulted in a step backwards in the connection between primary and hospital care in some areas of the country.

"We have several examples in which the integration worked very well between the ACES (group of health centres) and the hospital, but, from the moment in which the ULS were created, in some places in the country, this connection that was good became worse", stated Carlos Cortes.

The president also highlighted that the generalisation of the ULS throughout the country "has worried the OM a lot", regretting that the order had been "excluded from the process" of its creation.

On Monday, close to three dozen professionals from the Porto Ocidental health centres, integrated in the Santo António Local Health Unit (ULS), complained to the Minister of Health, Ana Paula Martins, that the ULS model "does not serve the users, the professionals and the management".

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