We already had the bureaucratic monster of the regional administrative system and its gigantic tentacles all over the place, a galaxy we have created in this half-century of Autonomy.
We’re creating another small monster of inoperable bureaucracy – the regional health system.
You only have to look at the chaotic situation in the sector at the national level to realize that we don’t want our region to imitate it. Still, the ineffectiveness of policies over the years shows the opposite every day.
There are hospitals and Island Health Units (not all of them) that are beginning to be seen by patients as highly bureaucratic structures, where machines stall at every administrative corner or in every corridor of illness.
The news in recent days that requests for consultations referred by General Practitioners “are triaged and returned when they don’t meet hospital referral criteria” and that only after they are returned is the doctor asked to re-evaluate the patient immediately leads us to ask: so what is the family doctor for, to complicate things?
It’s just like when family medicine sends a patient to a specialist. The specialist determines a specific treatment, and the patient has to return to their family medicine unit to receive a “passport” with a “visa” for the respective treatment. It’s a waste of time and bureaucracy. Does this make sense? I’ll give you an example later.
Another incomprehensible piece of bureaucratic red tape is the failure to get a Transcranial Magnetic Stimulation device up and running to treat patients with Machado-Joseph disease, something that will only work in a few months, according to the Regional Secretary.
Let the patients wait, as is standard in our regional health system, where waiting lists continue to grow daily.
Each patient has the impression that a sense of priority has been lost in the rigidity of superfluous formalities.
Another practical example we witnessed this week: a patient can’t get an appointment with his family doctor in a small health center in one of our small parishes in a large municipality (“only in two months”!), so he goes on his own to a specialist physiatrist, who prescribes physiotherapy.
He returns to his family doctor’s health unit to ask for a requisition for the treatment and is sent back, paper in hand, to the municipality’s health center, “where they’ll tell you where to go for physiotherapy.”
When they arrive at the health center, they are told that there has been a fault, and they have to go back to the origin to be “referred” by the family doctor and “put the type of treatment on the platform.”
And off the patient goes again, back to the administration, paper in hand, to hand in his treatment to the administrative services, “and then we’ll call you,” returning home empty-handed, not knowing whether he’ll die of the disease or the cure, especially if he’s an elderly patient and doesn’t have his own transport to get back and forth.
In this kind of via sacra, the patient, carrying the cross of pain, is already waiting almost a week for the health unit to pass the “sentence”!
In the age of digitalization and the PRR’s huge investments in the “digital transition,” our health is still treated as it was in the nineteenth century.
Poor people who are sick in this land. They say that bureaucracy kills.
That’s why, before we ask the Republic if they’re giving us early retirement because we’re dying earlier, we should ask why we’re dying earlier on these islands.
With a health system becoming increasingly cumbersome, stuck, bureaucratic, inoperable, inefficient, and full of waste, despite the millions invested, there is at least one certainty: (life) expectancy is the last to die (without irony).
But it’s still an ordeal.

Osvaldo Cabral is a veteran journalist in the Azores. He is te director and editor-in-chief of the Diário dos Açores newspaper.

NOVIDADES will feature occasional opinion pieces from various leading thinkers and writers from the Azores to give the diaspora and those interested in the current Azores a sense of the significant opinions on some of the archipelago’s issues.

Translated to English as a community outreach program from the Portuguese Beyond Borders Institute (PBBI) and the Modern and Classical Languages and Literatures Department (MCLL).