Low values lead doctors to refuse tests for the NHS

The National Association of Diagnostic Imaging Units holds the State responsible for the unequal access of National Health Service users to private examinations, arguing that the failure to update prices is the root of the problem.

“The problem is that they are constantly thinking they can pay for ultrasounds at three euros, five euros, eight euros, or whatever, without updating the agreements for 10, 12, 14 years and thinking that the fault lies with the contracted providers who discriminate,” Nuno Castro Marques, secretary general of the National Association of Diagnostic Imaging Units (ANAUDI), told Lusa.

Despite considering any discrimination against users, whether from the NHS, insurance companies or other subsystems, "unacceptable", the association highlights that the current difficulty in access results from the refusal of health professionals to work for NHS agreements, due to the low amounts paid.

"What happened is that the tables of agreed acts and their respective prices were not updated for decades. When I say decades, I truly mean decades," he emphasized.

ANAUDI argues that this lack of updating leads to a situation where, for example, a provider may have 20 radiologists, but only three or four agree to perform procedures for the SNS agreement. This leads to a disparity in response capacity and waiting times for SNS users, it acknowledges, but denies that the intention is to discriminate.

"Failing to comply with conventions means failing to address access to the NHS. When tables haven't been updated for 10, 12, 14, or 16 years, access to the NHS isn't being updated," he argued.

The association claims to have alerted the Ministry of Health, the Central Administration of the Health System (ACSS) and the Health Regulatory Entity (ERS) to the situation, but without success.

The leader also criticizes the “omission” of the State, which does not comply with Decree-Law 139/2013, which establishes the methodology for the annual review of prices, and which would allow the amounts paid to be updated, as was done with those of public contracts, due to inflation.

“We hold the State responsible, because the tables are unilaterally set by the Ministry of Health and the ACSS,” he stated.

The problem is already spreading across the country, according to the association, which gives the example of Castelo Branco, where there are no longer any clinics authorized to perform ultrasounds for the NHS.

"This is a widespread problem across the country. I don't think it's provider A, B, or C that's discriminating. Quite the contrary. Often, the providers themselves want to perform the services, but they can't find the healthcare professionals who refuse," he concluded.

This situation, warns ANAUDI, creates a vicious cycle: "users seek insurance and subsystems to be able to have exams, and doctors become accustomed to working only under this regime, making it even more difficult to return to the NHS."

The association further argues that the only way to reverse the situation is for the government to assume its responsibility and update its pricing tables. "It's impossible to hire healthcare professionals who work with rates that were in effect 10, 12, 14, or 16 years ago," it concluded.

Lusa reported today that six of the 14 districts where Unilabs offers breast and thyroid ultrasounds do not have available appointments through the National Health Service (SNS), which is not the case if the exams are carried out as an insured or private client.

Faced with this situation, Unilabs admits that "in some geographic areas and types of exams, there is already, in fact, some difficulty in access", highlighting, however, that the lack of updating of prices agreed upon more than 15 years ago hinders the availability of specialists to perform these exams.