WONCA president and editor visit clinic near Lisbon

Photo: WONCA President Michael Kidd with staff from the clinic

While in Lisbon to attend the recent WONCA Europe conference, the WONCA President, Michael Kidd and WONCA editor, Karen Flegg, were invited by local GP, Dr Carlos Canhota, to visit his unit which is part of a health centre and meet some of the staff.

Our visit was to the ACES Lisboa Ocidental e Oeiras which serves a population of 233,465 - ACES stands for Agrupamento de Centros de Saúde and refers to a group of health centres, and the actual Centre we visited was in Oeiras a suburban area just to the west of Lisbon.

Michael Kidd noted in his Wonca News July 2014 column “Portugal has an impressive network of primary care clinics with teams of health care workers led by specialist family doctors. Outreach community nursing teams work alongside family doctors to provide services to marginalized communities that would otherwise have no access to health care at all”.

Specifically we visited a unit run by Dr Helena Febra called Unidade de Saúde Familiar (USF) de S. Julião. At the unit we saw a group of family doctors working together in a clinical setting, each with their own spacious consulting room computer-generated records.

Photo (right): Dr Helena Febra in animated discussion with Dr Carlos Canhota.

However it was not just 8-10 family doctors working in the team including registrars - there are also 8-10 nurses and six administrative assistants. All doctors except the one academic doctor are full time but hours vary for each doctor.

Housed in the same building as the family medicine clinics was a very impressive outreach nursing unit (called Unidade de Cuidados na Comunidade – UCC). Nurse, Luísa Horta e Costa described to us a wonderful system where the nurses undertake outreach visits to the poorest and most marginalised people. They deliberately target people who avoid health care and try to encourage them to attend clinics. Such an initiative has been successful at increasing the percentage of the population accessing healthcare.

This is despite free treatment being offered by the health person to a significant number of groups in the population: including children; unemployed and families with very low income (as defined by the Ministry of Finance); people with 60% of incapacity or above (from medical problems); blood and organ donors; firemen; transplant patients; follow up consultation for diabetes patients; patients on haemodialysis; pregnant women. As well as free care for these groups of people, family planning services, smoking cessation services and immunisation are also provided free.

Our gratitude to Carlos Canhota who invited us to visit, to the clinic staff who enthusiastically showed us around, and to overall manager of this ACES Dr Fatima Nogueira and Medical Director Dr Nordin Rafic who gave us some vital statistics over a delicious morning tea.

Photo: (from l to r) Karen Flegg and Michael Kidd with the manager of this ACES Dr Fátima Nogueira and the President of the Medical Council Dr Nordin Rafic.

Dr Karen Flegg
WONCA Editor and Executive member