The Minister of Health today challenged the Lisbon City Council to sign the health decentralization agreement, considering that the municipality is already participating, but without funding, a speech that did not convince the mayor.
“We really have to move forward with what’s left of the decentralization process in Lisbon, because right now decentralization in Lisbon is already underway and it’s only underway in the worst possible way. At the moment, it’s costing Lisbon City Council and what I want is for it to continue, to deepen, dividing expenditure more fairly between the central state and Lisbon City Council,” said the Minister of Health, Manuel Pizarro, at the inauguration of the Beato Health Unit in Lisbon.
Pointing out that there has been a “very frank” dialogue between the Ministry of Health and the Lisbon City Council, Manuel Pizarro (PS) expressed his “absolute certainty” that, as has happened in other municipalities in mainland Portugal, it will also be possible to sign the health decentralization agreement with the Lisbon municipality.
When questioned by journalists, the mayor of Lisbon, Carlos Moedas (PSD), defended “a decentralization that goes further, in which the city council is not just a task-master, a government task-master”, stressing that he agrees with the process of transferring powers from the central administration to the municipalities, but with the necessary resources.
“I can’t sign a decentralization without having the financial resources to be able to carry it out, because otherwise it’s always the Lisbon taxpayer who pays, and this is a function of the central state, it has to be the central state that pays and then the city council does it better, because we’re closer, we have greater capacity for execution,” said the Social Democrat.
The Lisbon City Council has accepted decentralization in the area of education, but has had “a very bad experience”, said Carlos Moedas, explaining that the municipal budget for this year includes 44 million euros that the state transfers to education, but the municipality will spend 60 million euros, meaning that there is a ‘deficit’ of more than 20 million euros.
“In health, I first want to see what resources the state is going to transfer, because I can’t live with another ‘deficit’ also in health, which is not transferred by the central state, and in education what happens is that every year I have a 20 million euro ‘deficit’,” complained the mayor of Lisbon, also demanding “greater control” by the municipality in the strategies of the areas to be decentralized by the central administration.
The mayor highlighted the work being done to build a local welfare state, with various measures in the area of health, namely the Lisboa 65+ health plan, which has 12,000 users aged 65 or over signed up, the provision of free mammograms for all women living in the city and the implementation of a pilot project for medical and nursing care for the most vulnerable populations in social housing estates, which will begin in Marvila, complementing the response from health centers.
In addition to these measures, the Lisbon City Council is investing in the construction of health centers, with a total investment of 48 million euros, said Carlos Moedas, noting that this includes the Beato Health Unit, a facility budgeted at 2.6 million euros, to cater for around 15,000 users, which has been in operation since August 14, 2023, although the inauguration took place today.
The Minister of Health praised the municipality’s efforts to build health centers, noting that the Beato facility is an example of the process of generalizing Family Health Units (USF) type B, in which the work of professionals is contracted with the state and remuneration is linked to performance.
“We are absolutely convinced that the generalization of family health units will, on the one hand, increase the capacity of more people to have a family doctor, our estimate is that these 222 new USF model B will increase the care capacity by around 250,000 users, but at the same time they will also attract more professionals and will be able to increase the retention of professionals,” declared Manuel Pizarro.
