I have already been invited twice this year to give a talk about emigration of doctors out of Portugal. I find this a sign of the difficult times we’re going through in Portugal. Doctors, like every citizen, have been subject to relentless austerity measures and to progressive impoverishment. But we’re not currently seeing doctors leaving the country in droves. Nurses, however, are a completely different story. Portugal is currently the second country (after Spain) to have the most nurses registered in the UK’s Nursing and Midwifery Council and the number of Portuguese nurses in the UK has grown over 40 fold in the last six years. more…

A few days ago I was having dinner with a group of close friends who are all doctors, and working in the Portuguese public healthcare sector. One of the topics of conversation was the need everyone felt to carry out additional work in the private sector just to earn a decent income at the end of the month. One of my friends confessed that she only carried out shifts at a private hospital for financial reasons, even though she didn’t enjoy the actual work. Considering that most doctors in Portugal already work at least 35 to 40 hours per week in the NHS, doing additional work in the private sector causes considerable strain to their personal and family life, as well as their health, not to mention whether they are complying with European Working Time regulations. In a way, doctors are no different to the rest of the Portuguese population as it is common to see many people juggling two, three, or even more jobs to make ends meet—and that is for those people still lucky enough to find work. more…

Some time ago a patient told me that he needed to borrow money from a neighbour to buy a train ticket to come to his appointment at the practice. At the same time, this patient told me about the scarcity of food at home, and how it was a constant struggle to feed his daughter. The shocking thing is that this is happening in Portugal. The daily life of an increasing number of people in Portugal is affected by poverty and hunger, two of the most dramatic consequences of the austerity that has been crippling Portuguese society for the past year and a half. A recent report by the Organization for Economic Co-operation and Development states that the spending cuts in the health sector in Portugal have been two times larger than those agreed by the “Troika”—the International Monetary Fund, the European Central Bank, and the European Union). The Portuguese Ministry of Health denies this. But, the report adds that Portugal’s spending in the health sector is expected to fall to 5.1% of GDP in 2013, down from over 10% in 2010, and much lower than the average of 7% of GDP for the Eurozone. more…

I’ve blogged before about the impact of austerity on healthcare, mainly on the hard hit Portuguese healthcare system. And just when I thought things have already gone too far, new developments over the last few days have cast even more dark clouds over the healthcare system, and have spread additional apprehension and outrage in the population.

The International Monetary Fund has released a report consisting of “technical advice provided by the staff of the IMF to the authorities of Portugal (the “TA recipient”) in response to their request for technical assistance.” The report proposes a number of measures aimed at cutting 4000 million euros of government spending starting in 2014. This includes making about 20% of public sector workers redundant and decreasing salaries by up to 7%. more…

The unemployment rate in Portugal is at an all time high of 16,3%, and 2013 is looking even bleaker, due to announced tax hikes that will see people’s net income squeezed even further.

As a locum doctor, my hourly rates have dropped by about 20% compared to one year ago, and sadly, I am expecting them to drop further in January. Considering tax and social security rates will go up significantly in 2013, I fear my disposable income will probably end up as about half of what it was compared to one year ago, and may end up at the level of a trainee doctor, or even lower. In Ireland, a country that has also been bailed out, locum rates are still currently about three to four times higher than those in Portugal, which makes me wonder how they do it. more…

The University of Antwerp, Belgium, recently hosted the 75th meeting of the European General Practice Research Network. Paul Van Royen, dean of the Faculty of Medicine and Health Sciences at the University of Antwerp spoke about the challenges for primary care research, namely innovation, transferability, interprofessionalism, social impact, and partnership. In terms of innovation, he stressed that primary care research needs increasingly to make use of the translational pipeline (including basic sciences), with a good example being the TRACE project. He added that it is also necessary to improve recruitment of patients to clinical trials, which would allow, for instance, to answer many questions about treatments for acute stroke in just 24 hours. more…

A recent BBC article about the globalisation of work and people, written by Lynda Gratton, professor of management practice, argues that there will be more professionals called “transnationals,” as the job and education market become increasingly globalised.

Gratton defines a transnational as a “worldwide group of people who are able to relocate at any time, making decisions based on relative global employment and investment opportunities,” “with hybrid associations among multiple cultures and societies,” and who are “able to speak more than one language and often carrying dual citizenship, will be able to adapt to the sort of cross-cultural communication that is so important for global organisations.” more…

Population control in the developing world is a major public health issue, as large families and overcrowding perpetuate cycles of poverty. The dire situation in the Philippines is considerably overlooked, even though it is extremely serious and the country has one of the highest birth rates outside Africa. The Philippines is the 12th most populated country in the world even though it is just 73rd  on the ranking of countries by surface area. The national capital region of Metropolitan Manila hosts around 12 million people in a surface area just over a third of the surface area of Greater London, whereas the population of Greater London is estimated to be 8.1 million. This year, the Philippine’s population is estimated to reach nearly 98 million, up from 86 million in 2006. more…

I am a keen social dancer and take several ballroom and salsa dancing classes a week. I’ve often wondered whether dancing has any physical health benefits. I get the feeling that dancing is considered more of a socialising tool and a form of artistic expression, rather than a serious type of physical activity.

A lot of research has been carried out to determine the health benefits of physical activity, but there isn’t really much published on the health benefits of specific types of social dancing, like salsa, which have become extremely popular around the world. more…

The standards of both undergraduate and postgraduate medical training vary widely around the world. This partly explains why the medical profession is so fiercely regulated when a doctor wishes to practise in a country different to where they trained. Whether better training necessarily predicts more professional success and competence is a different matter. I don’t think it does, so I don’t think that it matters where doctors do their training. But controversy has surfaced following the recent announcement that a Portuguese private higher education institution, CESPU, has made an agreement with a private Spanish university, Alfonso X El Sabio, to allow the graduates of its three year biomedical sciences programme to automatically enter the fourth year of medical school in Spain, starting in the upcoming academic year. more…