Obstetricians in Revolt: Barreiro Doctors Defy Forced Transfer to Garcia de Orta Emergency

Obstetricians Refuse Emergency Shifts in Almada

Doctors from the Gynecology/Obstetrics Service are refusing to cover emergency shifts in Almada, with one physician even threatening to resign. A government dispatch aimed at forcing their relocation may have limited effects, as resistance mounts.

Obstetricians at the Barreiro Hospital's Gynecology/Obstetrics Service—whom Health Minister Ana Paula Martins is reportedly preparing to forcibly summon to reinforce emergency shifts at Garcia de Orta—do not want to be mobilized to Almada, according to a source familiar with the matter. Most of the specialists are over 55 years old, which exempts them from performing emergency obstetric duties under current agreements. Only two of the seven doctors are below that age, and one has already warned that she will terminate her contract if the forced mobilization proceeds. The Ministry of Health's solution to bolster Garcia de Orta's shifts may ultimately have very limited impact.

In Barreiro, to keep the obstetric emergency operational, the obstetricians, particularly the older ones, continue to cover emergencies despite most being above the age limit for such duties. However, this willingness could change if the ministry decides to mobilize these professionals for Garcia de Orta. "We do [emergencies] because we are at home. Otherwise, we wouldn't," assured the same source, emphasizing that Barreiro's obstetricians are not available to work at Garcia de Orta.

Last Friday, the weekly Expresso reported that Minister Ana Paula Martins was preparing to forcibly mobilize Barreiro's obstetricians to the Garcia de Orta emergency department in Almada, with the dispatch ready for her signature. This news is surprising, given that Martins had repeatedly stated that negotiations with medical unions were necessary before any team concentration, as relocation is a labor matter.

Only Two Doctors Could Be Mobilized; Majority Exempt from Emergencies

Two events may have prompted Martins' decision to force mobilization without prior negotiations: the simultaneous closure of three obstetric emergencies in the Setúbal Peninsula in early September, and the failure to reinforce Garcia de Orta with seven private-sector doctors (only two have been hired so far). This forced reinforcement has drawn severe criticism from unions and the Medical Association. "This solution will further complicate our situation. Forced displacement creates revolt," said a source, warning that it could be counterproductive.

According to the source, the Barreiro Hospital currently has a team of seven obstetricians, five of whom are over 55 and exempt from emergency work under agreements from 2012 and current collective bargaining agreements. Most are in full dedication, a regime allowing mobilization within 30 km, but age limits override this. Joana Bordalo e Sá, president of the National Federation of Doctors (FNAM), confirmed that "age limits in collective agreements override full dedication."

"We do [emergencies] because we are at home. Otherwise, we wouldn't." — Source to Observador

Doctor Threatens Resignation if Forced Mobilization Proceeds

The government's强硬 stance could yield minimal results. Besides the five exempt doctors, another obstetrician has threatened to resign if the measure advances. "One doctor says that if this happens, she will resign. It's almost forcing the younger ones out of the SNS. It doesn't make sense," the source noted. Thus, the dispatch might only mobilize one doctor, having little impact on Garcia de Orta's deficient shifts.

"This is useless because there are no doctors to mobilize," stressed the FNAM president, advocating for team reinforcement through hiring and improved working conditions instead. Martins is aware of the risks; in summer 2023, when she headed Santa Maria Hospital, forced mobilization of obstetricians led to internal protest and the resignation of eight doctors.

Last Sunday, Garcia de Orta—which should have been fully operational—had to redirect patients to Barreiro due to insufficient staff, with Barreiro covering the entire peninsula's obstetric needs for most of the day.

Concentration of Care in Almada Leaves Areas 70 km from Services

The Ministry of Health did not respond to questions about guarantees from Barreiro doctors or pre-dispatch contacts, only stating that teams are "finalizing the legal framework for the future regional emergency in Setúbal Peninsula," ensuring fair compensation for professionals. The Barreiro and Montijo health unit also did not comment.

Barreiro's service handles about 1,200 births annually, covering Barreiro, Moita, Montijo, Alcochete, and Quinta do Conde. If a regional emergency is established at Garcia de Orta, eastern Montijo areas like Pegões will be 70 km from the reference emergency—exceeding the 50 km safety limit recommended by experts.

However, there is no turning back on concentrating Barreiro's emergency at Garcia de Orta. Martins announced last week that the Setúbal Maternal-Child Center will launch in 2026 at Garcia de Orta, integrating teams from three hospitals, with Setúbal's emergency remaining open for the Alentejo coast. The center is expected in three to four years.

"The solution is not forced displacement because it creates revolt among people." — Source to Observador