DRAFT LAW No. 154/IX
Discussion in the Assembly of the Republic,
February 6, 2003
Source: DAILY ASSEMBLY OF THE REPUBLIC
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Mr. President (Narana Coissoró): - We the discussion, in general, the draft law No. 154/IX - Integration of dentistry in the National Health Service (BE). To start the debate, has the floor to Ms Mrs Joana Amaral Dias.
The Mrs Joana Amaral Days (BE): - Mr. President, ladies and gentlemen: We believe that the right to health is a universal right and a Accessibility of the conditions of democracy in which the state should have a role structuring and regulator and not resign. Do not accept a mercantilist vision of health, opposed to this vision a humanist and a constitutional priority that always has been postponed. In Portugal, the deficiencies of the National Health Service show the fragility of health care. Our families pay about 40% of expenditure, which is approximately twice the effort occurred in developed countries.
The dental health is an integral part of the general health of individuals. The dental health is not a secondary aspect of the general condition of the individual nor is a luxury. The prevalence of diseases which seeks, as well as those that may have severe implications on health overall individual in particular, digestive, kidney, heart and cancer, put the oral health, so compelling, as a central issue in public health. It should then be to ensure the rule, so free, under the National Health Service, care of basic oral health. However, the situation of oral health in Portugal, is alarming and is in last place regarding all EU countries and behind non-EU countries such as Switzerland, Norway, Czech Republic, Slovakia and Slovenia. The oral health is effectively excluded from the right to health of the Portuguese. 60% of the population is unable to access the private dental clinics, 90% of children and adolescents have no access to the Oral Health Program and 98% of dental practitioners engaged exclusively private medicine.
According to a survey of the Order of Dentists, covering all public hospitals and health centres, around 70% of hospitals do not have oral health services, as well in 90% of health centres, the situation is serious, in Lisbon , With waiting lists of up to three years in the health units that have this valencia, very serious, in Alentejo and Algarve, where in each of these regions, there is only one health centre, with this provision, or unbelievable, in the districts of Beja , Guarda and Portalegre, where there is only one dentist.
In addition to the brutal consequences physical, psychological and social problems that are caused by negligence for the individual in the oral health, also found that, economically, this issue is complex, and that only in absenteeism at work, caused by low levels of assistance in this area, Portugal lost 35 million euros annually. Furthermore, doctors dentists, whose university training lasts six years and is in Portugal since the decade of 70, did not have a career itself, which, of course, would have the right, nor is considered superior technical health.
Here too we live in a paradoxical situation and extremely unfair, both to users and for professionals. On the one hand, we have enough doctors and dentists admittedly the most well qualified in Europe, with a significant increase in the number of professional and moving towards a situation of potential excess, is not regulated because their career, and, secondly, we have a large part of the population unable to access services for lack of economic capacity.
The political promises, consistently asserted, the recruitment of Dental Practitioners for the health units have been systematically put back defraud the legitimate expectations of doctors and dentists and students, especially, of a population which assists thus powerless to prevent a right Human and social base.
Mr. John Teixeira Lopes (BE): - Very good!
The Speaker: - It is at least strange that, in Portugal, 143 health units have the equipment necessary for the practice of dentistry, most of these devices are fully operational, but without dentist who can exercise and therefore without the enjoyment the user. It is incomprehensible that at least in Portugal, even the agreements with private clinics are made under a table that provides a reimbursement of $ 127, or about 60 cents for each treatment of a tooth. Thus, the Left Block stresses the urgent need for a reversal of this situation, including dentistry in the National Health Service (NHS) and including the classification of doctors and dentists higher health technicians. In oral basic health care, advocating that priority be given to the monitoring of pregnant women, children, adolescents, the elderly, heart patients and other circumstances, also ensuring the human and technical resources in health centres, in emergencies and in consultations. We extend fundamental, quantitative and qualitative terms, the programme of oral health for children and adolescents, organizing the collaboration of the Ministry of Health with local authorities under their jurisdiction, in programmes of prevention, early diagnosis and treatment of emergency. We consider it essential to ensure the respect of transactions and dentures. Mr. President, ladies and gentlemen, with this bill, so we want to see-just completed a constitutionally enshrined right, the right to health, and that the dental health, Portugal, leave definitively to be the 'poor relation' .
Applause from BE.
Mr. President (Narana Coissoró): - In a speech, has the floor Mr Jose Antonio Silva.
Mr. Jose Antonio Silva (PSD): - Mr. President, Honourable Members and Sr.as: The oral health is an integral part of general health. No person may be considered healthy if you have any kind of disease in the oral cavity. Although the mortality directly caused by diseases of the oral cavity is low, these diseases may eventually affect the health of many individuals. In addition, the dental disease contribute to a decrease in productivity, whether at work or at school. The main feature of dental caries is its universal prevalence, affecting virtually all individuals. In children and adolescents is the main cause of the loss of teeth. Most preventive procedures require an individual action, whether in terms of changes in diet either in the practice of good oral hygiene and regular visits to the dentist.
Under the strictly economic point of view, the importance of prevention of oral diseases comes from the high price of dental services provided to deal with the consequences of these diseases. In Portugal, the continuous and persistent intervention of the family doctor has contributed decisively to be provided to children, from birth, care essential for their dental health.
Consultations of child health and, later, health education opportunities are privileged to inform and sensitize parents and children. Parents, here, have an irreplaceable role in the fight against oral diseases. A father informed and motivated can do more for your child's dental health than any dentist. Under the NHS, there is a program of intervention in oral health, defined since 1985, whose intervention has been targeted at children and young people of school age. This programme has been developed by health centres, in child health and school health, and even in kindergartens and primary schools. In 1999, the Directorate General of Health restructured the program, outlining a strategy of intervention based on a model of primary and secondary prevention of oral diseases, aimed at reducing the incidence and prevalence of oral diseases, particularly dental caries in children and young people under 17 years. This program is built on three levels: the level 1 - basic program of oral health, the level 2 - specific programme for application of sealants, and level 3 - programme of medical and dental intervention. The programme of basic oral health is a set of activities for health promotion and disease prevention, such as the administration of fluoride and oral hygiene.
The specific programme for application of seals has been executed for oral hygiene and also by the NHS contracts with others. The programme of medical and dental assistance is made not only through the services of the NHS but also by contracting with dentists and dental practitioners, and it is possible to apply in such cases where there are no seals of oral hygiene and the treatment of injuries caused by dental caries that prevention was unable to avoid, thereby obviating the unmet needs in oral health, the NHS.
In 2001, started the project of oral health in disability, with the aim of reducing inequalities in oral health, reduce the prevalence of oral diseases in children and teenagers suffering from physical or mental disability and intervene from the school, in institutions that support.
Mr. President, Honourable Members and Sr.as: Despite the improvement in standards of oral health of children and young Portuguese, we must continue to invest in promoting health, disease prevention and oral assistance in strengthening the curative. Hence, more gains in oral health involves extending the basic program to all kindergartens and primary schools, strengthen the framework of personnel with oral hygiene in the NHS and gradually extending the contract with the private sector, creating new partnerships to the provision of health care in an area needy in the NHS (which admit as much needy) and involving the public and private sectors in solving the problems of oral health of children and young people. Thus, to achieve this strategy, the system was approved for 40 000 children, plus 15 000 who have already begun the process this year and complete basic education. The concern with the excluded groups and with children with disabilities will be enhanced, either through the production of materials or through appropriate training to health professionals and the institutions that support them.
The Manual of Good Practice for Oral Health, for those working with children and young people with special health needs, will be released by the government shortly. Mr. President, Honourable Members and Sr.as: Regarding the draft law presented by the Left Bloc, yet we consider the initiative in the virtuous goals, it is completely useless and unnecessary, since the gains in health, obtained with the application the programme of oral health in hand, make us think we are on the right track.
The model on which the draft law of the Left Block, in our opinion, is outdated - is in decline, has the best health system, namely complementarity between the public sector, private sector and the social sector.
Mr. Luis Marques Guedes (PSD): - Very good!
The Speaker: - In this organizational model for the provision of health care that differ from the Left Bloc. For us, integration of dental practitioners in the NHS is not to link the obligation of public function, much less the creation of a career in technical higher for dental practitioners. More gains are possible in oral health concluding contracts for service with dental practitioners, with oral hygiene and other professionals from the private sector for the provision of care to users of the NHS.
Mr. President, Honourable Members and Sr.as: The way forward should be, in our view, enlargement of reference for contracts under the programme of oral health for children and young people, should be investing in the training of health professionals that make up the teams of school and health professionals in the schools where the program is implemented, should be the establishment of partnerships with the Order of Dentists and with local authorities in order to extend the provision of oral health to another type of the target population, especially elderly and needy.
Applause from PSD.
Mr. President (Narana Coissoró): - There being no requests for clarification, you have the floor for a speech, Ms Mrs. Luisa Portugal.
The Ms Luisa Portugal (PS): - Mr. President, Honourable Members: The bill 154/IX No, the Left Block, provides in its articles, the classification of doctors and dentists technical higher health and establishing criteria for their release as professionals in services and establishments dependent on the Ministry of Health, the Santa Casa da Misericordia de Lisboa and the Ministry of Justice, to which proposes amendments to Decree-Law No. 414/91, 22 October, in their articles. 2 and 9. Proposes thereof, in its transitional provisions, its phased implementation, and, from the third year of its term, applies to all units of health. The proposed model is based on a clear option for public service of care, not taking into account, in particular, the experience and impact of measures already adopted in Portugal and other European Union countries.
In a first point, more specifically, analysis of this law, say that the Socialist Party considers the debate on the oral health of the utmost importance. Important by the magnitude of the problem - if the scale is large, with oral diseases highly prevalent among the population of all ages, we estimate, as has already been said, that 60% of the Portuguese do not have access to health care in this area.
Important economic effort yet by causing the Portuguese households, since the existing care are provided almost exclusively in the private sector, and co-financing is only for some, but subject to deductions on taxes. Important because it is a health problem with great vulnerability to programmes of prevention, whose assessment shows very positive indicators. Important because its resolution involves all levels of care across the board, forcing the work of a team scheduled and continued. In fact, oral health is a challenge for the organisation of care and health services, so that the correct implementation of its measures and targets program has positive impacts, not only in oral health but also on learning to proper nutrition, for personal hygiene in general, to the knowledge of risk factors and therefore for the care of prevention and for the teamwork and knowledge of the various professionals involved.
It is not an easy area to boost up its implementation because it calls into question the biomedical model of care that, although already in disuse, we have seen with some concern take body in political discourse of the current Minister of Health.
Mr. President, Honourable Members and Sr.as: In a second point of consideration of the draft law, it is important to stress the difficulties of access to curative care in this area by the majority of the Portuguese population and the need to find an costumes organization of human and material resources and financing that responds to those impediments that lead to inequality, which penalises the most disadvantaged, particularly in economic terms.
The Socialist Party in 1999, hosting previous lessons and strategic proposals of the World Health Organization (WHO) in this area, started a program of promoting oral health for children and adolescents through contracting with curative care, dental practitioners to engage in clinical private sector, benefiting the network of resources and equipment already spread across the country This program was part of an overall strategy of intervention, based on three sub-programmes: the basic program, as part of the activities of school health, covering a large population student of pre-school and. 1 cycle of basic education; strengthening the tables of staff of health centres with more oral hygiene to support the specific programme for placing the crack sealant, and the programme of medical and dental assistance already said. In 2001, he started up a draft oral health disability.
This route is allowed to Portugal today between the group of countries with moderate prevalence of dental caries at this age and achieve objectives consistent with the recommended by WHO for the European region, as stated in assessment by the Directorate General of Health and published in March 2002, has also previously said here.
The positive assessment of the implementation of this programme and satisfaction for professionals and citizens leads us to conclude that this is a model that, to be extended to the entire population, could bring significant benefits and gains in terms of overall health. They should take into account the criteria of access, the health objectives of the reach and cost / benefit of co-financing by the NHS. Finally, say that extending the programme of contracting does not mean for the Socialist Party - and hopefully also for the government - the slowdown in the basic program of oral health and collaboration with schools and other partners, or the strengthening of oral hygiene in Tables of health centres.
As parentheses, and finally, I say to the PSD and the CDS-PP which have in this area, a window of opportunity to achieve what they both have been repeated by the Minister of Health: 'give a doctor every Portuguese. They can start with the oral health goals and reach good health cross towards the end, as will a healthy collaboration to put a beautiful smile in the mouth of each citizen.
Applause from PS.
Mr. President (Narana Coissoró): - In a speech, has the floor Mr Bernardino Soares.
Mr. Bernardino Soares (CFP): - Mr. President, Honourable Members: The first observation that needs to be done with regard to this law is that oral health is part of health care. It seems a redundancy to say, but, actually, we must also reaffirm it to justify and noted that an instrument which, in our country, exists to give substance and content access to health care, provided in the Constitution, which is the NHS, has no oral health care sufficient to meet the majority of the population and their needs.
Clearly, this situation is the result of a route where there is a decrease of dentists as specialty of medicine - today, will be 300 or 400 - without which they are to train new experts in this area and, in parallel, its replacement In practice, with a new course, relatively new in dentistry. Only that doctors dentists are being integrated into the NHS, occupying the place, so to speak, that until a few years ago, was played by doctors dentists. The result is that the NHS has no answer to the problems of oral health. And this is clearly visible in the indices that our country has in this area. The WHO estimates that in our country, the population up to 6 years, 47% of it is affected by caries, in people up to 12 years, 70%, and an index that WHO has for the calculation of caries in the population, our country has an index of 3.1, when the world average is 1.74. Without doubt, is an index that in shame!
Nor are strangers this index and these results when we see that in our country, the spending on oral health is 0.3% of GDP, against, for example, 6.2% in France, or 4.65%, the United Kingdom.
Mr. Bruno Days (CFP): - That is this!
The Speaker: - The Order of the Left Bloc is undoubtedly a laudable objective and opportunity in this area, proposing concrete measures to begin to reverse this situation, in particular pointing a per capita ratio, which could be achieved if the majority of dental practitioners were integrated into the NHS. It is not a problem of quantity, but not of integration and not affixed in the public service in this area of health care.
A doubt that in this law raises concerns of the BE form used for such integration, through the inclusion of dental practitioners in the career of higher health technicians. I think we could find a more appropriate, given that doctors are closer to dentists in terms of function, in prescription and many other materials - in their training, three years have common - and the doctors. Therefore, it may not be the most appropriate status. Perhaps the creation of a career own or another solution would be more appropriate rough. In any case, this does not cut validity to the plan presented.
We agree with their priorities, also highlighting the proposal on the approximation of contributions to the scheme of the ADSE and remembering that in successive Budgets of State, PCP proposed for dentures, and also for other, the approximation of the contributions General contributions to the scheme envisaged for the ADSE, something which, in time of the socialist government, came to be entered in the State budget but was never fulfilled and that, now that the PSD budget was simply failing in the last budget debate, because It appears that the Honourable Members of the PSD and the CDS-PP are not concerned about the cost that is the treatment of the teeth and use of dentures for our population.
Voices of the CFP: - Very good!
The Speaker: - your vote and your denounces this misunderstanding. On the issue of human resources, it is clear that the framework is contradictory to the proliferation of private courses in this area, which has generated opposition even from Order of Dentists, for lack of qualification of some of these courses that, not quite sure why, ultimately be approved. As has been said here, a study of the order of Dentists say that, of around 3500 professionals registered, 700 are unemployed or under the underemployment because the private market no longer extends more and are being integrated into the National Service Health, and every year more 400 to 450 leave the Faculties.
On the other hand, this is contradictory with those 60% of Portuguese who have no economic possibilities to go to private dentist. But this is particularly inconsistent with the policy that this Government has already approved, for example, for the Faculties of Dental Medicine. It is known that, for example, the School of Dental Medicine of Lisbon is always a substantial part of its money from revenue derived from the consultations and activities in the profession that are within the Faculty and who have always had. But this year, the budget cuts in education and in the area of higher education leads to that is threatening the funding for materials needed to perform these tasks, to make these consultations and that these treatments have always been a recipe itself of the Faculty. That means that we may be faced with a situation in a time of financial collapse, which says the intention of this government as well as to matters of oral health and training of professionals in this matter. Then, even in relation to human resources, lack a plan of needs for human resources allowing, in this area, to plan the growth of human resources trained in view of the integration in the National Health Service and taking into account the ability of the profession in practice absorb those who are being trained over the years.
There is also another issue which remains to look: that is, through the perversion that the entry into Medicine, Medicine and Dentistry in Nursing have in our country by the extremely high notes and the numerus clausus, this means that many of the students of Dental Medicine are students who took this course as a second option, and we must also know that consequence is that this eventually has in the training of these professionals and the future of the profession.
I would also point out an important resolution of the Regional Legislative Assembly of Madeira where he says: 'Whereas the care with teeth are, from an early age, the fundamental point of view of creating habits to a good oral health; whereas all citizens should regularly consult the dentist, whereas it is often the use of these consultations to treatments; whereas users of the Regional Health Service, when need of such care, are forced to rely on the expertise of consultations in private, which cost "says ADR Madeira 'that can reach hundreds of stories, the Regional Legislative Assembly of Madeira to the Government recommends the creation of consultations of dentistry at the health of the seats of county, in order to a more appropriate response to users of the Regional Health Service.
Mr. Lino de Carvalho (CFP): - Well, here is a good thing!
The Speaker: - For what is asked now is that the Honourable Members of the PSD and the CDS-PP, or at least the majority of the PSD which are in the Regional Legislative Assembly of Madeira, are in line with the recommendation of your Madeira companions and we have also to take in this debate that we are doing.
Applause from the CFP and the BE.
The Speaker: - Finally, Mr. President, this example is proof that without National Health Service, there is no democratic access to health care and, in this case, not taking the National Health Service capacity to provide care of oral health, this has meant that much of the population, for economic reasons, for social reasons, they lacked access to health care. That is why the privatization of the National Health Service, their abilities, as has happened with the oral health means, in practice, the denial of health care to the portion of the population that most need them.
Applause from the CFP and the BE.
Mr. President (Narana Coissoró): - In a speech, has the floor to Ms Mrs Isabel Gonçalves.
The Ms Isabel Gonçalves (CDS-PP): - Mr. President, Honourable Members and Sr.as, the BE submitted a draft law aimed at the integration of dentistry in the National Health Service since the situation, in the view of the signatories of the project, is alarming and worrisome. Certainly, we all know that currently, there is little efficient protection in the area of oral health and it is desirable that the national coverage, both in health centres and in hospitals, to be extended. But it is also true - I say with complete certainty - we all would like to have dermatologists, ophthalmologists pulmonologists or the health centres…
Laughter of the PS, the CFP and the BE.
… Transforming the health centres in authentic polyclinics with all specialties in the service of users, but, unfortunately, the financial situation of the National Health Service does not allow the government to implement this reality…! The explanatory memorandum of this law, the BE advances with a large number of professionals in dentistry that would be available for this service - not dispute the figures. It is true that the number of dental practitioners is increasing in Portugal, also, perhaps, depends of the situation here have said that the dental end up being a little a second alternative for those who can not, due to the numerus clausus, into medicine.
Voices of the CDS-PP: - Yes!
The Speaker: - But the fact remains that the costs of the National Health Service are also increasing. Mr. President, Honourable Members Sr.as and we have seen in recent years, the constant postponement of policies essential for health. The current government is now developing a policy to order the accounts of health, lower prices of medicines, streamline the management of hospitals, reduce operating costs, and enhance the vast and skilled human resources available in this area. We do not want to say that in their oral health, nothing was done - not!
There was, and with some positive results, the implementation of a strategy to prevent oral - we are talking about, particularly the already mentioned programme to promote oral health among children and adolescents, with which there were gains in the oral health in our country. We do not believe, however, that the creation of a more technical career top is the appropriate response to this problem.
Voices of the CDS-PP: - Very good!
The Speaker: - It is probably the easiest and most populist, but it would be one that would contribute to a further worsening financial, a worsening of the expenditure of the National Health.
Voices of the CDS-PP: - Exactly!
The Speaker: - In this sense, and inserted in the spirit of restraint and accuracy of expenditure in the health sector, the Government placed at the disposal of health centres and hospitals, especially those recently made undertakings, legal mechanisms that allow the hiring of experts. The recent amendment of the Basic Law on Health is to open the necessary legal resolution of this problem, will allow the possibility of extending the system of contract of employment to health professionals, thus allowing fill the needs with regard also to this specialty.
Mr. Bernardino Soares (CFP): - Oh, is it? It is automatic?
The Speaker: - But, Mr. President, Honourable Members Sr.as and, in addition to the individual employment contract, may still be concluded in accordance with the law, a services contract with the professionals of dentistry. Regarding the user, it is important to emphasize that it is not as unprotected as the proponents of this draft law want to believe. We emphasise again, and recognize that there is much to do for oral health in Portugal, but it is also important to remember that there are already many conventions and subsystems, such as ADSE, which give an effective response to users in the field of dentistry.
We believe that with these tools, you can substantially improve services to users of the National Health Service in relation to dentistry.
Mr. President, Honourable Members Sr.as and it is important the Portuguese are aware that all steps in this regard, when data have to be firm and solid to ensure the viability of that health system. We have a time of change, but of change for the better - better management, better accessibility, better service, better means all, of course, in order, ultimately, better health and, even now, with a beautiful smile, a best smile.
Applause from the CDS-PP and the PSD.
Mr. President (Narana Coissoró): - In a speech, has the floor to Ms Mrs Maria de Belem Roseira.
The Ms Maria de Belem Roseira (PS): - Mr. President, Honourable Members: I asked for permission to make a speech. I hope you do not take much time but I think it important that, in this context that we are talking about health and especially of gains in health, here are some guidelines for all this, because I think all sides were unanimous in recognizing the goodness of the objectives of the proposed measure.
The ways to achieve the results are not coincidental, but already now, let me make some comments on this issue. When the National Health Service was created in 1979 expressly allowed that there were linkages with the private sector to bridge the gaps of what was a public service to respond to all needs of the population. The National Health Service has grown and has been developing and remained largely on the conventions that existed and that problem was raised in relation to the conventions was in so, there is such conventions, there was an incompatibility, when people who were approved were, at the same time, officials from the National Health Service.
Indeed, this was explicitly recognized by the Statute of the National Health Service has been done in 1993, therefore, still the responsibility of the last government before the PSD government of the PS.
But during my mandate in the Ministry of Health, found that it was essential for strengthening the actions of the National Health Service and for a healthy conjunction with either private sector or with the social sector, there was a definition of incompatibilities in order to allow the agreements to be signed were agreements that respected the same status.
It is against this background that comes this new program of oral health, based on contracts with doctors dentists, conventions, so to speak, since the Dental Practitioners never entered the National Health And this not because there was lack of recognition of the importance of oral health, but because the financial difficulties sometimes determine solutions of substance, at a time when doctors had enough with the training. Moreover, this was a measure taken at a time much controversy over the training of dental practitioners in the past the mid 80's, but there was a coincidence: to be already a number of dental practitioners with adequate training, not making these doctors Party the tables of the National Health Service, because its integration into careers is very complex (and I will not have time to speak about it, but it is complex because it can not be different from other doctors, up because of the rise in relation to the direction services, etc.). and also the requirements of incompatibility of absence so that they could make the system that has already been mentioned by Mr Robert Silva.
So based on these guidelines and those guidelines, progress was made within what was possible and reasonable, in a program with potential to grow. But it was made more: it has developed an operational intervention on health, focusing on the strategy of health, with access also a line of financing for the installation of private clinics, with investment financed by the state to allow the setting of reasonable prices for people because, really, one of the difficulties that exist in Portugal is not only the National Health Service does not respond to this need as well as in private prices are extraordinarily high, but are not equal throughout the country.
So, in conclusion, since I have little time, say that there is this need by all diagnosed here, there are several ways to achieve its satisfaction, which are not, necessarily, for the creation of a career itself, which is not necessary to train companies to enable the system, which was made in a different context…
Voices of the PSD: - No one said that!
The Speaker: - It was Ms Mrs the PP, also with good intention. I am not even to raise any problem, I am saying that the creation of companies is not necessary, because that contract can be made, and either that was in a different context and with different legislation. What is essential is that the Government seize the opportunity to contractually, without conflicts, to achieve reasonable prices for the whole population.
What more reason to believe that maintaining a strong public service, a National Health Service and strategically strong player, is just as representative of nearly 10 million Portuguese, with the providers to negotiate reasonable prices for the population. This is the call that I leave here and congratulate me with the fact that matters of such importance be discussed here in the plenary, which means that it is possible we all agreed when we talk about the best interests of the people, that the same is true for higher interests of the country
Applause from HP.
Mr. Luis Marques Guedes (PSD): - Very good!
Mr. President (Narana Coissoró). - In a speech, has the floor to Ms Mrs Joana Amaral Dias.
The Mrs Joana Amaral Days (BE): - Mr. President, Honourable Members and Sr.as: In relation to the intervention of the central tone of the majority parties and specifically on the Program for Promotion of Oral Health in Children and Adolescents, if it is to say that "the mountain gave birth to a mouse", if only because this program is something that exists in all countries of the European Union from 0 to 18 years in age and not restricted, such as those where he is being applied, that is, from 6 to 7 years and 11 to 12 years, which is fully geared primarily preventive, when we know that in children, even at very early ages, the curative aspects of treatment and are very important, given that the valence of treatment has only two consultations, which raises serious restrictions on accuracy, the seriousness and commitment that, of course, the professional dentists and doctors put into treatment.
Mr. John Teixeira Lopes (BE): - Very good!
The Speaker: - therefore not worth doing the Program for Promotion of Oral Health in Children and Adolescents a flag, obviously it is necessary, but missing him a lot. The new contracts made earlier this year are important but are far, far away, they are what is necessary.
Regarding the other key issue that most presented here, that the draft law of the Left Block is outdated, I say that, perhaps that is outdated for what appears to be the new trend of the majority, the privatization of National Health Service It amazes me that, paradoxically, all Honourable Members who spoke here say that oral health is part of the overall health of the individual and, hence, is a human right and social compelling, and at the same time, will not say that it is necessary that it is part of the National Health Service, unless the majority has decided that the whole health of the Portuguese will be guaranteed by private, which, incidentally, I am not surprised, and then there would be no reason for dentistry that does not come in the National Health Service as all other specialties.
Mr. John Teixeira Lopes (BE): - Very good!
The Speaker: - What is under discussion here today, this draft law, are not the contracts or financial contributions, which is under discussion here is the oral health as an essential right, and you have not had a single in for that reason it is not seen as such.
As to the intervention of Mr Bernardino Soares, which we appreciate, we want to make clear, as I think we already have left at the time of submission of the draft law, we are completely available for the discussion of a career fit for the Dental Practitioners, which would be complex, as the Honourable Mrs Maria de Belem Roseira.
This solution for their integration and technical higher health seemed to us to be a possible solution, especially to address immediate and short-term to this tragic situation that this class professional lives, especially those students who are beginning to see this potential for excess as very complicated, and also, obviously, to users.
Returning to the question of the majority position in relation to the commodification of health and the slogan "Who wants to pay the health", which, of course, we do not agree in any way, Ms Mrs People's Party made a by saying that students of dentistry students are usually the second choice of doctors or frustrated,…
Voices of the PSD and the CDS-PP: - It was this that was said! It was the CFP! PCP is what I said that!
The Speaker: -… I must say that perhaps that this evidence and what is your position on oral health and its importance. If perhaps, still want to bring out the National Health Service to dentistry and see it as a poor relation of medicine, with the disrespect clear that there are such professionals and their rigorous training.
Voices of the BE: - Well!
Mr. President (Narana Coissoró): - Honourable Members, no more applications for word, I declare closed the debate the draft law No. 154/IX - Integration of dentistry in the National Health Service (BE).
END
Inside the Assembly of the Republic (February 7, 2003)
