In the beginning was the PICS: Integrated Care for Oral Health. It was a program of oral health in the community. Implemented in 7 of the 11 municipalities in the district of Castelo Branco, the PICS lasted 6 years and ended in 1997.
Given the good results achieved, the Dental Association (Professional Association of Dentists, the relevant date), just as the Medical Association, concluded with the General Directorate of Health a partnership agreement providing for the contracting professional of his associates that, in their offices, make the necessary treatments to the permanent teeth of children attending public school, discriminated against those of private education. It began so PAMDIA - Program of Dentistry for Children and Adolescents. The treatment of permanent teeth of each child was worth 75 euros.
Came, then the PPSOCA: Program for Promotion of Oral Health in Children and Adolescents, for still and only students in public schools. Dental care of permanent teeth of each child started to cost 75 Euros.
Finally, there is the current PNPSO: National Program for the Promotion of Oral Health. Its first part requires the treatment of temporary teeth (deciduous, milk or deciduous) and permanent teeth of each child or adolescent. Despite the increased workload, increased taxes and the increase of dental materials, all the treatments still worth 75 euros per person treated.
Another component of this PNPSO is the Oral Health of Pregnant. Pregnant women are entitled to the issuance of checks issued in dental health care facilities for the treatments that need be made. However, only pregnant women who are followed in the health centers are entitled to such checks. The other, even if they are followed in the National Health Service, are not entitled to dental check. Discrimination is evident. According to several legal opinions, endorsed also by forensic experts, this is an outrage to the Constitution of the Portuguese Republic. It is therefore an unconstitutional situation wound.
All the dental care of pregnant worth 120 Euros - an amazing recovery for the value of treatment provided to children and adolescents. But there's more: no dental check can be issued if there is no dental care to be undertaken. A scaling (cleaning) does not warrant the issuance of a check, as set out in the circular normative Directorate General of Health. And the first check issued to a pregnant then the Health Center of Olivais and sponsored by the Health Minister has served, according to recipient to make a clean, since there was no need for other treatments. Television showed and gave voice to that user of the Center for Health. The conclusion seems obvious: the rules conveyed by circular normative not be honored.
Finally, watch out about the third part of PNPSO: the issue of dental checks by family physicians in health centers, pensioners who benefit from the Solidarity Supplement for the elderly. Although morally acceptable - are vulnerable members of society - the present situation involves, once again, a trampling on the Constitution, given the explicit discrimination in the rules of the Oral Health Program for the elderly.
With regard to payment of medical and dental instruments, we are witnessing yet another surprise: the processing undertaken in the oral cavity of elderly worth 80 euros per senior per year, without specifying the amount of work is pursued. Thus, the oral health of the elderly, which is worth 80 Euros, worth more than the oral health of the child or adolescent (75 Euros) and unless the oral health of pregnant (120 Euros). No one explained the criteria that led to the allocation of those values. Nor is it explained why the Health Centers Oleiros, Castelo Branco, Covilhã and Belmonte were not allowed to deliver dental checks, if the Minister of Health stated that all health centers in the country could do.
Other situations exist that make up something wrong in the Ministry of Health, as part of Oral Health. The circular establishing the normative PNPSO clearly says that will be handled by professional contractors in the program that users can not treat the institutions of the National Health Service. The Health Minister certainly does not agree with this position that determines PNPSO since it excludes the hypothesis of a citizen to enjoy a medical and dental consultation in the Health Center asks: who should do the Doctors in office at the Health Center? There is also advise that the verification of existing resources, as the Doctors concerned. There is only "about 20" of those professionals working in the National Health Service should be clarified: in 16 health centers of the Azores work 17 Doctors, in Castelo Branco, there are 2 more, the IPO of Porto, 2; in Viseu, 2, plus more of those oral health professionals in Aveiro, Bragança, Hospital S. João, ...
The attachment of the Dentists National Health Service is a real surprise in terms of legal violations, there's the Dental Board Staff, Technicians and Career General in conducting clinics. Within the same career, there are Dental Clinic prohibited from exercising within the National Health Service, with purely administrative functions. There Dentists Resolves contract with a fixed term that are based on the Medical Career Hospital and others that are based on the Career of General Technicians. Both of clinical functions and do the same work schedule. However, they have ordered different. To all these receipts, there was also green.
The conclusions, of course, belong to the reader. Likewise, the anger that can lead to action.
Manuel Nunes
Dentist
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