Treat us like adults

Alexandre Lourenço
 

The development of the Portuguese health system suffered, like so many others, from excessive paternalism and over-centralization. Perhaps part of our failures in responding to the covid-19 pandemic lies in these two issues.

Last December, a Spanish friend shared an article from the El Mundo magazine where he gave some inputs: "nos tratam como niños, y nosotros tan contentos." The infantilization of Society - "the NHS will take care of everyone, everything is fine, the warm weather is the only cause for the excessive mortality, the cold weather is the sole cause for the excessive mortality, the vaccines are there and will solve everything" - demotes individual responsibility. Look at the peskiest kids fighting for the first sweets: vaccines. In the face of terrible mortality indicators, it is not so strange to see people's gatherings without any protection at the first ray of sunlight.

A year later, the inability to deploy an effective contact tracing and testing apparatus demonstrates our failure to do more than the routine. As with the ever-forgotten prevention, the system tends to focus exclusively on the conventional cure structures.

Last month, the British Government presented to its parliament the white-paper "Integration and innovation: working together to improve health and social care for all".  The topic is not new, but it is a sign that gives us hope in the middle of a pandemic. It is this kind of discussion that engages citizens and brightens our future.

It is not the millions from the European "bazooka" that will make us better. Persons, their ideas, and a vision that unites them will make us better.  As my colleague said: If the Government wants to engage Society, the first thing it has to do is to conceive us as adults.

Medicine, values and communication

Salvador Casado

Modern medicine has achieved a spectacular development in the last century in parallel with the rest of society. Spurred on by science and technology it has managed to overcome ambitious goals and shines proudly on the basis of its achievements. Unfortunately, there is a long shadow that contains burdens and threats. Inequalities in health, overdiagnosis and overtreatment, iatrogeny, the progressive dependence of citizens on health systems are increasingly present realities.

Illustration by Paula Alvear, from the poems Arconte Enfurecido

On the other hand, private health systems and the enormous conglomerates of pharmaceutical and technological industries based on profit seek interests that are increasingly distant from the common good. In the face of these interests, public health systems are slowly collapsing due to under-funding, cutbacks and the chronic overloading of their professionals. Everyone agrees on the complexity of managing alternatives but no one dares to implement them. Meanwhile, the public health systems are melting like butter as services are outsourced, professionals working conditions get worse or units are reconverted and closed (Public Health and others).

Research and Health Policy "to blog or not to blog"

By Tino Martí

That is the question. The strength of the link between research and health policy looks different depending on the perspective. Health services researchers expect a lot more feedback regarding their work in political decisions while the politicians need to be informed about the most effective way to ease the configuration of health policies based on scientific evidence. It’s a difficult transition bridge where the surface is eminently communicative.

In the "Web first" section of the influential Health Affairs, a study on the use of social media and perceptions of researchers has been published and is well worth reviewing (Grande D et al, 2014). During the Academy Health Annual Research Meeting, 215 investigators were interviewed using a mix of techniques (cases, assessment of broadcasting effectiveness and open qualitative questions). In the cases’ section, three ways of communicating research results to policy makers were presented: traditional media, social media and direct contact with decision-makers. Social media includes the blogosphere and the different social networks, particularly Twitter.