Portugal faces health sector shutdown in cuts protest

Unions will stage the biggest strike in Portugal's health sector in two decades on Wednesday as anger at sweeping cuts designed to meet the terms of a bailout deal reaches boiling point. The health budget is one of the biggest victims of a package of austerity measures imposed by the government to reign in Portugal's debt. Doctors, nurses and patients are all expected to protest at salary cuts, long waiting lists for treatment and the rising cost of medication. Although the strike will cause widespread disruption to patients, it has attracted widespread public sympathy from people fed up with the declining standards. Thousands are expected to join in a protest in Lisbon on Wednesday. In one health clinic in the southern Lisbon suburb of Almada, people say they have to start queuing for an hour before the centre opens its doors. "The doctor only has space for two patients without appointments so I have come early to make sure my wife gets seen," said Antonio Jose, a retired driver whose wife needed a check-up following a hip operation she had to wait 10 years for. "Health has become a real business -- those who have money manage fine but for the others these years are a nightmare," said Joao Palma, another of the clinic's patients. "Before I was exempt (from payment) but now I have to pay five euros for a consultation in a health centre and 20 euros at the hospital emergency room." Intent on demonstrating in what they promise will be the health sector's biggest protest in two decades, angry strikers have rebuffed an offer of talks from Health Minister Paulo Maceo. Portugal is locked into a three-year programme of debt-cutting measures and economic reforms in return for a 78-billion-euro ($103 billion) rescue package from the EU and International Monetary Fund agreed in May 2011. To cut the requisite 800 million euros ($985 million) from its health budget, the government has reduced overtime, increased prices for prescription medication and even closed certain services. Carlos Braga, head of a patients' rights group in the capital, said the numbers of people who can no longer afford to pay for health care is rising fast. "Thousands of people are now deprived of care because they cannot afford the prices that were put in place in January," he said. The number of consultations has dropped 4.4 percent in health clinics and 9.8 percent at hospital emergency rooms, according to government figures for the year up to the month of May. Overworked doctors have denounced a "worrying and dramatic" fall in the quality of care in Portugal's health system -- ranked 12th best in the world by the World Health Organization in 2000. "We are seeing general indignation over the increasing levels of work expected from doctors," who like civil servants, have seen two of their 14 months of salary cut," said Mario Jorge, president of a doctors' union in southern Portugal. Nurses have criticised the purchase of second-rate or obsolete equipment as a cost-cutting tactic and want the government to drop plans to use cheaper outside service providers instead of hiring additional nursing staff. "We don't have enough staff and the government refuses to hire anyone because of the troika," said one 40-year-old nurse, referring to the so-called troika of auditors from the EU, IMF and Central European Bank who are reviewing the finances of countries needing bailouts such as Spain and Greece. Portugal has been hit by a number of protests in recent months over austerity measures, although planned strikes by both pilots and air traffic controllers were called off last week.