Government violated the law by scheduling appointments for Portuguese-Brazilian twins

2023-12-14 07:48:52

“The internal controls implemented in the treatment of patients with spinal muscular atrophy, where the therapy used was Zolgensma, at the Centro Hospitalar Universitário Lisboa Norte (CHULN) ensure compliance with current legislation and operations in all aspects.” This is how the conclusion of the internal audit of the largest hospital in Lisbon regarding the use of that document begins. However, this same conclusion continues, mentioning an exception: the case of the Portuguese-Brazilian twins.

This same exception was the “referral for the first consultation of the Neuropediatrics specialty of the users”, who were referred to the Pediatrics department by the State Department of Health, in an appointment scheduled by telephone.

It is concluded, therefore, that “the provisions of ordinance no. 147/2017, article 8, were not complied with”, since the referral of the twins by the State Department of Health did not follow the five established assumptions: Referrals must be made through Health Center Groups (ACES), other hospitals or the same hospital, the National Health Service (SNS) contact center, units and teams of the National Integrated Continuous Care Network (RNCCI) or from entities external to the SNS.

“Registration in the system was made based on the users’ citizenship card presented on the date of the first neuropediatrics consultation”, can be read in the document, which notes a flaw in the law, as this reference came from the Government, thus failing to comply with the standard that defines referrals for the first hospital consultation.

The audit then involves the Secretary of State for Health, at the time António Lacerda Sales, saying that he was the one who forwarded the referral. The appointment was then scheduled, with the responsible neuropediatrician informing the department secretariat via telephone.

This non-compliance results in a “high” recommendation from the Internal Audit Service (SAI): “The acceptance of users for the first consultation of the Neuropediatrics specialty, as well as in other specialties existing at CHULN, must comply with the requirements defined for referral foreseen”.

According to CHULN regulations, these changes must be implemented within the next three months.

But there is more. The twins, two of the 10 children treated for this disease at Santa Maria Hospital since 2023, were the only users who presented themselves without any fields on the registration form. This information only exists in the clinical record, and auditors warn of the difficult traceability of the process.

“We concluded that internal controls are deficient in ensuring compliance with current legislation”, concludes the report.

This case, in which it is suspected that there was a “wedge” that came from the son of the President of the Republic, was reported first-hand by TVI (from the same group as CNN Portugal). Marcelo Rebelo de Sousa confirmed, several weeks later, that he had received an email from his son, Nuno Rebelo de Sousa, asking for the case to be analyzed. From there the request went to the Government, and it is now suspected that it was the Secretary of State for Health at the time, António Lacerda Sales, who continued the process.