Orlando Monteiro da Silva

Cancer is a leading cause of death around the world. WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention.

Each year on 4 February, WHO supports International Union Against Cancer to promote ways to ease the global burden of cancer. Preventing cancer and raising quality of life for cancer patients are recurring themes. Please read today’s WHO/Europe press-release about this subject: WHO stresses importance of physical activity for cancer prevention.

Here you can read the statement from FDI – World Dental Federation about Oral cancer (PDF).

Hereby the “take” from LUSA, Portuguese National News Agency, signed by journalist Sílvia Maio:

The President of the Portuguese Dental Association, Orlando Monteiro da Silva, has admitted that many dentists in the private sector have to use their “connections” in the National Health System, so that their patients with oral cancer can get adequate treatment before it is too late.

“As a clinician, I can confirm that these patients find it extremely difficult to get an appointment through the NHS, as there are no mechanisms for direct referral from private dental clinics to public hospitals or oncology hospitals”, has complained Orlando Monteiro da Silva, adding that, in Portugal, “dentistry can almost exclusively be found in the private sector”.

Most cases of oral cancer are detected in private dental clinics and many tumours are identified when the disease is at an advanced stage. The process from there is usually a complex one.

According to Orlando Monteiro da Silva, “more than half the patients whose cancers are diagnosed at an advanced stage do not reach a five-year survival rate”. Thus, when the priority is the patient’s immediate referral to the NHS, “things do not work as they should”, he adds.

When finding suspicious lesions, dentists “find it very difficult to refer patients through the appropriate channels”, due to the lack of a referral network. Although it is the Oncology and Central Hospitals which must actually receive them, “these patients have first to get an appointment at their local healthcare centres to get a document that allows them to be included in a weeks- or months-long waiting list before they are seen by a specialist”, explains Monteiro da Silva.
“Sometimes, in more urgent situations, we use our personal connections in order to go around the red tape and make sure that our patients are adequately treated in an oncology institution”, he acknowledges.

In spite of this bleak scenario, the president of the PDA believes that the situation will begin to change this year: “the Health Director-General has committed himself to the creation of a referral network from private dentists to oncology and central hospitals, so that a satisfactory solution may be found”. In fact, he recalls that during a conference held in November 2010, Francisco George, head of the Health Directorate-General, promised that efforts will be made this year to “speed up patients’ referral processes and increase the quantity and the quality of dentists working in the National Health System”.

Another promise made by the Health Director-General involves the implementation of self-examination campaigns among the general population. As explained by Monteiro da Silva, early detection of oral cancer is crucial and “it only takes looking at our own mouths in front of a mirror to do it”.

According to Daniel de Sousa, Chief of Head and Neck Surgery in the Lisbon Oncology Hospital, 1,500 new cases of oral cancer are detected each year – 1,200 in men and 300 in women. This specialist has also added that oral cancer is “the fifth most frequent form of cancer” in Portugal.

The data provided by the Portuguese Association Against Cancer, in the ambit of the World Cancer Day marked today, shows that in 2010 cancer killed 30 thousand people in Portugal, accounting for a 20-per-cent increase when compared with the previous year.

Lisbon, 4 Feb. 2011
Unofficial translations from Portuguese

Today, health is people’s main concern.

I would like to share with you some thoughts on the description of four challenges which, I believe, beveridge health systems must face (that is, national health systems based on equality and egalitarian principles):

• pragmatism
• transversibility
• accountability
• sustainability

1º The challenge of pragmatism

In politics, ideology, by force of circumstance, gradually gives way to pragmatism.

The meaning of the word pragmatism – “the doctrine according to which practical matters are the criteria of knowledge, as opposed to intellectualism” – speaks for itself.

In fact, politics is more and more concerned with issues affecting people’s everyday lives, such as health, education and social security, among others.

As an example of this, Mr. Obama’s health reforms played a central role in the latest presidential elections in the US.

Pragmatism prevents health policies from being irreversibly affected by ideological and ephemeral aspects, by the “isms” that have brought about so much tragedy in the entire world and drives health away from the most adequate solutions.

It is when the debate becomes a partisan dispute, depending on budgetary and electoral cycles, that solutions are compromised or postponed.

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