Vaccination against covid-19 is going well. The SNS has professionals in the field with high experience and commitment.

On the other hand, the decision to involve municipalities in the constitution and management of vaccination centers has proved to be correct. In line with the guidelines of the DGS, we observe the leadership of many mayors in the identification and preparation of facilities, contact and transport of patients, and even in the hiring of health professionals.

The discussion about the role of municipalities in areas such as education and health is not new, due to the inability shown by the central administration to meet local needs in a timely manner.

Constitutionally, the SNS has decentralized and participative management. Since 2008, municipalities are expected to constitute health and psychological and social support units at home and in the community. So far, none have been constituted by those. In 2018, a more comprehensive process began, including logistical skills in the health sector. It was anticipated that, as of January 1, 2021, it would be mandatory for all municipalities on the continent. Many refused, particularly due to the complexities of the health sector.

The municipalization of health services is controversial and is not without risks. We will certainly have a less homogeneous SNS, dependent on the initiative and financial capacity of each municipality. Let us also look at the high fragmentation seen in other health systems. However, let us learn from the vaccination process and jointly seek solutions that are closer to the needs of each citizen.

#H Today is my weekly chronicle published in Newspaper on Wednesdays.

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