Focus on: My career

I have been a member of Luz Saúde’s legal department for 14 years and coordinate the Litigation team in the areas of litigation (civil, administrative, criminal and misdemeanour), extrajudicial conflict resolution and management of clinical complaints and those associated with the provision of healthcare, participation of liability claims, investigation processes and administrative offenses with regulatory entities in the health sector and collection of credits from the Hospital da Luz network. I sponsor Hospitals and Luz Saúde professionals in civil and criminal cases of medical responsibility and disciplinary proceedings before the orders of doctors and nurses. I provide legal advice to the Superior Clinical Council and the Central Directorates of Luz Saúde, and to the Clinical Directorates, Executive Committees and Management Centers of the units of the Hospital da Luz network. I participate in the creation and review of Luz Saúde’s internal policies and procedures on informed consent, treatment of information and risk management of clinical activity; I train health professionals in these matters.

I consider it essential to know how to lead by working example, integrity, loyalty, cooperation and commitment to the organization’s mission and values. Have empathy and assess the capabilities of each team member to guide the development of their skills and qualities, with a view to their constant motivation and improvement of their performance with responsibility and autonomy. It is important to have and convey confidence, the ability to delegate and trust in the performance of each employee. The leader must know how to communicate, transmit knowledge, listen and learn from each member of the team. I try to cultivate these skills and transmit them to the team that I have the privilege to coordinate and have helped form over the years.

The health sector is exposed to various risks (financial, economic and operational) that Luz Saúde seeks to overcome through its strategic and business vision and an organisation and governance model geared towards the sustainability of its care network and health care system. health globally. The provision of health care coexists with risks that can produce a multitude of adverse effects, iatrogenic effects and sequelae with very negative impacts on patients and their families, which may lead to legal proceedings with significant compensation claims, criminal reports, inquiries by regulators and orders professionals, with relevant reputacional damage for Luz Saúde. Medical liability is an issue with increasing focus in the Courts, the media, social networks and public opinion. It involves issues of recognised complexity and sensitivity whose approach calls for not only legal knowledge, but also an intense study of scientific literature, mastery of medical/technical concepts and knowledge of medical-surgical, nursing and technical protocols and procedures. Scientific and technological advances in the fight against diseases, together with the evolution of patients’ rights to information and self-determination, have been beneficial in improving quality standards in health care and a practice that is more respectful of patients’ freedom to make informed decisions. But they do not allow the risk inherent in clinical activity to be ruled out and have led to a reversal of speculation about “medical errors” that generate the obligation to indemnify, with potentially perverse effects on the activity (e.g. defensive medical practices) and increased health care costs. Among the operational risks, the clinical risk is the one that occupies me most intensely, namely in the creation of internal norms that aim to mitigate risks or repair them in a timely manner, preventing the accountability of the units and their professionals in court; training management teams and health professionals to implement these standards; in the management of complaints and consensual resolution of disputes with patients; in improving the guarantees of professional liability and operating liability insurance and in the defence of units and professionals in legal proceedings and investigations by Regulators and Professional Associations.

I joined Luz Saúde at the age of 26, having recently joined the Bar Association with little experience in litigation and none in the health area, to be the only litigation attorney in the Legal Division, which had only two equally young lawyers. Luz Saúde (then Espírito Santo Saúde) was 8 years old, had 12 hospitals and clinics and a lot of ambition to grow and improve the health sector in Portugal. The first challenge was to learn Health Law and get to know the functioning of hospitals and the core of clinical practice in its various specialties, in particular the risks, challenges and difficulties. In 2009, medical liability was still a subject rarely dealt with in the national Courts and Medical Law was taught in few Law Schools. The second challenge was to deal with the exponential increase in litigation in the health sector, simultaneously with the expansion of Luz Saúde which, in a decade, doubled its size to 25 private units, built and managed a public hospital in a public-private partnership (PPP), was placed on the stock exchange (IPO) and changed its shareholder structure. The third challenge has been the defence of Luz Saúde units before the Courts and Regulators, who are increasingly demanding with private providers and protectionists of users. Finally, and perhaps the greatest challenge, it has been to contribute, with hard work and unconditional dedication, to the consistent and sustainable development of Luz Saúde, which today has 29 units, 14 thousand employees and the merit of being a reference operator in the health, along with the growth of the Legal Department, which has a team of 12 talented lawyers and trainee lawyers who are strongly committed to the quality of the work of the Legal Department and the Luz Saúde project.