Health is one of the main concerns of the Portuguese and the parties' electoral programs take this into account, with various proposals to improve the National Health Service (SNS).
Developing the current health system model or changing it, counting on greater private participation or refusing it are issues that divide them, while the appreciation of health professionals and oral and mental health occupy everyone's attention.
Below are some of the proposals for the electoral programs of the parties with parliamentary seats, except for the PAN (which should only present its program on Saturday).
PS
The Socialist Party's “an essential priority” is to defend, consolidate and increase the capacity of the SNS, intending to focus on “valuing health professionals”, on “improving the SNS governance model and management and care delivery processes” and in the “valuation and diversification of local health care”. Among the proposed measures are the following:
– Start immediate negotiations with professionals within the scope of a concerted plan to review careers and increase salaries, which includes “special incentives” for those “who work in less attractive territories”, such as “support for accommodation and families”
– Encourage full and exclusive dedication to the NHS, as well as “evaluate the possibility of introducing a minimum time of dedication” to the public service “by health professionals, namely doctors, following the period of specialization”. This proposal generated criticism from medical unions and the socialist general secretary has already explained that the proposal for young doctors trained by the State to be subject to a minimum period of service in the SNS will only be taken after negotiation with the sector's representative structures.
– Strengthen and diversify the offer of proximity care, improving access in relation to oral and visual health, pediatrics, speech therapy, clinical psychology, mental health and nutrition, through the “generalization of visual and auditory screenings (…) before entry into the 1st cycle of basic education” and the “free provision of glasses to children from families with lower incomes”
– Create a permanent care network, operating in reference health centers, to reduce the use of hospital emergencies, as well as increase complementary means of diagnosis and therapy, with the respective technicians, at the level of primary health care
– Reduce part of the use of external contracting, saving public resources that will be invested in the SNS itself
– Create emergency nursing teams and continuous monitoring, which travel to the homes of older users, along with the creation of medication delivery services for isolated elderly people, through coordination with the pharmacy network
– Creation of a mental health program for young people of school age and “reinforce the number of psychologists in Primary Health Care by around 300 employees immediately”
– Create the “User Electronic Health Record” (single digital process) and the “Individual Care Plan” (namely for people with multiple morbidities), allowing to speed up and diversify access points to information, safeguarding the necessary data protection
– Define a multi-annual cooperation strategy with the private sector, under the principle of supplementity, and “strengthen transparency in the State's relationship with private providers in terms of prices and quality standards, assuming responsibility for providing care to users and avoiding unnecessary treatments.”
AD
The Democratic Alliance coalition (PSD, CDS-PP and PPM) aims to combat inequality in access to health, motivate health professionals, expand proximity care and prevent disease, also defending a new model of hospital management, so that in By 2040, the NHS will be “among the 10 best in the world” in terms of, for example, “response times to consultations and surgery”, “mortality from cancer and cardiovascular disease” and “lifetime without disease”. Here are some of their proposals:
– Create the National Digital Health Agency and the Single Electronic Health Record (RES_U) for each person
– Present an SNS Emergency Plan 2024-2025, in the first 60 days of the new Government, and a Motivation Plan for Health Professionals, including work incentives, career development, flexible working hours, professional differentiation and “new profiles of skills”, as well as “progressively building larger multidisciplinary teams in the NHS, particularly at the level of primary health care”
– Inaugurate new Public-Social Partnerships for Palliative Care units and 2nd Generation Continuing Care Units
– Increase screenings for breast, uterine, colorectal, lung and prostate cancer, in addition to expanding Clinical Psychology, Rehabilitation Therapy and Nutrition consultations in Health Centers and creating programs to promote oral health and community mental health
– Guarantee Specialty Consultations within the maximum waiting time, namely through the attribution of a Consultation Voucher
– Promote clinical coordination in the management of patients in the continuous or palliative care network with health centers and Family Health Units and develop networks of continued, palliative care and nearby outpatient centers
– Create a National Health Data Ecosystem, implement the Single Electronic Health Record (RES_U) and transform the Shared Services of the Ministry of Health (SPMS) into the National Digital Health Agency.
– Reformulate the Executive Directorate of the SNS, with a profound change in its organic structure and functional responsibilities
– Strengthen hospital autonomy, through a new decentralized management model, and enable the direct election of Clinical Director and Nurse Director, with the option being the responsibility of each Hospital Unit
HE ARRIVES
Chega's priorities in terms of health are to “modernize the SNS” and change its model to ensure “an integrated response to citizens through the articulation of public, private and social health services”, reinforce primary health care, value health professionals, as well as “investing in disease prevention and health promotion”. Among the varied proposals presented are:
– Transform the National Health Service into a National Health System, with the integration of the entire Public, Private and Social Sector, formalizing strategic public-private partnerships to optimize resources and guarantee a more effective, rapid and quality service provision, as well how to develop innovative technologies and integrated information systems that improve coordination between the different aspects of the health system.
– Reform the Basic Health Law by introducing new management models and public-private partnerships (PPP) and amend the Statute of the National Health Service, namely, revoking the executive director’s forecast
– Carry out regular screenings to identify potentially problematic health conditions early
– Ensure fair remuneration and the valorization of the careers of health professionals, with the review of their salary tables, the creation of an individual or professional group incentive system, focused on efficiency and obtaining results for the community and the recognition of professions of doctors and nurses as high risk and rapid wear.
– Create “Family Health Units 2.0” equipped with complementary means of basic diagnosis, such as electrocardiogram, x-ray, blood gas analysis and laboratory evaluation, which allow “diagnosing and treating more complex cases, but which still do not require a trip to the hospital” .
– Introduction of the “Caregiver Valley”, granting a contribution to families who choose to care for the elderly at home
– Repeal Law No. 22/2023, of May 25th, which regulates the conditions under which medically assisted death is not punishable
– Create the Mental Health Check ensuring access to the necessary mental health care whenever the SNS is unable to guarantee a response
– Recognize and implement protective measures for people with rare and/or chronic diseases, such as fibromyalgia.
IL
The Liberal Initiative wants a “new health system that integrates the public, private and social sectors, where people can choose where and by whom they want to be treated, with more access and less waiting and without added costs”. Below are some of the proposals that form part of its electoral program:
– Family doctor – public or private – for everyone by 2028, starting with those over 65, pregnant women and children up to 9 years old, by 2025
– Recover Public-Private Partnerships in hospitals in Braga, Vila Franca de Xira and Loures, extending the model to other hospitals
– Reduce waiting lists, through the creation of a Special Access to Health Care Program that ensures timely access to consultations and surgeries
– Expand type B Family Health Units (USF) (with greater autonomy and financial incentives) and implement model C USF (privately managed)
– Variable remuneration depending on performance for all healthcare professionals
– Expand the care provided by Community Pharmacies
– Guarantee access to medicines and medical devices, with 100% reimbursement for those who cannot afford them, especially the elderly
– Create a Universal Electronic Health Record
– A new Health Regulatory Entity
CDU
The Unitary Democratic Coalition considers it “decisive to substantially increase public investment in public health services, improving response capacity, working conditions and care”. In this sense, it specifically proposes, among other measures:
– Develop the National Health Service (SNS) as a universal, general and free service, ensuring public management of all its units
– Guarantee a family doctor and nurse for the entire population, as well as the existence of medical consultations in other specialties in primary care
– Standardize a single USF operating model throughout the country
– Expand the public response in continued care and palliative care, ensuring the response to needs throughout the territory
– Ensure the availability of necessary medicines, reducing costs for the population, guaranteeing free access for chronically ill people, those over 65 years of age and families with economic needs
– Strengthen mental health care
– Ensure accessible oral health care for the entire population
– Encourage the establishment of professionals in needy areas through a specific early retirement scheme and the granting of support for housing expenses
– Increase the hospital capacity of the NHS
BE
For the Left Bloc, it is necessary to reform the SNS, with more investment, better conditions to attract and retain professionals and the development of their skills. He defends it like this:
– Doctor and family team (with auxiliary health technicians) for all people
– The creation of an “exclusivity regime, with a 40% increase on salary, without prejudice to supplements provided for by law, and 50% on points for career progression”, to retain health professionals
– Review and expansion of support for fixing in needy areas
– The immediate opening of competitions to hire the necessary staff and the reduction to 12 hours of the weekly emergency hours required of doctors, freeing up the remaining time for consultations and surgeries, so that these “are carried out on time”
– Equip health centers with the necessary resources to collect biological samples and complementary diagnostic means, namely X-ray and electrocardiogram
– Hire dentists, psychologists and nutritionists in sufficient numbers
– Strengthen reimbursement for medicines, glasses and hearing aids
– Adapt the SNS Budget to the “real needs of the population” and “create a multi-annual investment plan associated with a national health equipment charter”
– Repeal legislation that “opens doors to new public-private partnerships in the NHS” and that “allows the privatization of primary health care”, in addition to regulating the functioning of the private sector.
Regular
Livre's proposals aim to strengthen and reorganize the National Health Service, enhance the careers of its professionals, prevent disease and humanize healthcare, as well as a particular investment in mental health. The party specifically proposes, among other measures:
– The redefinition of the objectives of the SNS “with clear metrics for improving the state of the population” and the professional reward for compliance, as well as the evaluation of results in the quality of healthcare provision
– The reduction to less than 1.500 in the number of users per family doctor, to allow “effective monitoring” of people
– The increase in a sufficient number of services such as diagnostic exams, physiotherapy, mental health and others that can prevent the disease and minimize the need for emergency services
– The generalization of fixed teams of differentiated professionals in emergency services and with hospital contracts, avoiding resorting to service provision
– Ensure the public management of the SNS, safeguarding the quality and efficient response of services, and not renewing Public-Private Partnership contracts that are still ongoing
– Increasing capacity for continued care (including convalescence, recovery, rehabilitation and reintegration) and strengthening home hospitalization and home palliative care teams
– Guarantee the career progression of healthcare professionals and consider a salary supplement for annual bonuses based on team results
– The development of a National Fertility Support Plan and ensuring that the right to Voluntary Termination of Pregnancy is guaranteed throughout the national territory
– Combat discrimination and the stigma of mental illness, as well as “make mental health a priority of all public policies” and promote mental health, namely the development of socio-emotional and cognitive skills in children and young people, in educational establishments.
Comments