Health Systems in Transition

Health systems in transition

Portugal

sector. It is responsible for conducting, coordinating and promoting

health research at the Ministry of Health. It also has the objective of

producing evidence for policy and action in public health. Currently, the

National Institute of Health is organized in six departments: Food and

Nutrition; Infectious Diseases; Epidemiology; Genetics; Health Promotion

and Chronic Diseases; and Environmental Health. All operative units

composing the departments develop multidisciplinary programmes

in problem-areas of public health, namely: performing research and

development (R&D), health monitoring, training, laboratory external

quality assessment and general health services.

•

Regional Health Administrations (

Administrações Regionais de Saúde

RHAs)

, which are responsible for implementing national health policy

regionally, and coordinating all levels of health care. The NHS, although

centrally financed by the Ministry of Health, has had a regional structure

since 1993 comprising five health administrations: North, Centre, Lisbon

and the Tagus Valley, Alentejo, and Algarve. A health administration

board, accountable to the Minister of Health, manages the NHS in each

region. The management responsibilities of these boards are a mix of

strategic management of population health, supervision and control of

hospitals, and centralized direct management responsibilities for NHS

primary care.

The RHAs work in accordance with the principles and directives

issued in regional plans and by the Ministry of Health. Their main

responsibilities are the development of strategic guidelines; coordination

of all aspects related to health care provision; supervision of hospitals

and primary care management; establishment of agreements and

protocols with private bodies; and liaison with government bodies,

religious charities (

Misericórdias

), other private non-profit-making

bodies, and municipal councils. They are also in charge of developing

a long-term care network.

•

Hospitals belonging to the Public Administrative Sector (

Hospitais

do Sector Público Administrativo

)

, which currently are a minority

of public hospitals that were not converted into Public Enterprises

(

Entidades Públicas Empresariais

, EPE). In other words, these are public

institutions without an enterprise status and continue to be managed by

civil service rules.