Health Systems in Transition

Health systems in transition

Portugal

patients’ rights defence, quality of health care provision, economic

regulation, and promotion of competition in the health care sector

(see section 2.4).

2.1.2 Ministry of Finance

The creation of new staff positions within the NHS, whether hospital-based or

not, requires the approval by the Ministry of Finance. The proposals presented

by the Ministry of Health in this regard are included within the government’s

budget (which includes the NHS budget). The government’s budget is discussed

and approved afterwards in the parliament (see section 3.3.3), which potentially

limits the scope of the Ministry of Health and its agencies to make changes

towards more coherent patterns of service delivery and staffing.

2.1.3 Ministry of Labour, Solidarity and Social Security

This Ministry is responsible for social benefits such as pensions, unemployment

benefits and disability benefits. In 2000 social security expenditure in Portugal

corresponded to 9.6% of GDP, but in 2013 this percentage had risen to 26.9%

(DGSS, 2015). The Ministry’s collaboration with the Ministry of Health has

improved in recent years. Joint projects include a review of certification for sick

leave, a programme to improve coordination between health care and social

services, and an initiative to improve continuity of long-term care for the elderly

and people with disabilities. For more information on the relations between the

two ministries in the long-term care network, see section 3.6.

2.1.4 Ministry of Science, Technology and Higher Education

This Ministry is responsible for undergraduate medical, nursing and allied

health professionals’ education and for academic degrees. However, specialized

postgraduate medical training is the joint responsibility of the Portuguese

Medical Association (

Ordem dos Médicos

) and the Ministry of Health.

Specialized training in other health professions is, in general, within the scope

of the Ministry of Health and, in some cases, of professional associations

(e.g. nurses).

2.1.5 Local government

There are a number of initiatives being undertaken in cooperation with the

municipalities, such as promoting greater traffic and pedestrian safety, and

encouraging physical exercise. Nutrition is also being promoted in close