Health Systems in Transition - Portugal

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Health systems in transition Portugal 31
The Portuguese Constitution specifies that the economic and social
organization of the country must be guided, coordinated and disciplined by
a national plan. The national plan must ensure, for example, the harmonious
development of the different sectors and regions, the efficient use of productive
resources, and the equitable allocation of resources among the population
and between regions. As the NHS does not have its own central independent
administration, the Ministry of Health carries out most of the planning,
regulation and management functions of the NHS, which are centralized in
the ACSS.
Box 2.2
Evaluating priority-setting and planning
The government is in charge of health policy formulation and decision-making, whereas the
parliament has the role of supervision, as happens with other public policies. Traditionally, the
parliament and the media hold the role of monitoring and screening policy decision-making and
subsequent implementation of policies. Professional associations, particularly those of doctors as
well as patient groups, also play a role in shaping health decision-making.
Despite the existence of a National Health Plan that sets health priorities in terms of policies, the
government, taking into account the financial, political and social environment, can decide on
other health priorities, so giving the National Health Plan a secondary role. Nevertheless, having
a National Health Plan is considered important in terms of health strategy and guidance.
The Azores and Madeira, as autonomous regions, have, according to the Portuguese Constitution,
wide responsibilities for health care planning and management.
Regarding regulatory management mechanisms, the Portuguese health
system might be viewed as highly normative, with extensive legislative
provisions. There are, for example, numerous and sometimes very restrictive
controls over pharmaceutical goods, high-technology equipment, and
education, training and registration of health personnel (see sections 2.4.4
and 4.2.4, Doctors).
Established in 1993, INFARMED was reorganized in 1999 to meet the new
and reinforced EU regulations in the area of pharmaceuticals. It is responsible
for the regulation of pharmaceuticals and medical equipment, and supported by
the Pharmaceutical Inspection Service, the Pharmacosurveillance Service and
the Official Laboratory for Pharmaceutical Quality Control (see section 5.6).
In June 2015, the Ministry of Health launched the National System for
Health Technology Assessment (Sistema Nacional de Avaliação de Tecnologias
de Saúde, SiNATS), in the context of INFARMED (Decree-Law No. 97/2015,