Health Systems in Transition - Portugal

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Health systems in transition Portugal 32
of 1 June 2015) (see section 2.4.3, Health technology assessment ). The
Court of Auditors, a body responsible for supervising all public revenues
and expenditures, which can launch legal proceedings for bad management,
conducts periodic external auditing to several public bodies, including the NHS,
and in recent years has produced some critical reports. These reports have
looked at the overall public health expenditure as well as giving a comparison
across hospitals. Since the year 2000, a few major auditing reports have been
drawn up. These analyses have highlighted major organizational and financial
problems and have made recommendations.
Created in 2003, the HRA arose in the broader context of a regulation and
supervision system based on the principles of segregation of the state’s duties
as regulator and supervisor, operator and funder, and of independence of the
regulatory body. The HRA’s competencies include regulation and supervision
of health care institutions and services, regarding their legal and contractual
obligations concerning patients’ access to health care, quality of health care
provision, patients’ safety, and patients’ rights. HRA aims to guarantee enough
competition between health care providers and to protect the citizens’ right to
universal health care coverage.
Current HRA’s status, approved in 2014, has broadened the institution’s
competencies, namely concerning patients’ complaints, licensing of institutions
operating in the health care sector, and conflict resolution (see section 2.4.1).
Recent examples of the HRA’s work include:
• a study comparing the performance of two co-existing types of primary
care units within the Portuguese NHS: Family Health Units (Unidades
de Saúde Familiar, FHUs) and Personalized Health Care Units (Unidades
de Cuidados de Saúde Personalizados, PHCUs) (ERS, 2016a);
• a study evaluating the access to health care by immigrants in Portugal
(ERS, 2015a);
• a study aimed at analysing patients’ access, quality of care and
competition among providers in long-term and palliative care markets
(ERS, 2015b);
• a new report on health insurance, describing the existing complementary
types of health care financing in Portugal, more specifically VHI health
subsystems (ERS, 2015c);
• a study on access and quality in mental health services (ERS, 2015d);