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Health systems in transition
Portugal
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Table 2.3
Patient choice
Type of choice
Is it available?
(Yes/No)
Do people exercise choice? Are there
any constraints (e.g. choice in the
region but not country-wide)? Other
comments?
Choices around coverage
Choice of being covered or not
No
NHS is universal.
Choice of public or private coverage
No
Private coverage is optional.
Choice of purchasing organization
Yes
Only in private sector.
Choice of provider
Choice of primary care practitioner
Yes
Only in private sector. In public sector,
patient’s choice is limited to availability
of practitioner in the primary care unit
related to the patient’s residence area.
Direct access to specialists
Yes
Only in private sector. In public sector,
access to specialists is done through
referral in primary care.
Choice of hospital
Yes
Only in private sector. In public sector,
hospital access is related to the patient’s
residence area. However, since 2016,
NHS users can discuss with their GP and
be referred to a different hospital within
the NHS, based on waiting times, for
particular procedures or outpatient
consultations.
Choice to have treatment abroad
No
Treatment abroad is conditioned to prior
evaluation by a medical board.
Choice of treatment
Participation in treatment decisions
Yes
It is a patient right.
Right to informed consent
Yes
It is a patient right.
Right to request a second opinion
No
Only in private sector.
Right to information about
alternative treatment options
Yes
It is a patient right.
benefit from this measure were pregnant women and pensioners who receive
social benefits, and since then it has been widened to include children with
decayed, missing or filled permanent teeth, when referred by their primary
care physician.
The programme of the current government pledges to make “progressively
available to citizens the possibility of choosing in what health care units they
want to be treated, considering technical hierarchy and referral rules within the
NHS” (Government of Portugal, 2015b).