Health Systems in Transition

Health systems in transition

Portugal

pharmacists, veterinarians and architects. For all those where the Directive

does not apply, they must request the recognition of their diploma from the

Ministry of Science, Technology and Higher Education as well as the respective

professional association.

The ACSS also plays a role in career development and training of health care

professionals. For instance, in recent years collective labour negotiation with

doctors’ unions took place to achieve a new salary scale and the reduction of

supplementary work and external medical services, and to increase the doctors’

patient lists from 1550 up to 1900 patients.

4.2.2 Trends in the health workforce

According to the figures from the Portuguese Medical Association, the

number of physicians (physicians registered, including retired physicians)

per 1000 population is currently above the EU average (Portuguese Medical

Association, 2016). The situation regarding nursing staff is quite different.

The relative number of nurses in Portugal is well below the EU average. The

definition of tasks that can be performed by nurses and by physicians probably

contributes to this lower ratio. Still, recent years have witnessed a movement

towards a rebalancing of this trend, with a greater increase of nurses than

of physicians, and this is likely to continue in the future. One of the major

challenges for the next decade, not yet translated into policy actions, is the

redefinition of roles for health care professionals.

In 2015, there were 54 467 active members of the Portuguese Medical

Association (Portuguese Medical Association, 2016), whereas in 2014 there

were 25 246 physicians employed by the NHS – 816 more doctors (+3.3%) than

those working in the NHS in 2013 (ACSS, 2015). GPs, working in primary care,

accounted for 29.5% of the total number of physicians in the NHS, 69.0% were

hospital physicians, and 1.5% were public health specialists. After witnessing

a very rapid increase in the number of doctors during the 1970s and 1980s

(from 95 doctors per 100 000 population in 1970 to 283 per 100 000 in 1990),

since 1990 Portugal has maintained the increasing trend in the number of

physicians but at a lower rate (Fig. 4.2). In 2014, there were 443 physicians per

100 000 population, higher than the EU average (350/100 000) (WHO Regional

Office for Europe, 2016).