The Public Finance Council (CFP) has identified potential budgetary risks in its report on the performance of the National Health Service (SNS) over the past year. The report highlights that the limited diversification of funding sources, as outlined in the Health Basic Law, “may restrict the SNS’s ability to respond to emerging crises or unforeseen needs”.
Total revenue for the SNS reached 14.175 billion euros in 2024, a 4.1% increase from 2023, with state budget taxes being the main source of funding, accounting for 95% of total revenue.
“Considering the average growth rate of public health expenditure (5.8% between 2015 and 2024) and the increasing needs arising from an aging population, it is evident that exploring strategies to promote greater diversification in SNS funding is crucial to ensuring its long-term sustainability,” the CFP warns.
The independent entity that oversees compliance with budget rules and public finance sustainability notes that the “sharp growth” in SNS expenditure, particularly in personnel and hospital medications, also poses a challenge for both the “system itself and public finances”.
The document emphasizes that this pressure is exacerbated by structural factors such as population aging and therapeutic innovation, as well as recent commitments made by the Government with healthcare professionals.
Recent agreements with unions “indicate a continued increase in personnel expenses due to their multi-year nature”, with an average increase of 24% for nurses from 2024 to 2027 and 10% for doctors from 2025 to 2027, in addition to the revision of the pre-hospital emergency technician career agreed upon in March, the report notes.
The CFP indicated the necessity for “effective management and review of SNS expenditure” in 2024, promoting efficiency gains and ensuring the allocation of adequate financial resources in the initial budget to avoid deficit situations and payment delays.
“To consolidate the financial sustainability of the SNS, it is essential to implement the public financial management instruments foreseen in the Budget Framework Law,” the report emphasizes, further warning that Portugal continues to show investment levels in the SNS below the European Union average.
