The plea comes as we reach the midway point of the final week of the campaign: Parties poised to form the next government in Portugal, whether the Socialist Party or the Democratic Alliance, should consider health as a matter of state, not a sectoral battleground, stated the former Health Minister.
In remarks made to the news agency Lusa on the sidelines of the Health Re:Design Summit, hosted today at the Rectory of the NOVA University Lisbon, the expert argued that such a strategic understanding would be more crucial and effective than treating health as a confrontational issue or political weapon.
“As we witnessed yesterday, using everything, even manipulating what is an entirely acceptable and understandable trend in the variation of the infant mortality rate, it was envisaging the future,” said the official to Lusa. He pointed out that the infant mortality rate in 2018 was 3.3, higher than the 2024 rate of 3.0, which was disclosed on Monday.
The former Health Minister, who served from 2015 to 2018, emphasized the need for “more strategy and less conjecture,” highlighting that healthcare spending is currently “out of control.”
“Paulo Macedo [former Health Minister] and I had 9 billion euros to manage the SNS [National Health Service budget for 2025 is over 16 billion euros]. It’s true there was a pandemic, and it was necessary to update the remuneration of underpaid professionals, but we are not allocating resources proportionally to what we are extracting from the system,” he claimed.
For the former minister, “this provides ammunition to those who argue that the SNS is unsustainable and should therefore be privatized.”
“It also fosters the perception that the public sector is indeed incapable of delivering value on the investment citizens make through taxes,” he added.
On the relentless increase in drug spending—SNS hospitals experienced a 15% increase, reaching 1.9374 billion euros in the first ten months of 2024—he advocated for better negotiations with the pharmaceutical industry to ensure the sustainability of the system while not hindering access.
“We cannot deny access to good medicines and innovative therapies, but our relationship with suppliers must be highly demanding,” he noted.
He illustrated, “President Trump, widely criticized for his erratic actions, recently announced an average 80% reduction in medicine prices in the United States due to their growing unaffordability for citizens.”
He argued that the pharmaceutical industry “must cooperate with states on the social dimension of health.” “This necessitates strong governments engaged in robust dialogue, backed by a strong regulator, not a passive outlook, as passivity leads to spending surges that the country cannot bear.”
“Should the economy slow as anticipated (…), 20 billion euros in health would be hard to integrate into the State Budget, especially with increased financial allocations to defense, as well-known,” he remarked.
Adalberto Campos Fernandes, an adjunct associate professor at the National School of Public Health, recalled that the UK established the role of NHS executive director in 1985, yet today the system stands “on the brink of collapse.”
He criticized the establishment of a similar structure in Portugal, advocating for the executive director to be part of the Central Administration of Health Systems (ACSS).
“Why are we inventing this? The system, despite everything, is growing and yielding results, notwithstanding the unintended errors we all—myself included—make,” he asserted.
