The offered returns by the government were insufficient for desired profit margins, noted André Biscaia, emphasizing that these units are intended to facilitate the entry of international health groups into the Portuguese market.
Citing Public-Private Partnerships as examples, which he argued were less profitable than presumed, with some consultations not paid for, he remarked, “The government changes, priorities shift, and they are left with the project without salary adjustments or remuneration updates.”
“The risk is someone might accept a deal that doesn’t allow for profit margins, leading to quality cuts, as happened in the UK,” he warned.
Biscaia referenced a study from The Lancet regarding UK health units akin to the new model C Family Health Units the government plans to implement.
“Family doctors are expensive, so a new profession, ‘physician assistant,’ was created to support them,” he explained. These assistants underwent training for two years and initially handled triage and questionnaires but eventually started consultations and discharging patients, leading to increased treatable mortality.
The increase in treatable mortality is “directly related to the care provided,” he stressed, indicating the quality of care was lacking.
“The danger is price suppression, leading to quality cuts, which is the major risk,” he reiterated.
In September 2024, the government approved legislation for health centers managed by private, social sectors, and local authorities. Initially, 10 were planned for Lisbon and Tagus Valley, five in Leiria, and five in Algarve.
The health sector plan aimed to open bids for the first 20 model C Family Health Units in July 2024, intending to start operations by year-end, which did not happen.
