- Authors: Jorge Simões, Inês Fronteira, Gonçalo Figueiredo Augusto
- Publication Year: 2021
- Journal: Health Policy, 125(1), pp 1-6
- Link: https://doi.org/10.1016/j.healthpol.2020.11.005
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ABSTRACT
The Portuguese National Health Service (NHS) was established in 1979. Since its inception, the relationship of the NHS with private-for-profit and private-non-profit organisations has been controversially discussed between left and right-wing political parties, and this has also led also to academic debate. In 1990, a Health Basic Law was approved by right-wing parties, which allowed public-private partnerships (PPPs) in the health system and led to an increased role of the private sector in health care provision. During the 2015 general elections, the role of PPPs in the health system was an important topic of discussion, with all left-wing parties calling for an end of PPPs in the NHS. In 2019, after two years of intense political controversies, left-wing parties supporting the minority socialist government approved a new Health Basic Law. This paper analyses the process of policy formulation, tracing the process of adoption and the views of the main political parties involved.
Although some parties wished to eliminate PPPs and to mandate that services in the NHS should be provided exclusively by public providers, this was not included in the final version of the law. Nevertheless, the new Health Basic Law re-enhances the central role of the NHS in the health system, clarifying that the private and non-profit sectors should only play a complementary role.
HIGHLIGHTS
- • The 1990 Health Basic Law encouraged private sector development.
• Following the 2015 elections, political debates questioned the role of Public-Private Partnerships (PPP) in the health system.
• 2019 Health Basic Law re-enhanced the role of the public sector.KEYWORDS
Health system; Portugal; Private sector; Public-private partnerships.