Introduction
New NHS statute
End of covid-19 restrictions
Promoting access to medicines and innovation


Introduction

2022 stood out as a year marked by a focus on development and concern for the healthcare sector. On the one hand, the global life sciences industry is evolving at an extraordinary pace, driven primarily by the covid-19 pandemic. Healthcare is undoubtedly one of the central sectors of the post-pandemic economic recovery, and investors have not turned a blind eye to this fact.

On the other hand, covid-19 also emphasised the need for healthcare and pharmaceutical systems to be prepared and respond quickly to crises and adversities, including at the legislative and regulatory level. Thus, and to a certain extent still as a consequence of the covid-19 pandemic and the shift in the priorities that followed, the concern and commitment of the Portuguese state in this area proved to be significant, as was the case in 2020 and 2021.

This article provides an overview of some of the main developments that took place in the Portuguese healthcare sector in 2022.

New NHS statute

2022 was an important year in terms of the evolution of health legislation in Portugal. Decree-Law No. 52/2022 of 4 August 2022 was approved, defining the new statute of the National Health Service (NHS).

Since 1979, with the publication of Law 56/79, the Portuguese public health system has been universal and (mostly) free of charge. However, only now – 43 years after its creation – has the NHS received a new statute, which intends to:

  • improve the efficiency and effectiveness of the NHS;
  • give more autonomy to hospitals and other health institutions; and
  • provide greater motivation for its professionals.

This legislative measure, which was under public consultation for a two-month period, updates:

  • the definition of the NHS;
  • the list of its establishments and services;
  • the rights and duties of its beneficiaries;
  • its territorial and functional organisation; and
  • the rules relating to its human and financial resources.

Moreover, it provides for the creation of an executive board, which means that the NHS is now managed centrally. This body is expected to handle the most difficult challenges, such as reducing waiting times.

The new statute also creates the "full dedication" regime, which aims to contribute to the retention and motivation of health professionals in the NHS. Doctors who join the full dedication system, which will be voluntary, will have to commit to care goals and will be prevented from performing certain professional functions. In effect, this regime is incompatible with the exercise of functions of technical direction, coordination and leadership in private institutions and in the social sector of healthcare provision, and does not consider as such the medical practices of individual professionals. The counterpart to this commitment is a series of perks and benefits. At the moment, this system only applies to doctors, but the idea is to later extend it to other categories of health professionals.

Additionally, this legislation grants more autonomy to hospitals and health institutions, which now have more autonomy to hire workforce and to invest. With the new rules, only amounts above €2.5 million included in business plans submitted to the supervisor require an approval by the Minister of Finance

End of covid-19 restrictions

2022 was defined as the end of the pandemic era, in the sense that it officially ended the exceptional regimes of emergency that were in force in Portugal during the pandemic period, such as the state of emergency and the state of alert. Thus, restrictions on fundamental rights, such as freedom of movement, finally came to an end.

Decree-Law 66-A/2022, of 30 September 2022, revoked the decree-laws issued in the context of the covid-19 pandemic, ending the mandatory use of hygienic protective masks in almost all places.

In fact, this obligation currently remains only in:

  • health service establishments;
  • residential or care facilities; and
  • homecare services for vulnerable, elderly or disabled people.

In addition, the state reimbursement of rapid antigen tests for professional use, which began in November 2021 and lasted until September 2022, has also stopped, marking the end of the covid-19 era in this aspect as well.

Promoting access to medicines and innovation

The promotion of a mechanism for the automatic renewal of prescriptions for chronically ill patients was analysed and discussed in detail during 2022, and was even included in the Portuguese State Budget Report for 2023, under the measure "promoting access to medicine and innovation".

Allowing prescription renewal by other health professionals aims to:

  • achieve greater efficiency and better health due to fewer interruptions in therapeutics;
  • reduce unnecessary medical consultations; and
  • simplify patients' lives by making access to prescriptions quicker and cheaper.

The contours of this mechanism will only be defined during 2023. They will have to be precisely regulated – the limits must be drawn objectively and cautiously in order to safeguard patient safety and due respect for the rational use of medicines.

For further information on this topic please contact Eduardo Nogueira Pinto or Rita Antunes da Cunha at PLMJ by telephone (+351 213 197 300) or email ([email protected] or [email protected]). PLMJ website can be accessed at www.plmj.com.