Key Challenges in Health Principais Desafios na Saúde

Abstract

The health systems are under great pressure from internal and external factors that demand constant changes to the governance model, the organisation of the system and funding to ensure its sustainability and equity; the adaptation to new situations cannot only be legislative, it basically has to be organisational, economic and pragmatic.

This article identifies changes in the Portuguese health system that have to be implemented urgently; first of all the clear and transparent separation of the different roles that the state plays with obvious inefficiency. The Health Ministry should focus its actions on strong, effective regulation and competent contracting of the services that it has to ensure, but not necessarily provide, from the public and private sectors. Likewise, the rationalisation of the offer, with diversification of the means of management of the public units is also urgent, namely with public-private partnerships that are a powerful benchmarking factor for the entire network and regarding which have been proven to provide value for money for the state.

The true inefficiency of our health service is unknown, but we do know there are gains to be made both in terms of system governance and in the architecture of the system and the improved performance of the provider units.