Public/Private Partnerships in the Health Sector

Profession:Macedo Vitorino e Associados
 
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Introduction

The Portuguese government has announced that, during the year 2003, five new hospitals (Cascais, Sintra, Loures, Vila Franca de Xira and Braga) would be built, financed and oeprated under public/private partnerships. At a second stage, tenders for the construction, financing and operation of five additional hospitals will be issued.

Under Decree-Law 185/2002, of 20 August 2002, on public/private partnerships in the health sector (Lei das Parcerias Público-Privadas no Sector da Saúde - the "SNS Public/Private Partnerships Law"), private companies will be allowed to build and operate hospitals within the National Health Service (Serviço Nacional de Saúde - "SNS").

The public/private partnerships in the health sector will allow private entities to invest and operate healthcare facilities that will be part of the SNS, providing medical services to SNS beneficiaries, with the aim of reducing public spending in new hospitals and improving the service quality and management.

It is expected that public/private partnerships will have a positive impact in the SNS by providing a benchmark for the operation of public hospitals.

Health sector in Portugal

The SNS Public/Private Partnerships Law establishes three types of management for healthcare facilities within the SNS:

Hospitals under SNS direct management. Most Portuguese hospitals are owned, managed and operated by public bodies within the SNS, which was responsible for commissioning the construction of the facility. Hospitals under public management are financed by the government budget, although each hospital may enter into contracts with equipment and medical supplies.

Public hospitals under independent public management. Under this model, public hospitals are operated by separate legal entities, having their own budget and legal capacity to operate the hospital under the supervision of the SNS. With the purpose of establishing a more flexible and efficient management structure than hospitals ran directly by the SNS, the government established an independent management system in the São Sebastião Hospital, in Santa Maria da Feira through Decree-Law 151/98, of 5 June 1998. The São Sebastião Hospital is operated as a separate legal entity managed by a board of directors with the power to propose the hospital's investment and operating budget and the responsibility to manage the government's grants under a specific contract with the SNS. In this model, the SNS has less of a managerial function and more a supervisory role...

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