Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal.
Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal.
Health Policy. 2021 Jan;125(1):1-6. doi: 10.1016/j.healthpol.2020.11.005. Epub 2020 Nov 6.
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.
葡萄牙国家卫生服务局（NHS）成立于 1979 年。自成立以来，NHS 与营利性私立组织和非营利性私立组织之间的关系一直是左右翼政党之间有争议的讨论话题，这也引发了学术辩论。1990 年，右翼政党批准了一项卫生基本法，允许在卫生系统中建立公私合作伙伴关系（PPPs），并导致私营部门在医疗保健提供方面发挥更大的作用。在 2015 年大选中，卫生系统中 PPPs 的作用是一个重要的讨论话题，所有左翼政党都呼吁结束 NHS 中的 PPPs。2019 年，在经历了两年激烈的政治争议后，支持少数派社会党政府的左翼政党批准了一项新的卫生基本法。本文分析了政策制定的过程，追溯了通过过程和主要政党的观点。尽管一些政党希望消除 PPPs，并规定 NHS 中的服务应由公共提供者独家提供，但这并未包含在法律的最终版本中。尽管如此，新的卫生基本法重新增强了 NHS 在卫生系统中的核心作用，明确规定私营和非营利部门只能发挥补充作用。
