Summary
With Decree-Law No. 188/2003, of 20th August, the Government published a new model for the organization of public hospitals integrated in the national health service (Serviço Nacional de Saúde).
Following the enactment of the new Hospital Management Law (Law no. 27/2002, of 8 November 2002) a new organization model for hospitals integrated in the public healthcare network was published ("New Model").
- Objectives
- Management Structures and Organization
- Finance
The New Model aims to achieve several policy objectives, the most important of which are to obtain a decentralized and flexible structure, based on more autonomous and responsible top and middle management. The New Model also allows for a greater autonomy, and responsibility of the medical staff, and actively consents the introduction of incentives to increased productivity and quality.
Public hospitals shall have the following structure: (i) Board of Directors; (ii) Medical Board; (iii) Auditing structure; and (iv) Advisory Board.
The Board of Directors will have 4 or 5 members. The chairman, one or two executive directors and, as non executive directors, the hospital’s chief medical officer and the chief nursing officer. As in a regular company, the Board of Directors will be responsible for the overall management of the hospital.
The Chief Medical Officer and the Chief Nursing Officer Board form the Medical Board (also referred as Technical Management), which will be responsible for coordinating medical and nursing staff in the hospital, and to guarantee the quality of health care provided by the hospital.
Under the new regulation, all hospitals will have at least one auditor, which in units with over 200 beds, must be an independent chartered accountant. In hospitals over 500 beds, an auditing department must also be set up.
Representatives of the hospital staff (medical and administrators), as well as representatives of the local communities within the hospital catchment area will form the Advisory Board. This Board, whose chairman is appointed by the Minister of Health, will have as main attributions to advise the Board of Directors in all areas of activity of the hospital as well as to issue opinions on both budget and activity plans.
Public hospitals financing rules were also changed. From now on hospitals will be funded according to the services effectively provided. The price of each medical act and service will be set according to a Government Order.
Hospitals will be financed through yearly contracts entered upon with the Ministry of Health, establishing (i) the hospital objectives, according to the activity plans, (ii) service levels, and (iii) monitoring and performance evaluation methods. Performance incentives may also be included in the contracts.
© Macedo Vitorino e Associados – August 2003
This information is provided for general purposes only and does not constitute professional advice. If you have any question on a matter of Portuguese law you should contact a lawyer registered to practice law in Portugal. If you are a client of Macedo Vitorino e Associados, you may contact us directly at mva@macedovitorino.com or your usual contact partner.
