Government Revives Controversial Health PPPs: Are Private Hospitals Ready for a Fresh Start?

Government Plans to Reactivate Health PPPs

This month, the Portuguese Government announced its intention to reactivate public-private partnerships (PPPs) in health across five local health units. The Minister of Health and the Minister of Finance have been authorized to spend €100,000 to initiate procedures for launching PPP tenders in health units located in Braga, Loures, Vila Franca de Xira, Amadora-Sintra, and Garcia de Orta (Almada).

Concerns from Private Hospitals

During a press conference in Lisbon, Óscar Gaspar, President of the Portuguese Association of Private Hospitalization (APHP), welcomed the government's decision but expressed concerns over the traumatizing experiences from previous PPPs. He emphasized that the process is just beginning and will not be resolved in a few months. Gaspar highlighted the need for clarity on how the tenders will be launched and noted the significant changes in Portugal's health funding model, which now operates on a per capita basis rather than activity-based funding.

Historical Context of PPPs

Gaspar pointed out that the previous PPPs were a positive example in Portugal, having delivered four new hospitals with investments exceeding €460 million and managing over 1,600 beds. He stated that during the period of PPPs, there was no disruption in health services, contrasting with the current issues faced in hospitals of the National Health Service (SNS).

A Cautious Outlook

Despite acknowledging the past success of PPPs, Gaspar admitted that private hospitals emerged "traumatized" from the experience due to the high level of litigation and political disputes surrounding them. He stressed the importance of learning from these experiences to ensure better future outcomes.

Financial Implications

The 2024 State Budget allocated €86.4 million for contingencies related to PPPs, an increase from previous years. This funding is justified by the challenges faced in hospitals of Braga, Loures, Vila Franca de Xira, and Cascais, the latter being the only hospital currently operating under this regime.