It is perhaps the most Portuguese expression of all, the essential desire. “May there be health”, we Portuguese say, when money is lacking, love goes sour or the world seems to be falling apart. But this kind of pragmatic fatalism becomes almost an exercise in irony when we look at the Health sector and see it languishing for decades between political promises, improvisations and degradation of services that recur like seasonal flu.
The debate on Health in Portugal is chronically trapped in a vicious cycle of ideological and short-term political wars. Where the Left wants an almost exclusively public National Health Service, the Right touts the virtues of private and PPP. The ideological cleavage gains in this area a kind of preferential combat ground. Each government changes the course of the previous one, erases projects, changes directors, replaces teams and announces a “new era” that rarely lasts more than one legislative cycle.
The current case is exemplary. Luís Montenegro came to power a year and a half ago with promises of an “emergency plan” to straighten out the SNS in 60 days. If the goal might have sounded bold then, today it is just laughable: waiting lists have grown, emergency services continue to collapse, professionals are exhausted and more than 1.5 million users are still without a family doctor. Campaign enthusiasm is now giving way to embarrassed silences.
This week the debate was reignited, with the public intervention of the President of the Republic and the news about projected cuts to Health in next year’s budget.
Marcelo Rebelo de Sousa, who had been avoiding the topic for months, made, at the celebrations of the 50th anniversary of the Medical Service in the Periphery, the diagnosis that the Government did not want to hear (so much so that Minister Ana Paula Martins even canceled her presence): lack of strategy, decisions in the middle of the bridge and an SNS in a gray area. And he called for a regime pact, something as sensible as it is unlikely in a country where health serves as a party weapon.
The President spared the minister politically, but made clear the collective failure of the Government’s strategy, specifically pointing out that Luís Montenegro’s Executive chose to “not decide” by leaving the executive direction of the SNS – legacy of the Costa Government – “in the middle of the bridge”, with the dismissal of Fernando Araújo as a clear example of a policy of mere settling of accounts.
In addition to Marcelo’s diagnosis, there is the announcement of cuts of 886 million euros in goods and services in the health budget for 2026, lukewarmly justified by the minister in Parliament, which only suggests more shortages, more debts and a likely greater dependence on the private sector, as warned by the president of the Portuguese Association of Hospital Administrators, Xavier Barreto. All this when the threat of the “devil” in public accounts reappears on the horizon.
In a country that fails to politically translate the priority expressed in popular thought, perhaps we are left with fatalistic resignation: let’s be safe.