Dermatology teams at Lisbon’s Santa Maria Hospital must return more than €800,000 in payments received unduly for surgeries performed as “additional production,” according to the Inspectorate-General for Health Activities (IGAS).
IGAS said that a selected sample of 511 surgical episodes resulted in total payments of approximately €901.851,11, of which €818,756.11 was paid unduly.
These amounts will have to be reimbursed by all team members who received payment for surgeries performed as additional production outside normal working hours.
The amounts were paid in accordance with authorisations granted by the Board of Directors of the Santa Maria Local Health Unit between 2021 and 2025.
IGAS said it would monitor the recovery process, which is already underway, to ensure the hospital adopts all necessary procedures to ensure the effective and full recovery of amounts.
More than 20 professionals are involved in the case, including Miguel Alpalhão, the dermatologist at the centre of the case, who received €700,000 over three years for additional surgeries at Santa Maria.
In February, Expresso reported that the management of Santa Maria Hospital had asked the professionals involved in the additional dermatology work to return the amounts unduly received.
CNN Portugal followed the story up in May – and in its October audit reports, IGAS stated that Miguel Alpalhão had unduly received ‘incentives’ for surgeries he had coded – some of which were oncological.
It was also alleged that the doctor scheduled dermatology appointments for his parents without prior referral, subsequently creating the surgical proposals and performing the operations himself.
In its analysis of the period between 2021 and the end of the first quarter of 2025 within the Dermatology Department at Santa Maria Hospital, IGAS said that the surgical proposals “were not entered into the Integrated Management System for Surgery Patients (SIGIC) at the time of the consultation, only being recorded on paper, which distorted the list of patients registered for surgery, as it did not reflect the order of priority”.
According to IGAS, Alpalhão issued and approved 450 surgical proposals and, on 356 occasions, issued, approved, and coded the same surgical procedure – a practice prohibited by the Board of Directors in August 2024.
IGAS concluded that the clinical procedures analysed in the sample were indeed carried out, but the procedures “could not have been reimbursed through the SIGIC, as they did not fall within its scope”, but rather through another form of payment, such as overtime.
Miguel Alpalhão is no longer working at Santa Maria, where he was employed under an individual employment contract.
In a letter published in November, he said that he had carried out his duties and obligations “in accordance with instructions from senior management and the procedures in force” at the hospital, criticising the management of Santa Maria.
“Hold to account those who made the rules and ordered the procedures, not those who complied with them, as contractually obliged,” he said.
Lusa concludes that Miguel Alpalhão’s defence arguments “were completely disregarded”.
Giving a slightly different version of the story, CNN Portugal has suggested the lion’s share of the repayments ordered by IGAS are expected to come from Miguel Alpalhão who “still has not returned a cêntimo. Responding to TVI/CNN Portugal, he rejects that he has to return any money to Santa Maria – and certainly does not need to return an amount superior to that which he was paid for additional work, effectively carried out.”
