Study shows SNS health service suffered “third largest decline in decade”
The sustainability of Portugal’s SNS state health service has fallen for the third consecutive year.
A study released today shows that the 2024 dip was, in fact, the third largest decline of the decade, surpassed only by 2020 – the year of the Covid pandemic.
Sustainable Health Index, developed by NOVA Information Management School (NOVA-IMS), indicates that the sustainability of the SNS, measured on a scale with a base level of 100 points, fell from 84.8 points in 2023 to 79.9 points in 2024.
During the pandemic year sustainability fell from 101.7 in 2019 to 83.9 in 2020. (Without the effect of the pandemic, the figure reached in 2020 would have been the highest level of sustainability ever (103.6), adds Lusa).
Speaking to the state news agency, study leader, Pedro Simões Coelho, points out that the trend was already underway: “Once again, this (latest fall) is justified by a drop in productivity, understood as the relationship between activity and expenditure”.
“Activity grew at a rate, we estimate, of 1% and expenditure grew at a rate of over 10%. When this happens, productivity falls. If productivity falls, the index falls,” he explained.
The data collected, which will be presented today at the Belém Cultural Centre (Lisbon), pointsto an 11% increase in expenditure in 2024, which, not being accompanied by an equal increase in activity (which only grew by 1%), results overall in a fall in productivity – measured by the number of patients treated per €1 million of expenditure – which reached its lowest figure in the last 10 years (185).
Pedro Simões Coelho stressed that the Sustainability Index “has not fallen due to quality, on the contrary, quality has stabilised and even shows a slight upward trend; nor has it fallen due to accessibility, which has also seen slight increases, both from a technical point of view and from the point of view of citizens’ perceptions and feelings. It was exclusively due to this relationship between the growth in expenditure and the growth in activity.
“Technical and perceived accessibility”, which assesses access to healthcare, showed a slight improvement compared to 2023.
For example, first consultations within an adequate time frame, those on waiting lists, accident and emergency department visits attended within the expected time frame and use of available home hospitalisation capacity, rose from 49.7 points to 51 points, albeit it still remains “one of the weakest aspects of the system”.
The study also compares data from 2018 to 2024, concluding that expenditure grew by more than 50% (from around €10 billion to €15.55 billion) and activity grew by less than 10% (from 2.66 million to 2.85 million patients).
In these six years, the sustainability index fell from 102.9 to 79.9, and the effectiveness of the SNS from 73.3 to 70.9.
“We could even say that this year in particular there are justifications for this, because this was the year [2024] in which there was an enhancement of the careers and salaries of health professionals. Therefore, there is an increase in expenditure that is induced by this enhancement of professionals, which had long been desired, and this does not have an automatic effect on the system. (…)”.
“The greatest attraction in the future, greater capacity for creation, greater involvement (…). Basically, the effect of this enhancement in terms of expenditure will be seen as early as 2024, but its positive effects will only be seen in a few years,” Simões Coelho added.
The study leader also stressed the reduction in overdue debt as a positive point. This fell again in 2024 (-35%), from €0.45 billion to €0.29 billion, continuing the downward trend of recent years. Data collected also shows a reduction in the deficit (-217%).
“This is a very positive note because, in the past, the Portuguese State would have transferred expenditure to suppliers, but this is no longer the case. Suppliers have not been financing the deficit; on the contrary, this debt is getting lower and lower, so this is a positive note, along with the fact that we have good levels of quality and accessibility, which are not so good, but in any case, they are showing a slight upward trend,” he concluded.
Source: LUSA
