It’s not a popular budget. Nor “for the news”. Ana Paula Martins, Minister of Health, began her hearing in the Parliament’s Health Committee by saying that she is aware that the 10.3% reduction in the acquisition of goods and services from the National Health Service (SNS) is “a very demanding message for our managers”.
At issue is a significant cut – savings of 208 million euros – in medicines and clinical supplies in the 2026 budget for Health, accompanied by other cut, of around 29 million euros, in the contracting of professionals and external companies to meet temporary staff shortages.
Only the commonly called “tarefeiros”, doctors who work on task to make up for the lack of hired personnel, cost around 213 million euros to the public treasury in 2024, representing the largest share of the cost of external contracting.
Ana Paula Martins says that “a health service cannot depend on task work” and that this new phase, which comes from a “significant effort” jointly with the Ministry of Finance, is a “expenditure recalibration phase”.
In the explanatory note relating to the health area of the State Budget for next year it is expected to increase the number of surgeries by 1%, consultations in health centers by 1.5% and hospital consultations by 2.5%, in addition to the aim of increasing the number of people with a family doctor by 5%.
Opposition calls for more clarity
Mariana Vieira da Silva, deputy of the Socialist Party (PS), said that the government is writing a check without coverage with this state budget. And, after having requested to access the document containing the OE expenditure review, asked for clarification on what the document indicates are 886 million euros of promised savings next year.
The deputy mentioned the 23.9 million euros planned – 12 million in non-urgent transport of patients, 6.3 million in medicines and 5.6 million in medical devices – but said another 863 million still needed to be explained. “I really think it’s very important to know how these savings will be made and in what areas”, he noted.
Joana Cordeiro, from the Liberal Initiative (IL), accused Ana Paula Martins of a lack of clarity in the concrete explanation of the services that will suffer cuts next year.
“The minister cannot explain this 10% reduction”, said the IL deputy in parliament, asking for more details on the sectors where a spending cut is expected. “He’s been going around and still hasn’t been able to explain that they are [cortados] 15 million here and 10 million there.”
In response to deputies, the Minister of Health guaranteed that “there will be no shortage of what is needed for patients” and that, also in the area of medicines, “no patient will be left without medicines because of money”.
However, he gave some examples: “Anyone who has worked in a hospital knows that we can, with the same quality, buy surgical needles from one brand or another and achieve great savings,” he said.
Mariana Mortágua, deputy of the Bloco de Esquerda, focused her intervention on the issue of working doctors, to agree with the minister, on the one hand, on how “Taster workers are an efficiency problem for the SNS”and asking, specifically, whether the government is committed to saving the 100 million euros in hiring these professionals, as indicated in the approved document in the last Council of Ministers to “regulate” the hiring of these professionals.
Ana Paula Martins responded, saying that cannot guarantee reaching 100 million euros. “We would like to go a little further in the ordinance that will come out with the hourly rates. We are very dependent. In several areas of this country, also in the interior, we are very dependent. But we have to start somewhere”, he argued.
“Adequate monitoring of pregnant women is not being ensured”
The Communist Party (PCP) deputy, Paula Santos, focuses her intervention on the case of Obstetrics. With emergencies closing – the case of regional emergencies, which will start in the Setúbal Peninsula –, with more than a million users without a family doctor, “we fear a setback”, said the deputy.
“On the Setúbal Peninsula, 5,000 births are performed per year, on average”, recalls Paula Santos. “With only one emergency room open… Garcia de Orta Hospital does not have the capacity to carry out this number of births. In fact, not even the Alfredo da Costa Maternity Hospital carries out this number of births”, he also said.
“We are not closing emergency rooms. They are closed now”replied the minister, who has been questioned, in the specific assessment of the State Budget proposal, by several of the deputies because of the case of a 38-week pregnant woman who died in the early hours of Fridayat the Amadora-Sintra hospital, after a cardiorespiratory arrest.
“No, I’m not resigning”
Ana Paula Martins began by citing the information provided by the National Institute of Medical Emergency (INEM) and ULS Amadora-Sintra, to say that the 38-week pregnant woman, “a native of Guinea-Bissau”, was admitted to the emergency department at 1:50 am this Friday, transported by an INEM team, in a situation of cardiorespiratory arrest. He further informed that an emergency cesarean section was performed and that the baby has a “very poor” prognosis.
Directly questioned by deputy Marta Silva, from Chega, about whether she would resign in the face of this case, the minister refused to resign. “No, I’m not resigning”these.
Still during the debate, Inês de Sousa Real, from PAN, considered that the minister responded to this case in a “technocratic” way. In turn, Paulo Muacho, from the Livre party, accused Ana Paula Martins of adopting the “government’s discourse”, that “all problems are the responsibility of immigrants”, for having twice stated the nationality of the woman who died.
The minister recalled that she was also born in Guinea-Bissau and that she sees no problem in mentioning people’s place of birth when discussing specific cases. Regarding this case, he reinforced that the woman was not properly monitored during pregnancy, assuming that the same happens with many cases of less good outcomes in the area of obstetrics.