PPP have allowed in the past Portuguese and foreign private entities to invest and operate healthcare infrastructures and facilities in Portugal, reducing public spending in new hospitals and improving the service and management levels of the Portuguese healthcare system.
The healthcare sector played a relevant role in the establishment of Public/Private Partnerships (“PPPs”) in Portugal. It promoted new ways of sharing risk for healthcare care investments and new management experiences. It allowed private investors participation in the design, construction, financing and operation of hospital units within the National Healthcare Service (“SNS”).
Although the investment and operation of these units was undertaken by a private partner, SNS beneficiaries maintained the same access rights and privileges to clinical services as in any other public hospital.
On the other hand, PPP also had a positive impact on the running of the SNS by providing a benchmark for the operation of public hospitals.
All started with Amadora Sintra hospital, back in 1996. Unlike the other PPP’s that followed, all derived from the design, build, finance and operate model, the Amadora-Sintra hospital was built and financed by the SNS to be operated by a private company, José de Mello Saúde S.A., under a management and operation agreement.
The other Portuguese hospitals currently under a PPP regime are: (i) Loures Hospital (serving approximately 278,000 inhabitants), (ii) Braga Hospital (serving approximately 365,000 inhabitants), (iii) Cascais Hospital (serving approximately 285,000 inhabitants), and (iv) Vila Franca de Xira Hospital (serving approximately 245,000 inhabitants).
According to the Portuguese healthcare Regulatory Authority (Entidade Reguladora da Saúde), PPP hospitals have shown a high level of quality regarding to the services provided, with a special mention of the Hospital of Braga and the Hospital of Vila Franca de Xira.
On 1 August 2017, the Portuguese healthcare Secretary of State announced a new hospital in Lisbon, to be built as a PPP, establishing a possible new opportunity to interested healthcare industry private investors. The public tender for its construction is expected to be announced soon.