SNS waiting lists: Portugal pulls minor surgeries from the count as doctors cry foul
A new ordinance removes minor surgeries from Portugal's official surgical waiting list, and new payment rules have led hospitals to cancel extra operating sessions. Doctors call it artificial; the government denies it.
Surgical waiting lists in Portugal’s national health service are at the centre of a fresh clash between the Health Ministry and the medical profession — and this time the argument is not just about how long people wait, but about who officially counts as waiting.
What changed in the SNS waiting lists?
An ordinance published in late June rules that procedures classified as minor surgery no longer require registration on the official surgical waiting list, known as the LIC. In practice, around 300,000 patients awaiting a minor operation could vanish from the official list without having been treated. The Medical Association accuses the government of engineering an artificial reduction: the numbers shrink on paper while patients keep waiting, now outside the formal circuits of scheduling and prioritisation. The government insists there will be no cosmetic trimming of the lists and that patients will still be operated on, with these procedures paid as day-hospital or outpatient sessions.
Why are hospitals cancelling surgeries?
At the same time, the payment rules for so-called additional production — the extra surgery sessions run outside normal hours to shorten queues — have changed. In operations involving implantable devices such as prostheses, the cost of the material no longer counts towards the reference value used to calculate what surgical teams are paid. The result: since 1 July, several hospitals have cancelled additional surgery sessions, and doctors’ unions warn that patients are the ones footing the bill. The ordinance itself can be consulted in the official gazette, the Diário da República.
The standoff lands in a summer when the SNS was already under strain, with more than 1.6 million users lacking a family doctor. Between numbers that fall by decree and surgeries halted over the price of a prosthesis, this fight will be settled where it always is: in how long a patient actually waits for an operation.
Image: Ivendrell / Wikimedia Commons (CC BY-SA 3.0)