The Health Spending Observatory intends to provide regular analysis on the dynamics of health spending in Portugal. This includes the analysis of the State Budget, financial arrears, and financing sources of the health system, among others. This policy brief investigates the forecasts of the 2024 State Budget for the Health sector. The Budget for 2024 increases the public health expenditure by 5,3% in nominal terms, relative to the budget execution estimate for 2023. However, more than half of that increase is related with price effects and the share of health spending in public expenditure decreases to 12,9%. The current forecasts for human resources expenditures and goods and services purchases may not be enough to meet existing needs. Unless credible mechanisms are implemented to penalize problems (inefficiencies) in management practices, it is not clear that the generalization of Local Health Units, which are financed through capitation payments, will result in greater budgetary control. 

You can now download the report in Portuguese here.

This report is part of the Social Equity Initiative , a partnership between Fundación ”la Caixa”, Banco BPI and #NovaSBE.

Author of the study: Pedro Pita Barros and Carolina Santos.

Key messages:

1. In 2024, public expenditure on health grows by 5.3% in nominal terms, compared to the estimated outturn for 2023. However, in real terms the growth is only 2.8%. Despite this increase, the relative weight of public health expenditure in the context of general government primary expenditure falls to 12.9%.
2. Unless credible mechanisms are implemented to penalize management problems (inefficiencies), it is not clear that the capitation financing system in the ULS will result in greater budgetary control.
3. The planned increase in personnel costs seems meagre, given the history of budget slippage in this area, the salary increases planned for the Public Administration and the measures to enhance health professionals that are expected to be implemented.
4. Expenditure on the purchase of goods and services (which includes medicines, complementary means of diagnosis and therapy, public-private partnerships and subcontracts) will, compared to the estimated outturn for 2023, grow by less than the inflation forecast for 2024. A major effort will therefore have to be made to control this expenditure, so that the outturn in 2024 does not exceed what was budgeted.