Current political agenda combines the expansion and reorientation of policies initiated by previous governments (hospitals as public enterprises, PPPs, promotion of generic drugs) with a new philosophy concerning the role of the pubic, private and social sectors. The Portuguese health system is now thought as a network of health care delivery services belonging to any of the sectors referred to above. Citizens will be allowed to choose among them according to their need and preferences. Public financing will be available to support these demand patterns, within the limits of the agreements establishes between the Ministry of Health and the health care delivery services chosen.

Government has moved rapidly and decisively in passing reform legislation and initiating is implementation:

·         Access to health care: surgical waiting lists and "personal physician". Access to health care is seen as a trop priority. The surgical waiting list program was redesigned in order respond to more ambitious objectives (ending waiting lists in the short run). It extended its scope to a larger number of surgical procedures, promotes a more intense use of private and social (non-for-profit) services, and improves the extra-pay to NHS services and staff engaged in the surgical waiting list program. A new emphasis is placed on the notion of "a personal physician" (with different training backgrounds) for everyone, as a response to the incomplete coverage of GP services now observed in the country.  

·         Big Bang in hospital entrepreneurism. Legislation which introducing changes in  hospital management was adopted in September 2002. From January 1, 2003, approximately 30% of Portuguese public hospitals (corresponding to close to 50% of public sector's bed capacity) become "public enterprises". A special mission team was established to support managerially this process of change.  

·         Public-Private-Partnerships (PPPs) for all new public hospitals. The Ministry of Health has announced that 10 new hospitals expected to be constructed over the next few years will become PPPs - private investment, public financing, private management (including clinical services) and public ownership.

·         Primary Health Care reform. Government has adopted new legislation on health centre organisation which includes the possibility of health centres being managed by professional cooperatives, the private for-profit sector, or the social non-for-profit sector. GP's organizations as well as medical unions and associations have expressed strong opposition to this reform.

·         Drug policy. The Ministry of health has been very active n the area of drug policy. Strong emphasis has bee placed in generic drugs prescription coupled with reference pricing and drug prescription using the international common designation (ICD). There is already evidence that, following these initiatives, the generic market share expanded rapidly and considerably, and there is at least in the short run a decrease of public expenditures on pharmaceutics.  

·         A new health regulatory entity. Having in mind the expected development of a new kind of public-private-social mix in health care delivery, the Ministry of health has announced the establishment of a new "regulatory entity" for health.   

·         A new health strategy. Preparatory work is taking place in order to design and implement a new "strategic plan" for health with a 10 years horizon. A broad process of internal consultation has been initiated. External consultation, with WHO's support, is also taking place in order to take advantage of in other European countries experience in this area.

The current government programme also focuses on reorganizing medical emergencies, further developing long term care infrastructures, a pricing system for paying publicly financed health care delivery, financial incentives in order to increase productivity in the public sector, public information concerning the performance of public hospitals and health centres, and fiscal incentives for development of private health insurance.  A NHS "contact centre" for the public has also been announced.