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Portugal Health Care
Health conditions in Portugal were long among the
poorest in
Western Europe. Recent decades saw substantial
improvements,
however, although Portugal still lagged behind most of the
continent in some categories of health care. Portuguese
life
expectancy at birth rose from sixty-two years for men and
sixtyseven for women in 1960 to seventy-one and seventy-eight,
respectively, in 1992. The country's infant mortality rate
in
1970 was 58 deaths per 1,000--one of the highest in Europe
and
close to Third World levels--but by 1992 it had dropped to
10 per
1,000. However, the chief causes of death among the young
were
infectious and parasitic diseases and diseases of the
respiratory
system, a Third World pattern found in rural areas, as
well as in
city slums. Malnutrition and related diseases were also
widespread. The chief cause of deaths among adults was
thrombosis, followed by cancer. About 400 Portuguese died
each
year from tuberculosis.
The number of doctors, dentists, and nurses increased
greatly
between 1960 and the early 1990s. At 26,400 in 1987, the
number
of physicians actively practicing medicine in Portugal
represented a fourfold increase over the total in 1960.
The
number of dentists expanded even more dramatically, from
120 in
1960 to 5,700 in 1986. As of 1987, the number of medical
personnel per occupied hospital bed was 1.7, compared with
0.24
in 1960. By 1990 there were 2.9 doctors per 1,000
Portuguese, a
ratio higher than that found in most West European
countries.
However, most medical personnel were concentrated in urban
centers, to the detriment of those needing health care in
rural
areas. In the latter areas, folk health practitioners were
not
uncommon, even in the early 1990s. Their medical practices
were
often fused with magical, religious, and superstitious
elements.
Portuguese were able to take advantage of a national
health
system that, since the second half of the 1970s, paid 100
percent
of most medical and pharmaceutical expenses. The system,
managed
by the Ministry of Health, offered care at large urban
hospitals,
several dozen regional hospitals, and numerous health
centers.
The health centers specialized in providing primary care.
Care
provided by the national system ranged from the most
sophisticated to basic preventive medicine.
The national health system's overriding problems were
the
long waits, frequently months in duration, for medical
care, that
resulted from shortages of financial resources, lack of
personnel, and inadequate facilities. Medical facilities
in
Portugal ranged from those of centuries past to the
ultramodern.
Partly as a result of these inadequacies, there was a
substantial
private medical sector that offered better care. Many
doctors and
other medical personnel worked in both the public and
private
system, often
because of the low salaries paid by the national system.
Data as of January 1993
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