The Benefits and Drawbacks of the Irish and Portuguese Health Systems

Are outcomes within Portugal are as good as they are in Ireland?

Moderator and IPBN Board member Carolyn McKeown of Shebang Events & PR Management opened the webinar by explaining her experience with the private Portuguese and Irish public healthcare systems: a four-month whirlwind of being diagnosed with Crone's disease, finding a tumor on her ovaries, going into surgery in Ireland, and recovering in Portugal, all between May 2019 and August of the same year. McKeown said, “For me personally, both systems were very fast…very efficient, and obviously, I’m still here today because of it. I went down the private route in Portugal because I’m not a resident, therefore I have private health insurance, and then down the NHS route when I was at home. For me, it was a perfect system with no delays…which is a very big reassurance because it was life-saving. If that tumor had burst, literally I wouldn’t be sitting in front of you today." 

McKeown acknowledged that her process was quick, and asked keynote speaker Dr. Paulo Sousa, Clinical Director of the Hospital Particular do Algarve (HPA) to explain if people didn’t have private health insurance, how they would go about getting seen by a doctor. Sousa explained, “Up to 20 years ago the Portuguese national healthcare system was giving a good response to the general population, but there has been a reduction of investment into it by the government…costs are becoming higher and higher so we are not able to keep the pace…We are watching the private system grow a lot. We have 218 private hospitals and 220 public hospitals which makes it half-half. I would say that 50% of the people in Portugal have private insurance. The system in Portugal is partially free…the big problem is the waiting list. Getting from the GP to the specialist in the hospital can take a few months, sometimes years depending on the problem.”

Sousa says that the number of those insured is growing more than 10% every year as there are a variety of different plans available. With the public health system having to shut down some major services, responding to COVID, and waiting lists growing, private hospitals are stepping in to cover the burden. Sousa gave the example of the public cataract surgery waiting list being at about two years.

Desmond O’Neill from AllMarket explained the services of the General Medical Service (GMS) in Ireland, and how they decide on your eligibility and grant access to GP access, drugs, and access to hospitals depending on your income. "Access to healthcare here in Portugal is quite easy compared with Ireland, and it can be difficult to see a consultant, but outcomes are equally as good in both countries. The insurance schemes are more transparent and easier to follow, and it’s quite complicated in Ireland.” according to O’Neill. 

Dr. Shane Farrelly, CEO & Medical Director of SomarMed says the Portuguese and Irish healthcare systems are quite similar. “Again, it’s about the delays. I was a GP in Ireland about 25 years ago, so I’ve got both aspects…I actually feel that the outcomes within Portugal are as good as they are in Ireland…[However] in Ireland, you’ve always got to go back and get a letter from your GP to see a consultant. My understanding is that you can go yourself in Portugal directly to a consultant yourself without the GP referral.”

If you are moving to a country, it is generally best (and in some cases, mandatory) to register in that country for the national health service once you have established residency. However, for short stays, if you have a European health card, you can access services in the public hospitals when you need them for stays up to 90 days. McKeown named Bupa and Aviva as two examples of global health insurance companies that can allow you to access private care. If you have been on a waiting list in Ireland, doctors will approve your surgery to be done in Portugal, the NHS would happily pat Portugal, for example, to perform the procedure, giving EU citizens a little peace of mind. 

At a private hospital like the HPA, that could mean waiting as little as 48 hours after you arrive in Portugal to have a procedure depending on the case and whether your paperwork has been submitted by your doctor and reviewed by the hospital. The HPA’s fully integrated system can also help you access your medical records whenever you like, which is a bonus to anyone who has a lot of paperwork floating between countries. “Medical tourism in the Algarve is well used by temporary residents…there are a lot of patients that live in Germany or elsewhere…and they decide to come and do the surgery here…and they enjoy a bit more, with a sunny place to do their treatment…it’s quite quick fast, and simple to do for everyone,” Sousa says.

Dr. Farrelly said that “Looking at the comparisons, if you are brought in as an emergency into the public system in Portugal, you’re really gonna get a good level of care just as you would in Ireland, but it’s bout the delays…it’s unique in Portugal…that you have the option to go private to get a different level of service. And because rehabilitation is such a focus for me…that level of care might be even more readily available in Portugal than it is in Ireland.”

In terms of the cost comparison between Irish and Portuguese private healthcare insurance, Desmond O’Neill said, “The premiums of private healthcare in Ireland are probably double the price…I’m with Alliance here in Portugal and it’s still half the price that I was paying in Dublin…and it gives me access to everything that it does in Ireland.” 

McKeown went on to ask after the mental health of hospital staff in light of the COVID pandemic, what SomarMed’s focus was in terms of helping companies stay healthcare compliant, what pharmaceutical protocols are in place, and the best advice for those within the EU waiting for surgery. The end of the webinar came to pass once questions from attendees had been answered and the keynote speakers bid farewell to the network after their illuminating and helpful conversation.

The IPBN would like to offer our thanks to all involved for sharing their expertise for the benefit of the IPBN community.