The research came from a well respected non profit organisation FREOPP, the foundation for research on equal opportunity. I think it’s fair to say that many readers did not agree with their findings, but what are the facts.

The modern Portugal health care system was founded in 1979 with the establishment of the Portuguese National Health Service. Bear in mind that this was just five years after the 1974 revolution and building a proper public health service came with a lot of challenges. The UK NHS was started in 1948 by the then health minister Aneurin Bevan, and despite a thirty year start on Portugal the NHS still attracts major problems and criticism. People’s expectations of a free health service are high but difficult to meet.

In an emergency

Portugal’s health service is seen at its best in an emergency. I know from personal experience that if you call for an ambulance you are unlikely to wait more than ten minutes, though that does depend on your location. Our grandson went to the aid of an elderly lady who took a fall in Oxford last week and the ambulance took four hours to reach her. She had a fractured hip. I have never heard of such a delay in Portugal.

National emergency institute (INEM)

The INEM (that’s the yellow ambulances) paramedics are well trained and efficient and the emergency departments at all the hospitals I have had any dealings with are fast and good. These ambulances are kept locally on standby, usually at the local fire station, one reason they can arrive so quickly. In addition, the INEM service have ‘flying doctors’, that’s the small yellow car you may see rushing to an accident or emergency. They carry a doctor and a nurse who can immediately start appropriate treatment over and above what a paramedic can perform. They also have helicopters stationed within a few minutes of any appropriate emergency, INEM are very well equipped and well trained. Local firemen also have ambulances to deal with less serious needs. In an emergency, INEM offers an outstanding (free) service.

One person within a group of people I know well was told on her return to the UK “you would never have received such good treatment here". Most doctors and nurses I have had any dealings with seem to default to English dealing with any foreigner, and in most cases its very good English. That’s in the Algarve and it may not be the case further north.

Waiting times in outpatients

One of the major problems seems to be with the hospitals outpatient’s department. This is partly a cultural problem, by default most Portuguese people will go straight to the hospital outpatients for any health issue.

The government has tried, partially successfully, to address this by opening health centres in most towns and cities. In theory this is where you should find your ‘family doctor’ but the serious shortage of doctors means that you might wait years to get a doctor assigned to you. Meanwhile there will be a doctor on service, but there is a high demand to see them. The nurses are very good and seem capable of dealing with fairly minor issue with little delay. The reality is that if you go directly to the hospital you will see a doctor, albeit with a delay of two or three hours. In recent years the patient will be assessed quickly by a triage nurse to determine the urgency of treatment needed but it will still be a long wait unless it’s urgent.

Despite the governments best efforts, the lack of family doctors, what the English call a GP, is a major problem. If it’s a routine or minor illness you may be waiting a long time to get treatment, even to get an appointment. If you do manage to get a family doctor, matters can move a little quicker though the lack of specialists for non-urgent treatment is still a problem.

Public v Private

In order to meet the needs of fast treatment and care, the private sector has developed with impressive speed. They have their own emergency departments where you can see a doctor 24/7. As medical insurance is substantially less expensive in Portugal than many European countries, the private health care system seems to be a very viable alternative to the public sector. Its fast, accessible, and high quality. The cost of seeing a doctor or specialist, if you don’t have private health insurance, seems to be around €70 for an up to thirty-minute consultation. The private sector can offer all the services the public sector can offer, and with high quality of treatment.

To take an overview, if you need emergency care the public health system will take very good and very fast care of you, and the treatment etc will be free. Most countries have bilateral agreements with the Portuguese health system. As a foreign resident or visitor, the emergency health care is outstanding.

Shop around for Private health insurance

There is an extensive chain of private local clinics everywhere who can deal with minor ailments quickly. Although there is a cost, this is by far the best way to find a family doctor.

For day to day non urgent health care, the private sector can offer all you need. Shop around for health insurance, basic cover can be obtained for around 25 Euros a month while you are young, around €50 a month for someone in their early fifties. Look for a company that has a direct agreement with private hospitals, so they settle the bill direct.