JULY 2019.
APHP and ASPE challenge Portugal and Spain to put the capacity of private hospitals at the service of the citizens. During the 2nd Iberian Summit of Private Hospitals, which took place on 30 May in Lisbon, the Portuguese Association of Private Hospitals (APHP) and the Spanish Private Health Alliance (ASPE), representing the private hospitals of Portugal and Spain, presented 12 demands for the health sector.
In this joint Manifesto, Iberian hospitals place the citizen at the center of the system “to increase the value (value-based healthcare), to increase quality and efficiency, ie health gains, but also to contribute to the sustainability of the sector“. This is the vector they consider to be decisive for the provision of increasingly differentiated health care and to attract the necessary investment, also as a factor of the countries’ competitiveness.
The 12 demands that private hospitals in Portugal and Spain believe to be common and necessary to the improvement of Iberian Health are:
- Embrace Health as a national priority, in each of the countries, in order to respond to the demographic and technological challenges and to the legitimate expectations of citizens;
- Make value for the patient the central point of all the reforms;
- Give greater responsibility and freedom of choice to the patient regarding their health, treatment and care (adequate financing, promotion of health insurance, etc.);
- Promote equality in access and in the providers´ licensing process between public and private providers;
- Improve the collection, treatment and transparency of health data and indicators to encourage informed decision-making by patients and funders;
- Promote competitiveness among providers, as well as among health system funders;
- Simplify bureaucracy and reduce market costs which distort the market and inhibit private investment in health;
- Rationalize services and consolidate health infrastructures in order to maintain the universal healthcare model;
- Make use of existing resources in each health system;
- Invest in technology as a means of providing community-based health care and reducing costs;
- Strengthen the mission of a truly independent regulatory body;
- Decouple the functions of financier and provider.
The presidents of APHP and ASPE in their speeches considered that, despite the ideological constraints that still persist, Portugal and Spain need to start a new cycle of public policies in the field of health, focused on citizens and results.
“Without prejudice to the structural character of the public institutions for the Portuguese NHS, it would be important for the development of the sector, but also for the expansion of provision and access to make efficient use of the resources within the system,” said Oscar Gaspar, President of APHP.
In this perspective, he considered it unacceptable to maintain administrative obstacles to the initiative of the private sector, “all the more when it violates equity“. Not wishing to elaborate on a number of so-called “context costs”, the APHP President preferred to point out that “the excessive and discriminatory nature of the licensing process of private hospitals must be promptly eliminated”
Cristina Contel, President of ASPE, noted that: “The most important thing for the patient is not who owns the hospital where they are being treated, but rather issues such as quality of treatment, waiting times and health services“.
The President of ASPE considered that “improving the performance of Iberian health systems will provide citizens with a health network that will protect and guide them (prevention), with correct and timely information (training), with simplicity of access (agility and transparency) and with a prompt, efficient and integrated response“.
For both presidents, freedom of choice, in a context of universal coverage, is the key vector to place health systems at the service of the citizen.

Dr. Paul Garassus, President of the European Union of Private Hospitalis (UEHP), pointed out that the current context of formation of the new European Parliament was the crucial moment to elucidate the new MEPs – especially those who deal directly with health and social protection – on the process optimization capacity of private hospitals, in order to present the best provision of health services. For Dr. Paul Garassus, private hospitals are top players in responding to the challenges of European health systems.
Portuguese government represented
At the 2nd Iberian Summit of Private Hospitals, the Portuguese Government was represented by two Secretaries of State: Eurico Brilhante Dias, Portuguese Secretary of State for Internationalization and Francisco Ramos, Assistant Secretary of State and Health. Both supported the initiative and encouraged the debate between Portuguese and Spanish about the organization and provision of health services.
“The role of private hospitals in the export of services is crucial, it is a role recognized by the Government, and in the area of internationalization surely it is a strong partner to achieve these national goals,” he said.
The Assistant Secretary of State and Health, Francisco Ramos, welcomed “the development and increasing capacity of private hospitals, whose performance is at the level of the best in the world”. Francisco Ramos acknowledged that in the last 20 years, private hospitals in Portugal “went from a set of clinics to a sector where today there is an organized and differentiated offer, not evenly distributed throughout the c ountry yet, but on its way to be.”