Over 85% of Family Health Units waiting for incentives

M85% of Family Health Units (FHU) have institutional incentives in debt or not yet available and more than 63% have been informed that the values of 2025 will only be available this year, reveals a report of the national association.

According to a study conducted by the National Association of Family Health Units (USF-AN), which will be presented today, 85.7% of FHUs have institutional incentives in debt or not yet available and 63.6% received confirmation that the incentives gained in 2025 would be made available in 2026.

“ Institutional incentives are incentives that units, if they achieve some quality objectives, can have. They are money, money for improvements in your USF, training programs, etc. So the 85% who say they owe us means that the FHUs won us, tried to use them, and that was not allowed by the Local Health Unit (ULS). Of course that's another reason for dissatisfaction. And then there is a percentage where the ULS do not have the means to make the funds available or do not even intend to do so. The USF earns the money, the money is distributed to the ULS and the ULS spend it on other investments than what was intended ", lamented the president of USF-AN.

Listened to by Lusa, André Biscaia used expressions such as “retirement” and “dissatisfaction” to classify this situation that laments even because, he stressed, “what has been proved in recent years is that the USF use money very well”.

“ Autonomy exists in the law but is not put into practice because the funds are not distributed ", summarized.

In the report, which had the participation of 76% of the coordinators of the FHUs existing at the time of completion of the questionnaire, it is read that the contractualization lost value as stimulus, since in 2025/26, the period analyzed in this questionnaire, 56.6% considered it a stimulus to work with higher quality, but in 2024/25, the value was 64.5%.

Already “only 23.6% consider that the process has been improving and 80.9% disagree that it meets the deadlines.”.

This study contributed 541 coordinators of the 712 USF existing at the national level at the time the questionnaire was developed (between June 19 and August 4 this year).

More than half (55.6%) of the coordinators considered that the ULS respects their autonomy, but 84.5% advocate more autonomy for primary health care management bodies and 93.9% greater financial autonomy of the ULS to hire professionals and services.

“ Performance perception remains favorable, but backs: 61.7% consider that the quality of services is currently the best ever (64.6% in 2024/25) and 76.0% state that the current dimension of user lists conditions timely access to care ", reads in the document.

About a report that goes in the 16th edition, to Lusa, André Biscaia highlighted the persistence of structural problems that are repeated throughout the different editions, namely the reconciliation between the USF activity and personal and family life or the interoperability between computer programs, difficulties in hospital referral, as well as the size of user lists.

“The workload is not being sustainable. It's something that has to be addressed. In the top 5 of problems mentioned is the reconciliation [between professional and personal life], something that has been maintained in recent years. The size of the lists, political aspects, including the lack of prioritisation of health care Primary in health policies, everything has been maintained in recent years. That is, nothing has happened to change this state of things ", lamented.

In the report, the USF-AN identifies three challenges for the future, namely strengthening health governance, believing that “the future of Primary Health Care depends less on the creation of new reforms and more on the ability to implement the reforms already conceived effectively”.

The second challenge is to value professionals and strengthen the attractiveness of the NHS because “no health reform will be successful without motivated professionals, recognized and involved in the process of change”.

And turn knowledge into action: “Portugal has abundant technical knowledge, scientific production, legislation and strategic recommendations. However, the main obstacle is often execution. Reform implies deciding, implementing, evaluating and correcting”, reads in the analysis of the USF-AN.