OECD Secretary-General

Tackling Portugal’s Health Challenges and Promoting Well Being


Opening remarks by the Secretary-General for the seminar with Ambassadors, delivered on the occasion of the visit to the OECD by Portuguese Health Minister, Paulo Macedo

Paris, September 30th 2013, 11h30

Dear Ambassadors, colleagues:

It is a great pleasure to welcome Paulo Macedo, Minister of Health for Portugal, to the OECD today. We have a unique opportunity to learn from the Portuguese experience of handling what is one of the most critical economic and social challenges we face today: improving our nations’ health in an increasingly tight budgetary environment.

Minister Macedo is a Health Minister with a fascinating background. Among other roles, he has been Vice-Chairman of the Banco Comercial Português’ Executive Board of Directors, a Member of the Supervisory Board of Polish Bank, Bank Millennium, and a Member of the Supervisory Board of Euronext. In addition, he has served as Director-General of Taxation and Chairman of the Tax Administration Board in the Portuguese government. I cannot think of a better profile to serve in government at a time of financial and economic duress!

The challenge of delivering health reform in difficult times is one faced, not only by Portugal, but also by many of the countries represented around this table. In the decade up to 2009, health spending in OECD countries increased by 4.5 per cent a year on average -- around three times more quickly than income. We used that money to pay for more doctors, more nurses, more expensive diagnostics, more drugs, more surgery, and to pay higher prices for all these services. But, we failed to pay attention to value for money.

The public expenditure crisis has thus hit many of our health care systems hard.

In Portugal, health spending has been reduced from 10.8% of GDP in 2009 to 10.2% now. This has been achieved by rationalising spending on pharmaceuticals, promoting the use of generic drugs, moderating salaries; cutting the fees paid to hospitals, and increasing user charges, while still protecting those in most need. The Portuguese authorities have also taken steps to improve the quality of primary care and care in hospitals, and to increase the use of ICT in health. This is all very positive stuff.

But the challenge now, as for many countries, is to find ways to further improve the performance of the Portuguese health system to deliver better health to citizens, despite the persisting economic conditions. For example, tackling the causes of disease more effectively will be key to delivering a more efficient health system. Coping with dependency in old age and promoting higher quality of care are other major challenges.

I look forward to hearing the Minister’s own personal take on these challenges and his plans for future reform. We at the OECD stand ready to support you in your endeavours to deliver better health and better value for money to your citizens.

Thank you.


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