Reports

Despite the difficult economic climate, Portugal has continued to develop and reform its energy policies since the previous International Energy Agency (IEA) in-depth review in 2009. These changes have resulted in greater economic activity in the energy sector, increased renewable energy deployment, further market liberalisation and greater emphasis on energy efficiency in policy making. A new strategy emphasising renewable energy and energy efficiency has focused efforts on meeting national and European energy policy objectives, as Portugal seeks also to lower investment costs and greater national competitiveness. The new strategy includes proposals to reinforce interconnections with transnational European electricity and natural gas networks, and measures to promote economic and environmental sustainability. The strategy should accommodate regular independent reviews and monitoring tools to examine implementation of energy policy to ensure that it remains relevant and cost-effective. Following the economic crisis, Portugal was left with a substantial tariff deficit as retail electricity tariffs were set below costs, including subsidies to renewables. Portugal’s plan to address the tariff deficit was the outcome of a negotiation process with industry stakeholders. Eliminating the tariff debt by 2020 is a significant challenge. The government must ensure swift implementation of all reform proposals and continue its efforts to identify further potential cost-saving measures in the energy sector. This review analyses the energy policy challenges facing Portugal and provides recommendations for further policy improvements. It is intended to help guide the country towards a more secure and sustainable energy future.

The OECD Development Assistance Committee (DAC) conducts periodic reviews of the individual development co-operation efforts of DAC members. The policies and programmes of each member are critically examined approximately once every five years. DAC peer reviews assess the performance of a given member, not just that of its development co-operation agency, and examine both policy and implementation. They take an integrated, system-wide perspective on the development co-operation and humanitarian assistance activities of the member under review.

This report reviews the quality of health care in Portugal, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. The Portuguese National Health Service has responded well to financial pressure, successfully balancing the twin priorities of financial consolidation and continuous quality improvement. Even in the post-crisis years when GDP fell and health spending declined, improvements in quality of care continued. The need to reduce health spending has been met through a combination of structural reforms, and a well-designed suite of quality initiatives. Reforms around the purchasing and use of pharmaceuticals and medical devices have helped drive down costs, and Portugal has been innovative in how public funds are used to pay providers, increasingly basing payments on quality and efficiency. Important priorities for further work in the Portuguese health system do remain. Portugal will need to improve clinical processes and pathways, particularly in the acute sector. There is still room to improve efficiency, for instance increasing the share of generic drug consumption, and using the Portuguese health workforce more effectively, especially through expanded roles for nurses. Further structural reform is needed with an emphasis on shifting care out of hospitals into less-expensive community settings, and Portugal will also need to reflect on the strategic direction of the primary care system which, following an impressive reform, now risks developing into a two-tiered system with increasingly divergent levels of care quality.