A Torres Vedras Family Health Unit Becomes the First in the SNS to Be Run by a Private Company

For the first time, a family health unit inside Portugal's public health service is being run by a private company. The Unidade de Saúde Familiar (USF — Family Health Unit) at the São Pedro da Cadeira health centre, in the municipality of Torres Vedras north of Lisbon, opened under private management on Monday, 3 August 2026, marking a cautious experiment in how the state might plug the country's chronic shortage of family doctors.

The operator is Knok (KnokHealth Portugal), a wholly Portuguese company founded in 2015 that made its name in telemedicine and digital care. It won a public tender run by the Unidade Local de Saúde do Oeste (West Local Health Unit), signing a contract with the state worth €2.4 million over five years. Under the deal, Knok takes over day-to-day management of the unit while it remains part of the Serviço Nacional de Saúde (SNS — National Health Service), with care free at the point of use for patients.

Who it serves

The São Pedro da Cadeira unit is responsible for 5,463 residents in that parish and part of neighbouring Turcifal — among them people who had been left without an assigned family doctor. Reducing that number is the whole point of the exercise: the West Local Health Unit frames the private-run USF as a way to guarantee universal access to primary care in an area where the public network had struggled to recruit. Telehealth, Knok's specialty, is expected to feature in how the unit reaches its patients.

Torres Vedras is a pilot, not a one-off. Similar privately managed units are planned to open in the Algarve towns of Silves and Lagos in the second half of the year, giving health authorities three live tests of whether outside operators can deliver primary care at the price and quality the state expects.

A test the SNS cannot afford to fail

The context is a public system under visible strain. More than a million people in Portugal still lack an assigned family doctor, recruitment competitions leave posts unfilled — the most recent national contest filled just 273 of 711 vacancies, with the Lisbon region the biggest gap — and hospitals have spent the summer overhauling creaking systems and rationing emergency cover. As gaps widen, more residents turn to private care; private-hospital revenue hit a record €2.79 billion in 2025.

That backdrop makes the Torres Vedras handover politically charged. Supporters cast it as pragmatism — better a working unit run by a contractor than a shuttered one run by nobody. Critics, including health unions, warn it risks normalising the outsourcing of core public medicine and question whether a five-year, fixed-price contract can absorb the real cost of an ageing patient list. The results of the pilot will shape how far the model spreads.

What This Means for Expats

• Your care stays free and SNS: A privately managed USF is still part of the public system. If you are assigned to São Pedro da Cadeira, you use it with your número de utente exactly as before.
• It may help if you lack a family doctor: Units like this are being created specifically to absorb patients without an assigned médico de família. Ask your local health centre whether you can register.
• Get on the SNS first: None of this works without a valid patient number. Our guide to registering with the SNS walks foreign residents through the paperwork.

Whether Torres Vedras becomes a template or a cautionary tale, it is a genuine first for the SNS — and a sign of how far a stretched system is willing to experiment to get a doctor in front of every patient.