Complaints to Portugal's Health Regulator Fall 5.4 Percent in the First Half, Though the ERS Cannot Rule Out Providers Holding Some Back: How to Complain

Patients lodged 40,895 complaints about health providers in Portugal in the first half of 2026, 5.4 percent fewer than a year earlier, while compliments rose 7.9 percent to 10,869. The figures come from the half-year report of the Entidade Reguladora da Saúde (ERS, Health Regulation Authority), published on 20 October and covering public, private and social or cooperative providers.

The fall may not mean patients are happier. The ERS says it cannot rule out that some providers failed to send it their complaints on time, a duty it is monitoring.

What patients complained about

In the public sector, the most frequent subjects were waiting times in hospital emergency departments and breaches of the Tempos Máximos de Resposta Garantidos (TMRG, the legal maximum waiting times) in the Serviço Nacional de Saúde (SNS, the national health service), such as booking appointments.

In private hospitals, money dominated: patients were not told in advance what they would pay or what their insurer or subsystem would cover. In private clinics without beds, and across the social and cooperative sector, the most frequent complaint was that the care or procedure itself was not appropriate.

The ERS says 75.6 percent of complaints concerned 1,200 establishments belonging to 32 entities. Of these, 469 were in the North, 429 in Lisbon and Tagus Valley, 223 in the Centre and 79 in the Algarve; none in the Alentejo was among the most complained about. The figures are not weighted for provider size.

What the regulator did

The ERS decided 28,485 cases in the half-year, 16,107 of them from 2026. In 5,553 of the 2026 complaints (34.5 percent) it found the provider at fault and stepped in. Outcomes for the 2026 complaints included:

• 3,143 cases closed with corrective measures or the situation resolved;
• 838 that led to inquiries, monitoring or fines proceedings;
• 32 proposals for mediation;
• 8,735 cases with no sign of a breach.

In 1,439 cases, 1,318 of them in the public sector, the provider failed to give the patient a clear final answer. Of the complaints still open at 30 June, 20.3 percent (7,313) were incomplete, which the ERS says hampers its decisions.

Last month the regulator ordered private clinics to drop charges patients had never been quoted; we covered that ruling here. For SNS waiting times, see our report on patients waiting past the legal limit for surgery.

How to complain about a health provider

The ERS says anyone may complain, whatever their nationality or residence, and that complaining cannot be held against you. Its step-by-step page and complaints FAQ (both in Portuguese) set out the routes:

• The paper Livro de Reclamações (complaints book). Private providers keep the red book, and you keep the duplicate copy; public providers keep the yellow book. Decreto-Lei n.º 156/2005 requires the book to be handed over immediately and free of charge. If a provider refuses, the ERS says you may call the police (PSP, GNR or municipal police) to record it.
• The electronic book at livroreclamacoes.pt, compulsory for private, social and cooperative providers.
• Directly to the ERS. Its online form is currently marked "temporarily unavailable"; the notice asks patients to email [email protected] with their details and the provider's name, address and, if possible, tax number, or to call 309 309 309 on working days, 9:00 to 17:30.

There is no legal deadline, but the ERS advises acting soon. Under the ERS's rules, providers must send each complaint to the ERS within 10 working days, with their reply to you. If you get no answer, tell the ERS. For a disputed bill, see our guide to disputing a hospital or clinic bill.