Health Service Is Heading for an Overspend of About 11 Percent in 2026, and Parliament's Budget Office Sees the Same Risk Hanging Over 2027

Parliament's budget office, the UTAO (Unidade Técnica de Apoio Orçamental), has listed the National Health Service (SNS) among the main risks to the Government's 2027 budget, after a year in which health spending ran well past what was set aside for it. Its head, Sofia Terlica, said in an interview published by Público on Thursday that SNS spending in 2026 came in "about 11 percent" above plan.

The warning matters because the Government is promising a surplus of just 0.1 percent of GDP, or 275 million euros, next year. That margin is smaller than some single top-ups the health service has received this year.

What the budget office's report says

The UTAO set out the risk in its final appraisal of the 2027 budget (Report No. 18/2026, dated 30 October). The figures for the health budget programme show the pattern it is worried about:

• Goods and services (medicines, exams, outsourced services): budgeted at 7,915 million euros for 2026, now expected to reach 8,833 million, 11.6 percent more than the initial budget.
• For 2027, the same line is budgeted at 8,436 million euros: 4.5 percent less than this year's expected spending, and below actual spending in 2024 and 2025.
• Staff costs are budgeted to rise 5.2 percent, to 8,184 million euros.

The UTAO says this under-budgeting "has been common" in earlier years too, and that the gap is normally closed during the year by reinforcements the Government authorises itself. It warns that persistent SNS deficits, "despite successive reinforcements" and recurring capital injections to clear overdue bills, point to spending pressures that "may not be fully accommodated" in the 2027 funding, which could mean extra money during the year and a weaker overall balance.

A billion euros in injections this year, none planned for next

Terlica told Público that the State put about one billion euros into SNS bodies in 2026 as capital injections, which allow, for example, overdue debts to suppliers to be paid. No equivalent sum is foreseen for 2027. "Having had such large deviations in 2026," she said, the office flagged the chance of something similar next year, while stressing that it has "no indication" that it will happen: it is a warning based on history.

The report also names other risks: the 300 million euros the Government expects from fighting fuel tax fraud, an estimate the UTAO calls unsupported, and the path of public-sector employment. The budget's final vote is on 24 November.

What it means for you

An overspend does not mean less care at the counter: unpaid bills are usually covered by mid-year top-ups, as happened this autumn when the Government authorised another 1,538 million euros for medicines and exams. The cost shows up elsewhere: in overdue bills to suppliers, and in a thinner cushion for the public accounts. If health spending repeats this year's pattern, the 275 million euro surplus could turn into a small deficit. Terlica noted that the gap between a surplus, a neutral position and a slight deficit is "very small"; an SNS overrun is exactly the kind of item that could tip it. The budget office had already questioned the Government's jobs forecast in its preliminary report.