Lisbon and the Tagus Valley Gained 49,000 People Without a Family Doctor in a Year, and the North and Centre Cancelled It Out

Portugal ended June with 1,672,130 people enrolled in primary care and no family doctor assigned. A year earlier the figure was 1,669,681. On the national headline, twelve months of effort moved the number by 2,449 people, which is nothing.

The national headline is also useless, because underneath it two halves of the country moved hard in opposite directions. The figures below are taken directly from the Health Ministry's own Portal da Transparência do SNS (SNS Transparency Portal), comparing June 2026 with June 2025 across all 39 primary-care units.

The South lost, the North and Centre paid for it

• Lisboa e Vale do Tejo: 1,130,216 to 1,179,164 without a doctor, up 48,948
• Algarve: up 12,104
• Alentejo: up 5,734
• Centro: down 37,230
• Norte: down 27,107

Lisbon and the Tagus Valley now hold roughly seven in ten of everyone in Portugal without a family doctor. The three southern regions added just over 66,000 people to the uncovered list; the North and Centre took just over 64,000 off it. That is the whole of the flat national number.

Loures and Odivelas is the worst single unit in the country

The Local Health Unit of Loures and Odivelas went from 66,230 people without an assigned doctor to 83,311, a rise of 25.8 percent in a year. As a share of everyone enrolled there, coverage fell from 72 percent to 66 percent: one in three residents now has no family doctor.

The area is one of the fastest-growing immigrant destinations in the country. According to INE figures cited by Expresso, the foreign-born share of the population roughly doubled in both Loures and Odivelas between 2021 and 2025, and by the end of last year more than a quarter of Odivelas residents, 27 percent, were foreign nationals. The two councils together gained about 57,000 foreign residents over those four years.

Almada and Seixal tell the same story on a smaller scale: 62,521 to 70,769, up 13.2 percent, in two councils whose foreign population more than doubled since 2021 to about 78,000. Other units in the region moved less dramatically but in the same direction, including Oeste (up 11,196, and now 46.6 percent of its enrolled population without a doctor) and Arrábida (up 8,358, at 39.8 percent).

The mechanism is enrolment, not disappearance

Here is the part that gets lost in the political argument. Lisboa e Vale do Tejo also gained about 68,000 people with a family doctor over the same year. Both numbers rose because about 115,698 additional people enrolled with primary care in the region in twelve months. Nobody lost a doctor they already had. The service grew, and the queue behind it grew faster.

Whether that is a migration story or a recruitment story depends on which end you look at. The Health Minister, Ana Paula Martins, told the PSD congress in June that a sudden population increase driven by immigration was making the government's success in hiring family doctors "seem not to exist". The counter-argument sits in the same dataset: Coimbra cut its uncovered population by 52 percent and Leiria by 22 percent, and the North and Centre routinely fill almost every family-medicine vacancy they advertise while Lisbon filled 113 of 446 in the last national round. Twenty-five percent against ninety-five percent is not a migration differential.

What this means for you

• If you are moving to Loures, Odivelas, Almada or Seixal: assume you will not get an assigned family doctor quickly. You still get a número de utente and you still get seen, but through open consultations rather than a named GP.
• If you are choosing between Lisbon and the interior: Coimbra now has 4.6 percent of its enrolled population without a doctor. Estuário do Tejo has 47.7 percent. This is one of the sharpest quality-of-life gaps in Portugal and it does not follow the cost-of-living map.
• Check your own status: the SNS 24 portal shows whether you have an assigned doctor. If you have been abroad a while, read the registry-cleanup rules before assuming you still do.
• Background: our médico de família coverage map explains how assignment works, and this piece from May sets out why the vacancy rounds keep failing in the south.

The next national vacancy round will tell you more than the next national total. As long as Lisbon fills a quarter of its posts and the North fills nearly all of them, a flat headline is just two problems cancelling each other out on a spreadsheet.