New Patient-Registry Rules Put 122,000 Long-Absent Users at Risk of Losing Their Family Doctor

More than 122,000 people who have had no contact with Portugal's Serviço Nacional de Saúde (National Health Service, or SNS) for five years are at risk of losing their assigned family doctor (médico de família) under new rules governing the Registo Nacional de Utentes (National Patient Registry, or RNU).

The change arrives through a despacho (ministerial order) signed by the Secretary of State for Health Management, Francisco Nuno Rocha Gonçalves, published in the Diário da República (Official Gazette) and taking effect from the middle of June. It updates the conditions for registering with primary care and broadens an existing measure: where the old rule counted only contact with primary-care centres, the new one counts any contact across the whole SNS, including hospitals.

The mechanism is straightforward. Patients who hold a family doctor but have not used the SNS in more than five years will have their slot released back into the pool, freeing it for someone on the waiting list. A further 262,000 or so people are affected for a different reason: their records are out of date, and an "updated registration" (registo atualizado) status is now required to be matched with a family doctor.

The ACSS (Administração Central do Sistema de Saúde, the Central Administration of the Health System) has sought to calm fears, stressing that affected patients do not lose access to primary care and keep their registration with the SNS, provided they carry the updated-registration status. In its account, they simply give up a doctor they were not using so that the place can go to someone who needs it.

The Ordem dos Médicos (Portuguese Medical Association) is less reassured. It warned of a "risk of exclusion and a break in the continuity of care," cautioning that the reshuffle could administratively strike off patients who still have "real needs" but happen to have stayed away from the system — including older or chronically ill people who avoid appointments.

For The Portugal Brief's readers, the rule carries a specific warning. Many foreign residents and Portuguese citizens who split their time abroad may not have used the SNS in years, even while keeping their registration. Under the new criteria, that inactivity — combined with an out-of-date record — is exactly what can cost them their family doctor and, in some cases, their place in the queue.

The practical step is simple but worth taking now: confirm that your details are current with your local centro de saúde (health centre), update your registration if it has lapsed, and make sure any recent contact with the SNS — anywhere in the system — is on file. Doing so before the rules bite is the surest way to avoid being quietly removed from a doctor's list.