Portugal's Biggest Private Hospital Group Signals It Will Bid to Run Public Hospitals — but Only Under a Better Model

Portugal's largest private hospital group has put its hand up for a job the state has spent years shying away from: running public hospitals. In an interview with the news agency Lusa, the president of Lusíadas Saúde (a private healthcare group), Vasco Antunes Pereira, said the company is willing to bid for new public-private partnerships to manage hospitals within the SNS (Serviço Nacional de Saúde, the National Health Service) — but only if the state fixes the model first.

"This intention and availability has already been presented to the Government," Antunes Pereira said, signalling that the group is not merely open to the idea but has actively pitched it. The condition attached, though, is pointed.

The "improved model" Lusíadas wants

The sticking point is oversight. Antunes Pereira argued that the current tender frameworks for the ULS (Unidades Locais de Saúde, the Local Health Units that now group hospitals and health centres) are "insufficiently precise," and that the units are "still very young in terms of maturity" when it comes to monitoring a private operator. A workable partnership, he said, needs the granting authority to have real capacity to measure performance — and to measure the right things. He called for a shift away from simply counting consultations toward tracking how many citizens actually receive timely care.

That caution is rooted in experience. Lusíadas ran the Hospital de Cascais for 14 years under Portugal's best-known health Parceria Público-Privada (Public-Private Partnership). The concession ended not because the company rejects the model, Antunes Pereira stressed, but because it "could not find, within that financial envelope, the security of being able to guarantee quality." In other words: the money on offer did not stretch to the standards required.

A model the government is quietly reviving

The timing matters. In March 2025 the Government approved the launch of PPP processes for a cluster of hospitals — Braga, Vila Franca de Xira, Loures, Amadora-Sintra and Garcia de Orta (in Almada-Seixal) — reopening a management approach that had been largely mothballed after a wave of concessions expired. Lusíadas signalling its appetite gives those plans a credible bidder, while also setting out the terms on which the private sector will engage.

This is a distinct debate from the recently launched SINACC system for buying contracted private and charity care: that scheme is about the SNS purchasing individual treatments; a management PPP hands a private operator the keys to run an entire public hospital.

What this means for expats and residents

• Access to care: Whether hospitals in Braga, Loures or Almada end up privately managed could shape waiting times and service quality for anyone in those catchment areas.
• SNS vs private: A management PPP still delivers state-funded, universal care — it changes who runs the hospital, not who is entitled to use it.
• Quality guarantees: Lusíadas's Cascais exit is a reminder that the fine print on funding and performance metrics is what determines whether these deals deliver.
• What to watch: The revised tender terms will be the real test of whether the private sector actually bids — or walks away again.

For now, the ball is with the Government. Lusíadas has said it is ready; whether Portugal's renewed appetite for hospital PPPs survives contact with the numbers is the question the coming tenders will answer.