Portugal's New Health Framework Holds Family-Doctor Coverage at 85.37 Percent Until 2028, and It Reached the Official Gazette Nine Months Late

The document that sets what Portugal's health service is expected to achieve over the next three years was published in the Diário da República on Friday, and its headline number is one that does not move. The Quadro Global de Referência for 2026 to 2028 puts the share of users with an assigned family doctor at 85.37 percent in 2026, at 85.37 percent in 2027, and at 85.37 percent in 2028. That is the same figure the service recorded in 2024.

Two years ago the stated goal was 98 percent coverage by 2026. The despacho signed by the Minister of State and Finance, Joaquim Miranda Sarmento, and the Health Minister, Ana Paula Martins, quietly replaces that ambition with a flat line, and it does so nine months late: although it appeared only on Friday, it takes effect from 1 January of this year.

What the framework actually promises

The QGR is the planning instrument each unidade local de saúde uses to build its own annual development plan, so its targets shape what every hospital and health centre in the country is funded to do. Medical consultations are projected to rise from about 47.7 million this year to more than 48.7 million in 2028. Surgeries go from roughly 799,500 to almost 832,000. Emergency attendances are expected to fall from 4.5 million to 4.2 million.

Total SNS spending is set at 19,714 million euros in 2028 against 18,498 million this year, and the service's debt is planned down from 891 million euros in 2026 to 785 million in 2028. Staffing is the sharpest constraint: the framework caps new permanent hires at a combined reinforcement of 1.4 percent of the workforce in 2026, measured against the position on 31 December 2025.

Both professional bodies say the same thing

The Ordem dos Médicos called the strategy "wrong" and said it falls "far short of the ambition needed". Its objection is not to any single number but to the shape of the plan: at a moment when the service needs to recover capacity, it says, "the answer cannot be to lower targets, limit recruitment and accept activity that is practically stagnant". It points to first hospital appointments within the legal maximum waiting time, set at 40.24 percent in 2026 and barely improving thereafter, and to a real fall in surgical activity, with 19,000 fewer scheduled operations between January and May this year than in the same months of 2025, a drop of 5.4 percent.

The Sindicato dos Enfermeiros Portugueses read the 1.4 percent ceiling and reached a blunt conclusion: in practice it means the roughly 3,000 nurses who qualified this year will not be taken on. The union puts the permitted increase at 1,596 workers in 2027 and the same again in 2028, and blames the Finance Ministry for the nine-month delay, calling it a spending-restraint strategy by another name. The gap between newly qualified nurses and available posts has been visible since the summer.

What this means for expats

• If you do not have a family doctor, do not expect that to change by 2028: the state's own plan assumes about one user in seven stays uncovered for the whole three years. Lisbon and the Tagus Valley added 49,000 uncovered users in a year while the north and centre improved.
• Registration still matters: you must be on a list to be counted at all. Our guide to getting an SNS número de utente sets out the routes.
• Waiting times are the number to watch: a target of 40.24 percent of first hospital appointments inside the legal limit means most patients will wait longer than the law allows.
• Emergency cover is a separate problem: emergency departments lost 204 days to closures in the first half of this year, an improvement, but from a very low base.
• Mental health sits outside the headline targets: the wait for a first SNS psychologist appointment runs to about half a year.