Portugal medical system SINACC implementation dispute

The Portuguese Medical Association (Ordem dos Médicos) raised concerns regarding the safety and efficacy of the newly introduced National System for Access to Consultation and Surgery (SINACC). The association warned that errors in the system could jeopardize patient access, clinical priority, and territorial equity, specifically calling for a technical-clinical validation of the system’s nomenclature before a nationwide rollout.

A central point of contention involves the definition of ‘small surgery.’ The Medical Association suggested that changes to these criteria could lead to a ‘ghost reduction’ of 200,000 to 300,000 surgeries if procedures under three centimeters are not properly registered on official waiting lists.

In response, the Portuguese Ministry of Health denied claims that surgery production is being scaled back and emphasized that no necessary clinical act would remain unregistered. To resolve the dispute, the Ministry agreed to establish a working group—including representatives from the Medical Association, the National Institute of Statistics, and other health directorates—to review the definition of small surgery while the SINACC system remains in its testing and expansion phase.