Therefore, looking at this table, it is worth highlighting that ULS in the Algarve was the one that spent the most, until September 2025, on service providers: more than 14 million euros to pay for 313,033 contracted hours, paying an average of 45.2 euros per hour. Then follows the Middle Tagus ULS, with a cost of 9.1 million euros in 262,738 hours – however, it is one of the units that even pays the lowest hourly prices, 34.8 euros. ULS do Oeste follows, with an expenditure of slightly more than eight million euros in 196,756 hours, which represents an average of 41.1 euros per hour.
But the calculations made by DN indicate that there are at least six units that stand out for what they pay in average hourly value: the IPO in Coimbra, where this value is, on average, 58.4 euros, the ULS of the Northeast (Bragança), where this value reaches 61.8 euros, the one in the Tagus Estuary, which reaches 59 euros, the one in Gaia/Espinho (56.3 euros), Alto Douro (53 euros) and Cova da Beira (51.9 euros). In the remaining units, the average hourly price varies between 26.1 euros at IPO in Lisbon, through 31.3 at ULS in Braga, up to 36 at ULS Almada Seixal, 48 euros at ULS Viseu-Lafões or 42 euros at Alentejo Central.
The hospital administrator reinforces that these values are common for more peripheral hospitals, because they are also those that are most understaffed. “Often, these peripheral ULS have to hire doctors who have to travel from Lisbon or Porto to carry out the service. And if the price is not attractive, they won’t go either”, he maintains.
In relation to urban areas, where there are more doctors and competition is greater, “lower prices can now be charged, but this is the law of the market”, which is what happens, for example, in the ULS of Porto and Lisbon. “They have more doctors on staff and greater capacity to attract and retain human resources, and services are only contracted when there is no internal alternative and the prices here are more acceptable.”
The president of APAH recalls that the situation of the service provision activity “was created by the system itself, so I think we have to have some empathy with the situation of these professionals, because, in many cases, this option was not theirs either”, considering that the first step should be “listening to them, knowing what they want, and then solving the problem”. However, he highlights, any negotiation “cannot be done with inorganic groups, these doctors will have to organize themselves”.
But, he guarantees, and knowing the sector as he does, that this situation can only be resolved “by offering professionals a contract that is attractive. These people have to feel like signing a contract with the SNS”.
* With Rui Frias