Web-economic-crisis-health-systems-and-health-web

464 Economic crisis, health systems and health in Europe: country experience
• E-prescribing now mandatory for publicly covered drugs (2011).
• Introduction of new support for prescribing guidelines (2011).
• Increased monitoring and feedback (2011).
Salaries and motivation of health sector workers
• Introduction of a freezes on salaries, promotions and recruitment of new
staff (2010).
• Reduction of some claimable expenses such as travel, meal subsidies and
overtime (2010).
• Abolition of the two annual bonuses of a month's salary (2012).
• Adoption of more flexible working schedules and reduction of overtime
payments by 10% (2012) and a further 10% (2013).
• Agreement reached between unions and the Ministry of Health establishing
better working conditions for doctors entering the NHS (2012).
• The two Portuguese medical unions called a two day medical strike in
July 2012. After the strike an agreement between the unions and the
Ministry of Health established better working conditions for doctors
entering the NHS.
Payment to providers
• Moved to per capita payment for hospitals (2011).
• The Ministry of Health has been investing in substantially improving the
capacity of its central purchasing agency; real effects are not yet visible.
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• Scheduled the Office of the High Commissioner for Health for closure.
• A centralized purchasing authority was created (SPMS) and steps taken
to make generic drugs available more quickly.
Provider infrastructure and capital investment
• Reorganization and rationalization of the hospital network, including
mergers and closures, to reduce hospital operational costs by 15% from
2011 to 2013, compared with 2010.
• Introduction of a target to save 5% on current expenditure costs in every
department/medical service, excluding personnel costs (2011).
• Efforts to increase competition among private providers to the NHS and
reduce expenditure by 10% in 2011 and another 10% in 2012. In 2011,
a reduction of 10.4% was observed, but 2012 figures are not yet available.