Using Portuguese healthcare

Portugal has a universal healthcare system which is available to foreigners who are legal residents. The system has is a network of clinics and pharmacies in towns and villages all over the country. Usually, these health centers, “Centro de Saude” are open just a few hours a week. Ideally, there is a doctor who is available during these times, but some centers only have a nurse. The Covid situation put the Portuguese health system under great strain.

Fortunately, I enjoy good health and have had little reason to use my local health clinic. The only times I have been are few and far between. When I first arrived one of my new neighbor’s little dogs bit me and I had to get a tetanus injection. This was actually a blessing in disguise, because it obliged me to go to the main health center for my “Concelho” or municipal area, to register in the system. I had to provide identification and my residency permit and was eventually given a “numero de utente” or user’s number. This is the number you must always show when seeking to use any of the services in the Portuguese healthcare system.

The other time was when I was having some digestive issues. I went to the clinic in my local village and the nurse told me to wait. I was able to see a doctor who spoke English. He ordered a battery of tests which included bloodwork, electrocardiogram, abdominal sonogram and an endoscopy. Because I am over 65, I didn’t have to pay for the doctor visit. (People under that age usually have to pay a few euros.) I was only charged for one of the tests, and staff apologetically explained that it would cost me 15 euros!

Impact of Covid

Unfortunately, the Covid pandemic made it harder to access healthcare services during the past two years. Several hospitals had to temporarily close departments because of a lack of staff. The clinic in my local village did not have a doctor available for about a year. In order to see a doctor, you either had to go to the main municipal clinic on a Saturday morning, or go to the local hospital. Either option was about (16 kms) or 10 miles away.

Despite these drawbacks, Portugal had an efficient system for alerting people when they were eligible for a Covid vaccination or a flu shot. I received a text message on my mobile phone and sent a return text with my Utente number to confirm. I also received a letter in the mail giving me an appointment to get a mammogram at the mobile unit when it was visiting my area. No cost for the vaccinations or the mammogram!

Waiting game

I recently heard that a doctor would once more be visiting the Centro de Saude in my village. I stopped by one day when I saw the door open and a nurse told me I should come at nine o’clock on Friday morning to make an appointment. I duly turned up at the correct hour and found four people standing around outside the clinic, wearing masks. (There is something unnerving about wearing a mask, especially if you don’t speak the language fluently.) Luckily it was not raining that morning because I gathered from the conversations around me that the clinic was actually not scheduled to open until 10 a.m. We all stood outside in the chilly sunshine. More and more people showed up while we waited.

Finally, at about 9:45 the nurse arrived and we could go inside. Some of the people already had appointments. One of the other ladies told me I should go up to the window and ask the nurse. Fortunately my Portuguese language skills are improving and I was able to ask her if I could make a “marcação para uma consulta”. She scribbled out the time and date on a Post-It note. So, I have an appointment for next week. We’ll see how long I have to wait!

The hospital in Tomar, Central Portugal, which serves my area.

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