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Managing NHS money in Portugal: who decides?

Ana Maria Reis (ISAG - European Business School and Research Center in Business Sciences and Tourism (CICET - FCVC), Porto, Portugal)
Ana Pinto Borges (ISAG - European Business School and Research Center in Business Sciences and Tourism (CICET - FCVC), Porto, Portugal)
Nuno Araújo (CESPU, Instituto Universitário de Ciências da Saúde, Gandra, Portugal)

International Journal of Health Governance

ISSN: 2059-4631

Article publication date: 31 December 2020

Issue publication date: 4 June 2021




The need to reduce health expenditures raises the discussion on rationing possibilities and there is a growing interest in considering society's perspectives. The aim of this paper was to evaluate Portuguese citizens' opinion regarding the imposition of limits on National Health Service (NHS) spending. We also asked who decides how NHS money is spent, in order to obtain the respondents' views on public involvement.


An online questionnaire was used to collect data. Descriptive and inferential statistics, factorial analysis and a logit model were applied.


Our results showed that most of the respondents believe citizens have low participation on NHS' financial decisions, confirming the lack of public involvement. Health professionals are more likely to agree with limits on NHS spending, which could indicate potential inefficiencies.

Practical implications

From a health policy perspective, we have concluded that different stakeholders should be involved before deciding how public spending limits should be implemented. Health professionals' perspectives should be considered, taking advantage of their experience.


The main novelty of this paper is the evaluation of whether there should be limits on NHS spending, comparing health professionals and non-health professionals.



Reis, A.M., Pinto Borges, A. and Araújo, N. (2021), "Managing NHS money in Portugal: who decides?", International Journal of Health Governance, Vol. 26 No. 2, pp. 135-149.



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Copyright © 2020, Emerald Publishing Limited

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