Repealing Article 148 Of The Law No. 53-A/2006, Of 29 December, 2007 State Budget Did, That Creates The User Fees For Access To Inpatient And Ambulatory Surgical Act, And Repeals Article 160 Of The Law No. 64-A/2008 Of 31 December

Original Language Title: Revoga o artigo 148.º da Lei n.º 53-A/2006, de 29 de Dezembro, ¿Orçamento do Estado para 2007¿, que cria as taxas moderadoras para o acesso ao internamento e ao acto cirúrgico em ambulatório, e revoga o artigo 160.º da Lei n.º 64-A/2008, de 31 de Dezembro

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Group Group Parliament – Palace of Saint Benedict-1249-068 Lisboa-Phone:-Fax: 21 391 7456 21 391 9233 Email: – DRAFT law No. 47/XI TOTAL EXEMPTION FROM USER FEES in OUTPATIENT SURGERIES and HOSPITALIZATIONS the concept of outpatient surgery arises in the early 60. Since then, he has been developing exponentially. Currently, and in the face of surgical interventions carried out under internment, the European average of outpatient surgeries is 55%, and 75% in the United States of America.

According to the National Commission for the development of outpatient surgery, outpatient surgery provides improved access of patients to surgery, by reducing surgical waiting lists.

This is certainly an advantage to highlight in the outpatient surgery, but it's not the only one. This type of surgery are also health, social and economic advantages, internationally recognised and that it never hurts to remind:-Health Benefits:  The clinical level, this type of surgery ensures a smaller number of infections acquired in hospitals which results also in a lower incidence of postoperative complications, such as respiratory, gastrointestinal and thromboembolic;  The organisational level, there is an efficiency gain in achievement of the surgical programs, enabling the reduction of the extensive waiting lists for surgery;  the release of operating traditional reduces waiting times for more complex or urgent surgeries.

-Social benefits:  firstly, ambulatory surgery cause a rupture less than normal family environment of patients, especially in cases of Pediatrics and Geriatrics;  Second, there is a rapid integration with most important repercussion in the adult population, professionally active;  Thirdly, ensures greater humanization in healthcare delivery, through the creation of specific and functional units for ambulatory surgery that offers more granular assistance;  the fact of there being a separation with the normal environment of the user, provides a recovery with more humanization and convenience, enabling a greater family involvement in this process.

-Economic benefits:  the ambulatory surgery ensures direct savings through reduced hospital costs related to the occupation of the operating and internment. It is estimated that the reduction in costs is between 40% and 80%, depending on the type of intervention and the place where it is practiced;  There is also a reduction of indirect costs because the interventions on an outpatient basis resulting in less morbidity and a more rapid integration of the patient.

However, with these advantages for all recognised already in Portugal only 22% of the surgeries are performed in outpatient regimen. Thus, there is an urgent need to develop incentives for outpatient surgery, not only in the health units, but also with the wearer.

On the one hand, it is important to stimulate the offer:-carrying out the necessary adaptations in services and in health units;
-creating selection criteria, social and medical surgical, in order to make an appropriate prior assessment of users;
-designing effective awareness-raising campaigns in order to inform users so that always is medically feasible, can opt for outpatient surgery.

On the other hand, focus on and promote the outpatient surgery, too, by demand. In a country where pay user fees for any health service and establishes a moderating rate of € 5.20 for every outpatient surgery, it is urgent that there is the will and the political courage to improve the conditions of access of users to health care.

The outpatient surgery brings economic benefits to the State only has advantages for the welfare and recovery of clients, our health services are able to be quickly ready to perform and this type of surgery dramatically reduces the waiting list for surgery under hospitalization. Is, then, to motivate the growth in your urgent Portugal.

In the last parliamentary term, the CDS-PP has submitted to Parliament a draft law aimed at the total exemption from user fees in outpatient surgeries and which was rejected by the majority of the Socialist Party. To corroborate this rejection, the Health Minister claimed that "there is a an educational and pedagogical and that all citizens must be aware that health is expensive and we all contribute to her". Position, in fact, reiterated by the Socialist Party, at the time of discussion in General, last February, said that "the charges are an important means for disciplining and guiding the search for an asset that, by your essentiality, must be the subject of the best adjustment of the provision of the necessary care needs". Furthermore, it stated that "a national health service as we understand not pities with surgical measures and electoral as well proposals; needs, instead, sustained and sustainable measures of reorganisation, as this Government has put in place ".

To the contrary, has spoken recently to the media the Minister of health, Antonio Correia de Campos, stating that "over the political cycle, I see no reason to keep the charges. I would if you were in the Government ". Says the former Minister that "the expansion of user fees to the surgery and the hospital stay was carried out at a time when there was no certainty about the sustainability of the National Health System. Subsequently, it has been seen that revenue collected were insignificant, although the disciplinary effect collection and hospital services and enhance your action (...) ".

Well, contrary to what was stated by the PS less than a year ago, the CDS-PP did not submit to your initiative in order to be a "surgical measure and electioneering," but because, for all the reasons mentioned above, we believe is crucial to promote outpatient surgery in Portugal.

We believe that the charges for hospitalization, introduced with the 2007 State budget are devoid of utility since, on the one hand, the admission is a clinical decision and will not likely to be "moderate". On the other hand, as recently stated Correia de Campos, these fees came to be "insignificant" in terms of revenue received.

In view of the above and pursuant to the constitutional rules, the CDS-PP presents the following draft law: article 1 is repealed article 148 of the law No. 53-A/2006, of 29 December article 2 is repealed article 160 of the law No. 64-A/2008 of 31 December article 3 this law shall enter into force on the day of 1 January 2010.

São Bento Palace, 11 November 2009.