"In these 15 months, despite the external constraints, the largest reform in organisational terms in the 45 years of existence of the NHS was carried out", states Fernando Araújo in the statement in which he announced that he will present, together with his team, his resignation to the new Minister of Health, Ana Paula Martins.

At the end of 2023, the now Minister of Health resigned as chair of the board of directors of the Centro Hospitalar Universitário Lisboa Norte, denying at the time that her decision was based on "any disagreement with the Executive Directorate of the NHS" (DE-SNS).

In today's statement, Fernando Araújo stressed that reforms in any area are difficult, in "health they are particularly complex and demanding", but that since January 2023 it has been possible to implement legislative changes, introduce new economic models, plan strategies and organise processes, involve the teams of the various institutions, establish external mechanisms to monitor and evaluate the reform and "really change the NHS".

Among the "most important dimensions implemented", the doctor highlighted clinical integration, the constitution of an "effective network of NHS institutions that would function in an articulated and complementary manner", per capita funding adjusted to risk, supplemented with funds to cover the flow of patients between local health units (ULS).

In terms of guaranteeing the sustainability of the NHS, Fernando Araújo guaranteed that the creation of value-based health programs has been initiated, focusing the NHS on results for the user, on primary health care and on proximity, "finally effectively prioritising the prevention of disease and the promotion of health".

"Our concern was to simplify the management of the NHS, by increasing the autonomy of institutions in relation to other decision-making levels (sometimes called verticalisation, but whose scope is to reduce the levels of decision-making, increasing the speed of responses and bringing the decision closer to the place where care is provided), and reducing the number of institutions by more than half (from over 100 to less than 50) and the respective administrative positions", added the resigning executive director.

According to the doctor, the defence of human resources in a "vision of motivation and recognition for the excellent work carried out", the investment in the modernisation of the NHS structures and equipment, were among the "most relevant aspects and whose work still has a long way to go".

"At the same time, a de-bureaucratisation agenda was implemented", added Fernando Araújo, pointing out the examples of self-declaration of illness, certificates of temporary incapacity in private and social services and in the emergency services of public hospitals and the renewal of prescriptions for chronic diseases available in pharmacies.

In addition, the extension of the validity period of prescriptions and complementary means of diagnosis and therapy to 12 months, the pilot projects of the Medical and Psychological Assessment Centres for the issuing of medical certificates for driving licences and other purposes, vaccination in community pharmacies and access by doctors from the Social Security boards to the electronic clinical process were implemented.

"These measures, some of which had been demanded for decades, have a common characteristic: administrative simplification, making life easier for users, de-bureaucratising the work of health professionals, and improving satisfaction in the use of services", assured Fernando Araújo in the statement that takes stock of 15 months in office.

The executive director announced today that he will present his resignation, together with his team, to the Minister of Health, arguing that he does not want to be an obstacle to the Government in the policies and measures that it considers necessary to implement.

"Respecting the principle of institutional loyalty, I will present to the Minister of Health, together with the team that I lead, the request for resignation from the position of executive director of the National Health Service", added Fernando Araújo.

Leia Também: Fernando Araújo's resignation was expected, says the president of the Medical Association (Portuguese version)