Portugal’s governing parties have tabled a bill requiring illegal immigrants and foreign nationals without a permanent residence to pay for the use of the national health service, the Serviço Nacional de Saúde (SNS). The exception is acute, life-threatening cases, but even in such instances payment will be required retrospectively.
The proposal was submitted to parliament at the end of September. Portuguese citizens and foreign nationals with legal or temporary residence will continue to have preferential access. For people in irregular situations or without a place of residence in Portugal, access will be conditional upon payment for the services.
Necessary to safeguard the welfare state and curb medical tourism
It is claimed that an increasing number of third-country nationals are travelling to Portugal to access free healthcare services, and that people smugglers are also being used. The governing parties place the blame for the current lax regulations entirely on the Socialist Party and the rest of the parliamentary left.
The parties refer to a report from November 2024 showing that around 330,000 foreigners not resident in Portugal were treated at the A&E departments of SNS hospitals between 2021 and September 2024. Of these, more than 140,000 had neither insurance nor international agreements covering their treatment.
In the Algarve, in southern Portugal, unpaid bills totalling over 1.2 million euros were recorded for emergency treatment of non-resident foreigners in 2023–2024 alone. Nationally, the annual cost of unpaid healthcare services is estimated to exceed five million euros – and the figures are rising.
– Even the president admits that people arrive at the airport and head straight to hospital. SNS cannot be a free hospital for the world, writes Pedro dos Santos Frazão, deputy chairman of Chega:
40 per cent of patients at Amadora-Sintra are foreigners. The president herself admits that there are people who arrive at the airport and come straight to the hospital.
Portuguese people wait months for appointments and hours in A&E whilst Portugal pays for the healthcare of those coming from abroad.
The National Health Service… pic.twitter.com/9WNK6josMb
— Pedro dos Santos Frazão (@Pedro_Frazao_) 13 September 2026
The governing parties believe that these measures are necessary to safeguard the welfare state and put a stop to medical tourism. The bill is largely identical to a proposal adopted during the previous parliamentary term with the support of Chega, but which came to nothing due to a snap election.
Critics on the left believe the proposal diverts attention from the healthcare system’s real problems, such as staff shortages and underfunding.
The bill is now due to be debated in parliament. If it is passed, clear mechanisms for identification, collection and advance payment/guarantees will be established.
