The New Statute of the Portuguese Medical Association

Law no. 9/2024 of 19 January revises the Statute of the Portuguese Medical Association for the third time, introducing changes that directly affect the competences, autonomy, and independence of the Portuguese Medical Association, as well as the role that doctors play nowadays. Considering the changes in question, the new Statute of the Portuguese Medical Association requires particular attention from those who exercise the medical profession.

The changes introduced form part of a legislative reform of the Statutes of Professional Associations as part of the Recovery and Resilience Plan (PRR), which aims, inter alia, to reduce barriers to access to professions regulated by Professional Associations and to combat socio-economic discrimination in the access of new generations to these professions.

A new reality for the medical profession

With the new redaction, the Statute of the Portuguese Medical Association now expressly lists the acts of doctors in Article 96-A (1). This includes the exclusive exercise of diagnostic, prognostic, surveillance, research, medico-legal expertise, clinical coding, clinical auditing, prescribing and carrying out pharmacological and non-pharmacological therapeutic measures, medical, surgical and rehabilitation techniques, health promotion and disease prevention in all its dimensions, namely physical, mental and social of people, population groups or communities, while respecting the deontological values and leges artis of the medical profession.

Simultaneously, the Statute of the Portuguese Medical Association now permits the practice of acts specific to doctors by people not registered with the Portuguese Medical Association, provided they are legally authorised to do so, as prescribed in Article 96-A (4). This permission reflects a tendency observed in similar changes to the statutes of other professional associations, raising significant questions as to how authorisation to perform specific medical acts will be implemented empirically.

Furthermore, it is worth highlighting the possibility for doctors to set up or become partners in medical professional societies or multidisciplinary societies, as provided for in Article 116 (1) of Law 9/2024 of 19 January. These societies need to be registered with the Portuguese Medical Association and, therefore, enjoy the rights and are subject to the duties set out in the new Statute, thus guaranteeing the Portuguese Medical Association the exercise of its supervisory and disciplinary functions over these societies.

In addition, the Statute of the Portuguese Medical Association implements the incorporation of a “Supervisory Board” in the list of the higher bodies of the Portuguese Medical Association, as stipulated in Article 61. This body will assume crucial competencies, set out in Article 63 of Law no. 9/2024 of 19 January, including the supervision of the legality and statutory and regulatory compliance of the activity carried out by the various bodies of the Association. Regarding the composition of the Supervisory Board, only 40 per cent of its members will be doctors with current registration.

Alongside the Supervisory Board, the Statute of the Portuguese Medical Association establishes the “Ombudsman for the recipients of services”, an independent personality who is not a member of the Portuguese Medical Association, who will be responsible for defending the interests of the recipients of the professional services provided by the members of the Association, as set out in Article 64-A. Among other things, it will analyse complaints submitted by recipients of medical services and issue recommendations for their resolution, as well as for the improvement of the Portuguese Medical Association.

The road traveled

The new Statute of the Portuguese Medical Association results from a long and rocky road, and the President of the Republic vetoed the decree amending the Statute. In his letter to the President of the Portuguese Parliament, the President of the Republic concluded that the Statute does not guarantee the autonomy of the Portuguese Medical Association, prevents the Portuguese Medical Association from intervening in areas of a purely technical nature, such as recognising the suitability and respective training capacity of services, as well as defining the training content of each speciality. Furthermore, the President of the Republic expressed concerns that the changes to the Statute could jeopardise the quality of training for future professionals and, consequently, the quality of medical care and the stability of the National Health Service itself. Despite the concerns expressed by the President of the Republic, the Assembly of the Republic confirmed the decree, which led to its promulgation by the President of the Republic.

In theory, the revision of the Statute of the Portuguese Medical Association aimed to balance flexibility in access to the medical profession and strengthening the supervision of professional activity, whether in individual practice or multidisciplinary societies. The reality, however, may be more challenging, and there are doubts as to whether the changes made to the Statute of the Portuguese Medical Association will benefit or harm the quality of the medical service provided in Portugal in the medium to long term.