Doctors must file interests under new access system

Update: The new National System for Access to Consultations and Surgeries (National System for Access to Consultations and Surgeries (Sistema Nacional de Acesso a Consultas e Cirurgias)) requires doctors who participate to submit annual declarations of interests and includes an alert mechanism to guard against fraud. The model was promulgated by the President of the Republic, who nonetheless expressed reservations, while authorities say the rules aim to increase transparency in the programme. This may affect how publicly referred consultations and surgeries are allocated and monitored — important if you use public referral routes.

Context & Explainers

A declaration of interests is a written statement listing financial, professional or personal ties that could influence someone’s official duties; in Portuguese this is a declaração de interesses (declaração de interesses). For doctors this typically includes payments, research funding or relationships with pharmaceutical and medical-device companies, and public declarations are used to increase transparency and manage conflicts of interest in healthcare.

SINACC (Sistema Nacional de Acesso a Consultas e Cirurgias—National System for Access to Consultations and Surgeries) is Portugal's new digital healthcare management platform replacing the outdated SIGIC system, created in 2004. Approved by the government on October 24, 2025, SINACC became operational in late 2025, with President Marcelo promulgating it on January 8, 2026.

The system is fully computerized, requiring all patient referrals to be electronic, eliminating paper-based processes. Patients can track their position on waiting lists in real time via app, website, or SNS contact center and choose between public, private, or social-sector hospitals when reaching 75% of guaranteed maximum response times for surgery. The platform uses artificial intelligence to identify anomalies—unusual pricing or suspicious list growth—addressing perverse incentives in SIGIC where longer waiting lists generated more additional-surgery revenue.

SIGIC permitted doctors in private/social sectors to refer SNS patients then operate on them in public hospitals. SINACC's strengthened incompatibility regime prevents this conflict of interest. The system also prevents physicians from cherry-picking additional surgeries, eliminating a distortion where hospitals profited from maintaining long queues.

Financed by Portugal's Recovery and Resilience Plan (PRR) with €5 million for phase one, SINACC aims to reduce patients exceeding maximum waiting times and increase operational transparency. Implementation delays occurred due to insufficient staff training across health units, though testing in Coimbra, Alto Ave ULS, and Lisbon's Oncology Institute proceeded smoothly. The system represents a major modernization of Portugal's surgical-access governance.