A Dinheiro Vivo analysis argues the National Health Service (Serviço Nacional de Saúde) needs a predictable, result-focused organisation, with Reference Centres and Hospital Referral Networks forming a structural pillar of quality and safety. The piece says formal universal access alone is not enough: without properly organised referral pathways and specialised centres, patient outcomes and system reliability suffer. The article highlights ongoing debates over how to structure specialised care in Portugal and how to measure results. Those who rely on the SNS should watch for administrative changes that could affect where and how specialised care is referred.
Reference centres and referral networks underpin NHS
Monday, 2 March 2026AI summary
Context & Explainers
The Alfredo da Costa Maternity Hospital (Maternidade Alfredo da Costa, commonly known as MAC) is Lisbon's principal public maternity facility and one of the busiest maternity units in Portugal's National Health Service (Serviço Nacional de Saúde).
Located in central Lisbon, the MAC is a referral center for high-risk pregnancies and complex neonatal care. It handles a large volume of births annually and serves as a teaching hospital affiliated with Lisbon's medical schools.
The MAC has been at the center of recurring debates about maternity ward closures and staffing shortages across Portugal's public health system. Expectant parents in the Lisbon area may be referred to the MAC for specialist care or diverted there when other maternity units temporarily close due to staff shortages.
Hospital referral networks are organised groups of hospitals and specialised centres that handle complex cases and high‑level treatments within the National Health Service (Serviço Nacional de Saúde or SNS). In Portugal these redes de referência hospitalar concentrate technical expertise and coordinate referrals, so they determine which hospitals patients (including residents and expats) are sent to for specialist care and can affect waiting times and travel for treatment.
