The European Union member countries have approached the economic and financial crisis differently in 2008. There were only a few that have guided the outcomes of their policy responses.
Some evidences showed on whether or not savings undermined the performance of health systems. During this study and using Portugal as an example, researchers discussed the financial adjustment program implemented between 2011 and 2014, in order to explore the views of health workers on the effects of austerity measures on quality of healthcare services.
The way that health services are planned, purchased, and delivered has a direct impact on the key dimensions of health system performance, efficiency, quality and access. The economic and financial crisis that hit most member countries of the European Union raised a question about the impact of cuts in public funds and other austerity measures with neutral effects in the performance of health services.
This type of themes received a little attention in debates about the effects on the quality of health services of political responses to the crisis felt. A paper published on BiomedCentral tried to contribute for the debate, digging a deeper look on the different levels of care. There, it was explained why various categories of physicians, working in different environments have reached to various pressures generated by policy responses to the crisis.
There was a massive reduction in public cost and it came more from a cost-sharing, tighter drug-market regulation, control over prescriptions, and control over the management of public organizations. In contribution to a lesser extent, improvements in public-private partnership contributed for a better access to primary healthcare along with workforce changes.
The adjustment programs like those of Greece, Portugal, Ireland, and Cyprus filled an important gap in the literature on policy responses in Europe.
This study resulted in a non-convergent evidence and therefore further analysis was required. The main framework for this study was built on two unnoticed assumptions – first, the understanding of the effects of the crisis on health systems performance is still limited given that few analyses conducted on quality of care as compared to efficiency and access, and, second, looking at healthcare delivery, it is likely to reveal differences in relation to the analysis of planning or purchasing due to workplace-level emergencies.
Reforms made under the Portuguese adjustment program have negative effects on the quality of care with less favorable conditions for medical residencies. These reports showed a consistently higher number of negative effects among physicians working exclusively for the NHS, which illustrates that the public sector was the main target for the health-related austerity measures, even if it was expected to be applied to all types of providers without exception.