ERS
Professor Rui Nunes, responsável da ERS
O texto seguinte faz parte do Relatório da OCDE sobre "The Reform of the Health Care System in Portugal". Economics Department Working Papers n.º 405.
Depois de o ler, decidi fazer com ele um quadro que pendurei na minha sala de trabalho.
Todos os dias lhe lanço uma olhadela respeitosa. Tenho a máxima admiração por este pedaço de prosa que considero uma das mais notáveis peças de ficção programática que me foi dado conhecer e cuja realização, dificilmente, verá a luz do dia.
O texto seguinte faz parte do Relatório da OCDE sobre "The Reform of the Health Care System in Portugal". Economics Department Working Papers n.º 405.
Depois de o ler, decidi fazer com ele um quadro que pendurei na minha sala de trabalho.
Todos os dias lhe lanço uma olhadela respeitosa. Tenho a máxima admiração por este pedaço de prosa que considero uma das mais notáveis peças de ficção programática que me foi dado conhecer e cuja realização, dificilmente, verá a luz do dia.
The Health Regulatory Agency, ERS
47. The creation of the Health Regulatory Agency (Entidade Reguladora da Saúde, ERS) was approved in November 2003. This approach, apparently with few precedents in other countries, responds to the new public, private and non-profit mix of health care providers to the NHS (for hospitals, health care centres and continuous care) and the need to separate the state’s tasks of provider and financing from its regulation role. The new entity is a public body with financial and administrative autonomy (broadly in line with international best practices in designing sectoral regulatory agencies). The board is composed of a president and two members designed by the cabinet following a proposal from the Health Minister.57 It will be financed throught fines40 per cent of fines collected will be kept by the ERS, the rest going to the Treasury), fees on services (registration, provision of certificate and budgetary transfers.
48. The ERS regulates all actors providing health care services to the NHS including private actors, excluding activities that are already submitted to a specific sectoral regulation (such as the pharmacies). It is in charge of ensuring equity in access to health care, compliance to quality requirements and protection of patients’ rights and security. In particular, the ERS is in charge of preventing and fighting adverse selection and “cream-skimming”, as well as supplier-induced demand, which is more likely to occur when providers are paid according to activity. At the request of the Ministry of Health, it can assess contracts with providers and rules governing the sector. The entity can impose sanctions, including fines that will be made public. It will be also the entity in charge of collecting patients’ claims. The ERS will start its activity in 2004. The introduction of this independent regulatory body designed to ensure that productivity gains are not detrimental to quality and equity is an important step in the reform process. Care should be taken to redefine clearly the tasks of other structures already in charge of regulating the sector and ensuring quality of care - IGIF, the Directorate General of Health, the National Institute of Pharmaceuticals and Medicine (INFARMED) and the Institute for Quality in Health (IQS) - so as to limit overlaps.
57 - The President and members of the Health Regulatory Agency (ERS) have a five-year mandate (starting with two years, for the two members) renewable once. Professional activities in the two years before and after being a board member are strictly limited so as to avoid conflict of interests. Board members cannot be revoked except for serious professional fault. The agency will be staffed by people hired on individual contracts or civil servants in mobility. Of the 40 or 50 staff members, it is planned to have about ten inspectors who will be doing ground work in coordination with other entities involved in regulating the sector.
OCDE (Organisation for Economic Co-operation and Development)
47. The creation of the Health Regulatory Agency (Entidade Reguladora da Saúde, ERS) was approved in November 2003. This approach, apparently with few precedents in other countries, responds to the new public, private and non-profit mix of health care providers to the NHS (for hospitals, health care centres and continuous care) and the need to separate the state’s tasks of provider and financing from its regulation role. The new entity is a public body with financial and administrative autonomy (broadly in line with international best practices in designing sectoral regulatory agencies). The board is composed of a president and two members designed by the cabinet following a proposal from the Health Minister.57 It will be financed throught fines40 per cent of fines collected will be kept by the ERS, the rest going to the Treasury), fees on services (registration, provision of certificate and budgetary transfers.
48. The ERS regulates all actors providing health care services to the NHS including private actors, excluding activities that are already submitted to a specific sectoral regulation (such as the pharmacies). It is in charge of ensuring equity in access to health care, compliance to quality requirements and protection of patients’ rights and security. In particular, the ERS is in charge of preventing and fighting adverse selection and “cream-skimming”, as well as supplier-induced demand, which is more likely to occur when providers are paid according to activity. At the request of the Ministry of Health, it can assess contracts with providers and rules governing the sector. The entity can impose sanctions, including fines that will be made public. It will be also the entity in charge of collecting patients’ claims. The ERS will start its activity in 2004. The introduction of this independent regulatory body designed to ensure that productivity gains are not detrimental to quality and equity is an important step in the reform process. Care should be taken to redefine clearly the tasks of other structures already in charge of regulating the sector and ensuring quality of care - IGIF, the Directorate General of Health, the National Institute of Pharmaceuticals and Medicine (INFARMED) and the Institute for Quality in Health (IQS) - so as to limit overlaps.
57 - The President and members of the Health Regulatory Agency (ERS) have a five-year mandate (starting with two years, for the two members) renewable once. Professional activities in the two years before and after being a board member are strictly limited so as to avoid conflict of interests. Board members cannot be revoked except for serious professional fault. The agency will be staffed by people hired on individual contracts or civil servants in mobility. Of the 40 or 50 staff members, it is planned to have about ten inspectors who will be doing ground work in coordination with other entities involved in regulating the sector.
OCDE (Organisation for Economic Co-operation and Development)
Causa-me profunda estranheza verificar que os técnicos da OCDE, em relação a alguns temas, limitaram-se a transcrever os textos programáticos do ministro da Saúde, Luís Filipe Pereira, com escassa ou nenhuma análise crítica.
Ficamos a aguardar, com grande expectativa, pelo próximo relatório da OCDE sobre o Sistema de Saúde Português. Expectativa, redobrada, em relação a dois capitulos: "The Health Regulatory Agency "e "Reform in the Pharmaceutical Sector". Todo o relatório, para conferir se a efabulação sobre o Sistema de Saúde Português continua.
Ficamos a aguardar, com grande expectativa, pelo próximo relatório da OCDE sobre o Sistema de Saúde Português. Expectativa, redobrada, em relação a dois capitulos: "The Health Regulatory Agency "e "Reform in the Pharmaceutical Sector". Todo o relatório, para conferir se a efabulação sobre o Sistema de Saúde Português continua.
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