This additional production is seen as a vital mechanism for reducing surgical waiting lists and meeting guaranteed maximum response times (TMRG).

Figures a steady increase: 88,465 surgeries in 2020; 135,888 in 2021; 158,628 in 2022; 197,270 in 2023; and 239,172 in 2024. In the first quarter of this year alone, 195,214 surgeries were performed, with 63,000 carried out outside doctors’ regular hours, making up 45% of all operations in that period.

Total surgical activity – including standard, additional, and outsourced procedures – has grown from 458,000 in 2020 to over 733,000 in 2024. Additional surgeries are governed by agreements between hospital boards and service directors, under regulations that allow extra payment for staff involved. Terms may vary between units but must comply with legal parameters.

The DE-SNS did not disclose the associated costs. The system has come under scrutiny following a report that a dermatologist at Lisbon’s Santa Maria Hospital allegedly earned €400,000 over 10 Saturdays, prompting investigations by the Public Prosecutor and the Health Insurance.

This is linked to the current SIGIC system for managing surgical waiting lists, which the government plans to replace with SINACC, a modernised model aiming for better coordination, monitoring, and integrated care. A task force was formed in March to lead the transition, with the final report due within six months.