Most city councils have not yet accepted the decentralization of competencies in the areas of health, education and social work. Of the 201 municipalities eligible for the decentralization of health, 57 have agreed, and of these, only 20 (10% of the councils) have already signed the transfer notice allowing them to begin running health centers.
The latest report on the decentralization process, issued by the Directorate General of Local Authorities (DGAL), revealed that most of the municipalities that refused to take over health centers in 2020 “reported that this decision continued into 2021.” About 70% have not yet accepted.
The delay of the chambers that have previously approved the government, but still do not manage the centers, is due to the fact that they do not accept the draft transfer notice, which provides for the imposition of penalties or oversight by regional health departments or, to the extent, the withdrawal of jurisdiction. According to the DGAL, “these issues were raised by the National Association of Portuguese Municipalities” and, therefore, “there was a need to review the content of the draft report that had already been approved, with an ongoing negotiation process towards its harmonization, and to address the questions.”
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