The state of the health workforce in Portugal.

This paper discusses the state of the health workforce in Portugal's mainland during the past four decades. Healthcare workers represent 3.76% of the Portuguese workforce. All health professional groups significantly increased since 1960. Growth has been continuous for hospital physicians and nurses in general, as well as for primary care nurses. Primary care physicians are an exception, growing until the late 1970s but steadily decreasing afterwards. The density of physicians per 1000 inhabitants is above the European average. For nurses, Portugal is at the lowest European limit. However, the regional distribution of nurses, and also of pharmacists, across the country is more equitable than for physicians. The number of workers employed by the Health Ministry has grown by 44.6% between 1985 and 2004, with 127 013 employees registered in 2004. There has also been a marked increase in the number of female employees. Only 23.6% of healthcare workers employed by the Health Ministry, work at primary care level. Data on the private sector is insufficient in spite of its rising importance. The right number and mix of healthcare workers for an optimal healthcare system performance is a complex question and answering it requires an adequate information system. Portugal does not have such a system yet.