This trend contrasts with the occurrence in the first decade of the 21st century, where there was a strong presence of professionals from the nation-states with Portuguese as an official language in Africa (PALOP), a prevalence replaced by workers from the European Union, mainly from Spain, who represent around one-third of the Ministry of Health’s foreign human resources.

In the last decade, the majority of human resources of foreign nationality were from Spain (33 percent in 2011, gradually decreasing to 19.6 percent in 2022), Brazil (13.5 percent in 2011, gradually increasing to 24.9 percent in 2022) and Angola ( (from 8.2 percent in 2011 to 8.6 percent in 2022).

In 2021 and 2022, there was an increase in foreign human resources at the Ministry of Health, totalling 3,958 in 2021 and 4,055 in 2022 (representing 2.7 percent of the SNS’s human resources), recovering from the decline since 2004, the year with the highest number of foreign employees (4,490), which represented the greatest relative importance in the Ministry of Health’s total of human resources (3.5 percent).

Foreign doctors represented 5.8 percent in 2021 and 5.6 percent in 2022 of the total of SNS doctors, while foreign operational assistants represented 4 percent and 4.3 percent in 2022 of the total of operational assistants, increasing their relative importance.

Nurses of foreign nationality decreased to half of those registered two decades ago, maintaining their relative importance assumed since 2015, representing 1.3 percent of nurses in the Ministry of Health.

The SNS’s foreign resources are majority doctors, who in 2015 represented 62 percent of the total, despite losing relative importance in 2022, representing 43 percent, totalling 1,729 in 2022.

Followed by foreign operational assistants (1,312 in 2022), foreign nurses (677) and foreign human resources in other professions of the Ministry of Health (337).

The number of operational assistants of foreign nationality at the Ministry of Health has increased significantly in the last decade, from 413 in 2011, 1,071 in 2020, 1,343 in 2021, and 1,312 in 2022, surpassing the number of foreign nurses in the SNS since 2019.

Foreign health professionals decreased in 2020 to 1,256,584 less than in the previous year, representing the lowest value in the last decade, however, recovering in 2021 and 2022 to 1,747 and 1,729, respectively.

“Portugal, in comparison to other OECD countries, is far from being considered a preferred destination for the migration of health professionals”, reads the document from the Observatório de Migrações.

Among the causes, were difficulties related to the overqualification in the national job market, through requests for recognition of foreign academic degrees in the field of health and additional training programs.

If immigrants were to assume the role as healthcare providers, namely to fill the gaps in the supply of health professionals, the Portuguese have expressed being comfortable with the scenario, in accordance with respondents to the Special Eurobarometer on the integration of immigrants in the European Union (2017 and 2021).

In this study, among the 27 Member States of the European Union, Portugal secured fourth place (alongside Luxemburg and Spain) in the most favourable countries, with 92 percent of respondents declaring that they felt comfortable having an immigrant doctor (55 percent totally comfortable and 37 percent tend to be comfortable), only 5 percent tend to be uncomfortable and 1 percent are totally uncomfortable.