Table 1 Background information of the troika and the bailout programme

Troika’s sovereign creditors & decision group [40]:

 ▪ European Central Bank (ECB)

 ▪ European Commission (EC)

 ▪ International Monetary Fund (IMF)

Economic Adjustment Programme for Portugal:

 ▪ Memorandum of Understanding on Specific Economic Policy Conditionality (MoU)

 ▪ Technical Memorandum of Understanding (TMU)

 ▪ Memorandum of Economic and Financial Policies (MEFP)

• €4.7billion cuts of public expenditure by 2014 [6]

• Cuts predominantly in health care, education and social security

 ▪ Education:

  ▪ Reduction in spending by 23% from 2010 to 2012

 ▪ Social security:

  ▪ Family allowance for families with children was reduced to 44.60€ per month (2010)

• In healthcare mainly on: drug expenditure, workforce and user charges

• Workforce:

  ▪ Further cuts of 30.000 jobs in the public sector (2013)

  ▪ Salary freezes (2010)

  ▪ Income cuts (2011–2012)

▪ Drug expenditure:

  ▪ Decrease from 1.55% (2010) to 1.25% (2012) and 1% (2013) of GDP

  ▪ Savings in public retail pharmaceutical expenditure:

   ▪ reductions in pricing

   ▪ promotion of competition

   ▪ electronic prescribing

   ▪ prescription monitoring

▪ User charges increase

  ▪ Primary care: from 2.25€ to €5.00€

  ▪ Emergency visits for:

   ▪ Primary care: 3.40€ (2007) to 10.35€ (2014)

   ▪ Secondary care: 8.75€ to (2007) 20.65€ (2014) [11, 44, 66]

▪ Structural reforms: [44, 45]

  • enhance growth

  • generate employment

  • increase competitiveness

▪ A fiscal consolidation strategy

  • enhanced financial control over public-private-partnerships and state-owned enterprises

  • decreasing public debt and deficit reducing the deficit below 3% of GDP by 2014

▪ A financial sector strategy

  • to protect the financial sector against deleverage