Addressing migrant access to healthcare in Portugal: promoting rights in a landscape of socio-political polarization

Introduction. Over the past decade, numerous global events have unfolded, spanning from migratory and humanitarian crises to health, political, and socio-economic challenges, culminating in a worsening of armed conflicts worldwide. Portugal has been marked by pronounced migratory inflows, mainly from communities in Portuguese-speaking countries, but also other regions. Yet, the growing phenomenon of political polarization, both globally and locally, has generated perceptions that challenge traditionally safeguarded rights. This study aims to analyze Portuguese public policies on access to healthcare, understanding how they have been operationalized to guarantee the migrant population's right to health. Methods. Against this backdrop, this article examines public policies related to healthcare access in Portugal through an analysis of Portuguese legislation, data from international organizations, and interviews with professionals from social organizations that provide support to migrants. Results. Concerning healthcare access in Portugal, the National Health Service (SNS) is founded on the Portuguese Constitution that guarantees the rights to healthcare for all. Notwithstanding the coexistence of private healthcare options, the SNS is universal, tends to be free of charge, and does not discriminate against citizens based on their socio-economic situation. Portuguese legislation ensures that foreign citizens are allowed access to healthcare under the same conditions as nationals, according to certain criteria. Conversely, even foreign citizens lacking proper documentation retain access to healthcare services within the SNS, regarding urgent situations, public health contexts, and other specified circumstances. However, testimonies from NGOs’ professionals report persistent barriers and limitations in the operationalization of healthcare legislation and reflect issues that hinder access to healthcare services. Discussion and conclusions. The findings highlight that Portugal’s public health policies are widely recognized, but a landscape of socio-political polarization could change this scenario. Bureaucratic and operational barriers persist, hindering access to healthcare for certain migrant populations, especially the most vulnerable. This study underscores the need for more equitable and inclusive policy strategies, aligned with the National Health Plan, and presents key aspects requiring Social Work attention to promote collective health.