Healing the Health System: Innovation, Ethics and Sustainability

Healing the Health System is a practical manifesto to transform Portugal’s National Health Service (SNS), from the clinic to the Ministry, with feasible, measurable, patient-centred solutions. Using real diabetic foot cases as a “sentinel disease” for disorganisation and underfunding, the author shows how integrating teams, data, and technology can reduce amputations, waste, and waiting lists. More than diagnosis, the book lays out an action roadmap. Combining clinical and management experience in Portugal and the United Kingdom, the author proposes: Integrated care pathways and clear clinical leadership, replacing “islands” of specialties with multidisciplinary teams sharing common goals. Radical transparency of costs and outcomes, with interoperable records and public indicators to guide decisions and correct asymmetries. Tokenisation of clinical episodes and the use of blockchain for audit and accountability: every euro traceable, every procedure verifiable, every outcome measurable. MPBS — Medical Procedure-Backed Securities (bonds linked to medical procedures), a new financing track that complements the state budget, pays for delivered value, and accelerates care delivery. A National Digital Health Strategy: interoperability, health literacy, open data, and ethical governance so that technology serves equity, not the other way around. The book includes proposals for pilot projects (from diabetic foot monitoring to medicine traceability), a phased implementation plan in Local Health Units, and safeguards to avoid “two speeds” in access. Everything is framed with metrics, timelines, and success criteria to move from theory to practice quickly and rigorously. Who is this book for? Health professionals who want less bureaucracy and more results. Managers and decision-makers who need tools for sustainability and equity. Technologists, health economists, and citizens interested in innovation with public impact. Central message: the future of healthcare is decided today. With data, leadership, and value-oriented financing mechanisms, it is possible to rebuild trust and ensure an SNS that is fairer, more efficient, and more humane, without abandoning its founding principles. About the author A surgeon with more than two decades of practice in Portugal and the United Kingdom, a coordinator of surgical units and trainer, the author combines frontline experience with a strategic vision for health management and innovation.