The Legislative Assembly of Madeira’s 5th Commission for Health and Civil Protection, chaired by Joana Silva (PSD), has continued its examination of the regional ordinance governing the prescription of physiotherapy and rehabilitation treatments.
The proposed changes would restrict the prescription of certain Physical Medicine and Rehabilitation treatments to specialists in Physical Medicine and Rehabilitation (physiatrists) and, in specific cases, paediatricians.
The commission first heard, by videoconference, AntĂłnio Lopes, president of the Order of Physiotherapists. Lopes called for the ordinance to be reversed, arguing that it fails to recognise the professional competencies of physiotherapists, who are university-trained healthcare professionals. He criticised the Regional Government’s approach, saying it undervalues the profession’s expertise within the healthcare system.
Members of the commission also heard from Gil Bebiano Barros, president of the Madeira Regional Council of the Order of Doctors. Reiterating the position already submitted to IASaĂşde, he expressed support for the proposed changes to the regulations governing which professionals can prescribe treatments and which techniques are eligible for reimbursement.
According to Gil Bebiano, expenditure on these treatments has risen significantly in recent years without a corresponding improvement in patient outcomes. He also argued that the legal definition of a medical act means prescription powers should remain within the medical profession.
Meanwhile, the Liberal Initiative (IL) has voiced concern over the proposed model, warning that it could make timely access to physiotherapy more difficult and place additional pressure on the Regional Health Service.
In a statement following the hearings, the party said its concerns had been reinforced after evidence was heard from António Lopes, Gil Bebiano and IASaúde Board President Rubina Freitas. Although not a member of the commission, IL deputy Gonçalo Maia Camelo attended the proceedings.
The party argues that restricting prescribing powers primarily to physiatrists could create unnecessary delays. Instead, IL believes other medical specialists should also be able to prescribe physiotherapy when it falls within their field of expertise.
According to the party, orthopaedic surgeons should be able to prescribe treatment for musculoskeletal conditions, neurologists for neurological disorders, and other specialists for conditions within their own disciplines. It argues this would allow patients to receive appropriate treatment more quickly.
“The new model unnecessarily concentrates prescribing powers in a single medical specialty, creating a bottleneck that could result in avoidable delays in access to treatment,” Gonçalo Maia Camelo said.
The deputy also argued that limiting prescribing authority places additional pressure on a specialty already facing workforce shortages while creating unnecessary bureaucracy.
“Those who will ultimately pay the price for these limitations are the patients. Every additional administrative step or restriction on access to professionals who can prescribe the necessary treatment increases the risk of delays, worsening health conditions and a reduced quality of life,” he said.
The Liberal Initiative says it supports a “more open, functional and patient-centred” model of Physical Medicine and Rehabilitation, based on recognising the competencies of different medical specialties and ensuring quicker access to physiotherapy services.
Samantha Gannon
info at madeira-weekly.com
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