The Portuguese Physiotherapists’ Association at a hearing before the Legislative Assembly of Madeira

The President of the Portuguese Physiotherapists’ Association, António Lopes, took part this Tuesday, via videoconference, in a parliamentary hearing of the 5th Standing Specialised Committee on Health and Civil Protection of the Legislative Assembly of the Autonomous Region of Madeira.

The hearing focused on the changes introduced by Ministerial Orders Nos. 190/2026 and 191/2026, of 30 April, to the procedures for referral and prescription of physical medicine and rehabilitation care.

The involvement of the Portuguese Physiotherapists’ Association follows on from the monitoring that has been carried out on this matter, particularly following the institutional meetings held in the Autonomous Region of Madeira on 11 and 12 June, with the Regional Secretariat for Health and Civil Protection and with various parliamentary groups.

At the hearing, the President of the Order reiterated the position of the Order of Physiotherapists regarding the need to ensure that physiotherapy services are more accessible, appropriate and focused on patients’ needs, whilst recognising the technical and scientific autonomy of physiotherapists and their contribution to the health system.

He also emphasised that, under the current legal framework, physiotherapy services can and should be requested via referral from any doctor, regardless of their specialism, with physiotherapists bearing responsibility for the design, planning, delivery, assessment and adjustment of their treatment.

Concern was also expressed regarding the reversal of the model previously in force in the Autonomous Region of Madeira, under which doctors from various specialities could refer patients for physiotherapy, as this represents a step backwards in relation to developments in healthcare delivery models and the rational use of existing human resources.

Other concerns highlighted included the risk of duplicate medical appointments, the potential loss of entitlement to reimbursement of healthcare costs, and the clinical, social and economic impact of postponing the start of treatment.

The Order will continue to monitor developments in this area, in collaboration with the Madeira Regional Directorate and the relevant authorities, whilst remaining available to contribute to solutions that improve the public’s access to physiotherapy care.

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Pedro Maciel Barbosa

Specialist physiotherapist at the Matosinhos Local Health Unit Sub-coordinator for Primary Health Care, Matosinhos Local Health Unit Visiting Assistant Professor at the Porto School of Health Member of the Board of Directors of the Foundation for Health - SNS Member of the General Council of the Order of Physiotherapists

Carlos Sand

Carlos Areia has been a physiotherapist since 2013, and has worked in various hospitals, clinics and clubs in both Portugal and the UK. He began his academic career at Oxford University in 2016, where he led a clinical trial comparing physiotherapy vs surgery in anterior cruciate injuries in 32 hospitals in England. In 2018 she moved to the neurosciences department, where she developed her own studies on remote monitoring of vital signs, which were implemented during the pandemic. Here he discovered his passion for data, and in 2022, he joined Digital Science as a Data Scientist. He completed his PhD earlier this year, and has more than 60 publications in journals such as The Lancet, BMJ, Cochrane, among others. He is also an honorary lecturer at Oxford Brookes University and a consultant in clinical research.

Eduardo José Brazete Carvalho Cruz

PhD in Physiotherapy from the University of Brighton, UK. Post-Doctorate in Epidemiology from the National School of Public Health at the New University of Lisbon.
Coordinator of the Studies and Planning Office of the Order of Physiotherapists. Coordinating Professor of the Physiotherapy Department of the School of Health of the Polytechnic Institute of Setúbal (ESS-IPS). President of the ESS-IPS Technical-Scientific Council. Coordinator of the Physiotherapy Department at ESS-IPS. Integrated Researcher at the Comprehensive Health Research Centre (CHRC) (a partnership between FCM-UNL, the National School of Public Health, the University of Évora, the Lisbon Institute of Global Mental Health and Santo Espírito Hospital, Terceira Island, Azores).

Sara Souto Miranda

Sara Souto Miranda has a bachelor's and master's degree in physiotherapy from the University of Aveiro, and a postgraduate qualification in adult respiratory physiotherapy from the same institution. In 2023 she completed her double doctorate in Rehabilitation Sciences/Health, Medicine and Life Sciences at the Universities of Aveiro and Maastricht (Netherlands) and is currently working as a technical-scientific advisor to the Studies and Planning Office (GEP) of the Order of Physiotherapists, and as a guest lecturer at the Piaget Institute in Vila Nova de Gaia. As a member of the Respiratory Research and Rehabilitation Laboratory at the University of Aveiro (Lab3R), she has carried out applied research in which she has assessed and treated patients with respiratory pathology, having taken part in 6 research projects. Throughout her career she has published 19 scientific articles in international peer-reviewed journals with an impact factor, 1 book chapter and more than 50 abstracts in conference proceedings. She was a research volunteer at the Ciro rehabilitation centre (Centre for expertise in chronic organ failure) in the Netherlands, and is currently a member of the Guideline Methodology Network of European Respiratory Society. She was honoured by European Lung Foundation e European Respiratory Society for carrying out patient-centred research, by the Directorate General for Higher Education with a merit grant for his master's degree, and by the Ciro Centre with a grant to support research abroad.

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