Olhar para o passado, analisar o presente para antevermos o futuro no setor da saúde.

Olhar para o passado, analisar o presente para antevermos o futuro no setor da saúde.
You may be interested in my monthly article in the Portuguese publication Dentistry.
Open the English version of the article (pdf).
Open the Portuguese version of the article (pdf)
Desde a sua criação na década de 1970, o CEPLIS é a única organização que representa os interesses dos Profissionais Liberais ao nível europeu.
A Assembleia Geral do CEPLIS, European Council of the Liberal Professions, Conselho Europeu das Profissões Liberais, decidiu na sua reunião a 6 de dezembro de 2022 em Bruxelas aceitar a candidatura da ANPL, Associação Nacional dos Profissionais Liberais como membro Observador.
O CEPLIS é uma organização de cúpula que reúne associações, federações e confederações dos estados membros da União Europeia, nomeadamente, Aústria, Espanha, Bélgica, França, Irlanda, Itália, Luxemburgo, Malta, Roménia, de entre outros.
Tem como objetivos a coordenação e defesa dos interesses morais, culturais, científicos e materiais das profissões liberais, bem como a identificação e disseminação de toda a informação ou ação que ajude nos seus propósitos.
Desde a sua criação na década de 1970, é a única organização que representa os interesses dos Profissionais Liberais ao nível europeu.
Na prática, o CEPLIS é ao mesmo tempo um forum, uma organização de lobby, e uma embaixada da importante família sócio económica das profissões liberais e regulamentadas.
Ao longo da sua presença no cenário comunitário, construiu naturalmente uma ampla rede de contactos com as instituições e órgãos da União Europeia.
O CEPLIS é membro do Comité Económico e Social Europeu, no Grupo III, o das Organizações da Sociedade Civil. Mantém contactos estreitos com a Direção Geral da Concorrência da Comissão Europeia, das Empresas, do Mercado Interno e Serviços, da Saúde, Investigação e Inovação, etc.
Tem também sinalizados um conjunto de deputados europeus que revelam particular interesse pelas profissões liberais.
Esta estrutura, é regularmente consultada sobre questões relativas ao diálogo social europeu, relevantes para o exercício das profissões liberais. A este respeito, a parceria estratégica que estabeleceu com o Conselho Europeu de Profissionais e Quadros Dirigentes (Eurocadres), expressa os interesses intersectoriais de 6 milhões de profissionais por meio da advocacia, diálogo social, negociação coletiva, em trabalho conjunto com organizações membros e parceiros de cooperação.
Regularmente o CEPLIS organiza por si ou em parceria, seminários e conferências com o objetivo de reunir os funcionários da EU com os representantes das profissões, dando a estes últimos a oportunidade de fazer o seu próprio lobby, aumentando a visibilidade do setor nos países de origem.
Graças a esta rede e ação de lobby, o CEPLIS tem tido um impacto considerável na elaboração de importantes documentos do Parlamento Europeu para as profissões liberais, bem como no debate sobre a legislação da EU relevante ao nível do Parlamento e Comissão.
A Associação Nacional dos Profissionais Liberais (ANPL), assume-se em Portugal como a voz de defesa e promoção dos profissionais liberais, freelancers e consultores, entendidos como “os titulares de habilitações de natureza intelectual, incluindo as de carácter artístico e cultural, promovendo a sua responsabilidade, autonomia e independência no melhor interesse dos consumidores e da comunidade em geral.”
A ANPL tem uma cultura profundamente pró União Europeia. Temos uma visão estratégica de que é fundamental acompanhar e monitorizar os processos legislativos aí originados, sabedores que a legislação nacional tem origem em mais de 90% nas instituições europeias.
Acreditamos na importância da inteligência coletiva potenciadora das instituições da sociedade civil, partilhando valores, abordagens de governança e boas práticas nomeadamente ao nível da inovação, eficiência, sustentabilidade, digitalização, com o objetivo de melhorar a qualidade dos nossos serviços, contribuindo assim para aumentar a confiança dos destinatários dos nossos serviços e da sociedade em geral.
Como tal, estamos muito satisfeitos pela nossa recente adesão como membro Observador do CEPLIS. Pretendemos não apenas “observar”, mas participar ativa e construtivamente para partilhar a nossa realidade com os nossos colegas europeus, encarando esta nossa filiação como uma grande oportunidade para aumentar as redes comunicacionais pessoais e digitais entre profissionais liberais.
Orlando Monteiro da Silva
Presidente da Associação Nacional dos Profissionais Liberais
Ex-Bastonário da Ordem dos Médicos Dentistas
Este artigo foi originalmente publicado no jornal Observador a 13 de janeiro de 2023.
There is a different and deeply unfair treatment in Portugal and many European countries between employees and self-employed professionals. It is essential for liberal professionals to implement their own Statute. So that some don’t remain “more equal” than others.
The National Association of Liberal Professionals, ANPL, is assumed in Portugal as the only interprofessional voice for the defense and promotion of liberal professionals, freelancers and consultants, understood as the “holders of qualifications of an intellectual nature, including those of artistic and cultural, promoting their responsibility, autonomy and independence in the best interests of consumers and the community in general”.
Our reflection is as follows:
The organization of work is undergoing profound changes. Liberal professionals and alike, freelancers and consultants, will take an even more relevant role in the new realities that are affirming themselves.
In the European Economic Area, one in six self-employed workers works in a sector related to the liberal professions, and the trend is to increase.
In Portugal, despite the fact that there are already over 400,000 regulated professionals and more than 200,000 exercising qualified but unregulated professional activities, we see self-employed professionals without proper representation and defense of their interests in the economic, fiscal and social protection areas.
It is time to face and change this situation.
Only when they are properly heard and recognized, will it help to mitigate the tendency of proletarianization and remunerative degradation of these professionals and their consequences, such as the affectation of the quality in the provision of the respective services as freelancers as well in companies and organizations.
Thus, starting with the foundations, it is essential to implement the Statute of the Liberal Professional, so that around it a European and national legislative and regulatory building is consolidated allowing the integration, valorization and framing of these professionals.
A statute that recognizes in liberal and equivalent professionals a different form of practice, not only by specific training and qualifications, but above all by technical autonomy and independence, based on professional, corporate and organizations ethics, in many aspects an interdisciplinary ethics, oriented to the best interests of consumers and the community in general.
A Statute that integrates and contemplates essential aspects such as, among others:
Having observed this framework of basic requirements, we will be able to accommodate in this Statute, not only those who exercise the classic liberal professions, some of them organized in public and private professional associations, but also a set of other professionals who have been affirming the relevance of their activities in the economy and in various sectors and areas of knowledge, consultants, freelancers and digital nomads.
It should be recalled that the professional associations regulating in several countries specific aspects relating to the particular professions organized in them are faced with limitations imposed by different European and competition legislation, with regard to the approach of important aspects affecting their professionals:
in particular the impediment to engage in or participate in trade union activities or which relate to the regulation of the economic activities of its members.
However, an important part of the challenges and problems that affect liberal professionals are precisely related to these “prohibited” areas, for example, hiring modalities, wage or fee issues.
On the other hand, trade unions do not incorporate the concept of liberal profession in Portugal. Now, this omission also contributes, in addition to the social emptiness resulting from leaving hundreds of thousands of professionals without a voice.
There is a different and deeply unfair treatment in Portugal and many European countries between employees and self-employed professionals. It is essential for liberal professionals to implement their own Statute. So that some don’t remain “more equal” than others.
The ANPL is a structure that aims to help fill this gap, available to establish partnerships at national, European and global level, thus contributing to give voice to liberal professionals.
Orlando Monteiro da Silva
President of the National Association of Liberal Professionals
Health and Regulation Consultant
Past President of the World Dental Federation
European Union Transparency Register 742011744953-87
Visit us at https://anpl.pt/en/.
Article originally published in the Observador newspaper.
At the moment I am about to leave the presidency of the Ordem dos Médicos Dentistas – Portuguese Dental Association (OMD), elected and serving five consecutive terms, I hereby present a short review and some facts regarding these last 20 years.
Since then it was possible to:
At a national level, and as President of the Ordem dos Médicos Dentistas, it was also possible to occupy prestigious and prominent positions for all of us:
At an international level through the active participation in the most representative organisations of the profession, namely:
Today, Portuguese Dentists and Dental Medicine benefit from automatic recognition within the European Union and are considered valuable professionals worldwide.
I affirm, with the utmost pride in the profession, that the dental medicine practised in our country extends far beyond the limits of our borders. We are at the forefront of dentistry, recognized as a producer of knowledge and added value for Portugal.
Approximately 96% of OMD’s members practice in the private sector, in a country where, over the years, the public health system has repeatedly forgotten oral healthcare as a fundamental area for public health, which it undoubtedly is. As such, OMD maintained ongoing contacts with public decision-makers, creating a logic of permanent negotiation aiming, on the one hand, to defend the profession, Dentists and the general population and on the other, not less frequently, preventing harmful measures or inadequate policies from being implemented.
As other liberal professions, we have faced very difficult challenges during these last twenty years:
We leave an exemplarily managed and economically robust Order, with a body of employees and collaborators that constitute an enormous added value in the day-to-day of this Institution.
I, therefore, leave, with great pride in this collective journey, and total conviction of having served the Ordem dos Médicos Dentistas and the profession to the best of my effort, and, above all, with a clear conscience of accomplishment during my time in service.
The vast experience acquired will be applied to national or international projects related to health and that deem to be challenging.
I wish my successor, my colleague Miguel Pavão, and all the members of his team, the greatest success for the mandate that is about to begin. I declare my utter availability to collaborate with him and our Order, to the extent considered appropriate, especially in the handover to the next Governing Bodies, that will formally take office on July 18th.
Thank You!
Orlando Monteiro da Silva
The Ordem dos Médicos Dentistas, Portuguese Dental Association, 26th Congress took place at Altice Arena on the bank of the River Tagus, from the 16th to the 18th of November.
PDA 26th Congress (2017)
Total congress participants – 3.400
Number of scientific presentations – 107
Speakers – 96
Number of entries at Expo-Dentária – 16.600
The FDI President, Dr. Kathryn Kell, kindly accepted OMD’s invitation to participate at our Congress. See her inspiring speech below.
Official opening of Expodentaria Portugal with the presence of the Portuguese Minister of Economy, Manuel Caldeira Cabral.
The Secretary of State Assistant of Health, Fernando Araújo, presided the opening ceremony. It was one of the highest moments of the congress once he announced a proposal for the adoption by our National Health Service of a specific professional career for Portuguese dentists.
During the congress, the ceremony to award specialist titles in orthodontics (7), oral surgery (135),paediatric dentistry (63) and periodontology (55) took place.
More than 900 people attended the ceremony.
Saturday at the end of the day. Group photo of organising committee and volunteers. Mission accomplished. A happy end!
Macao is no longer administered by Portugal, but there is still a lot of Portuguese flavour in this Chinese territory. Perhaps these long lasting ties influenced my decision to accept the invitation to be Ambassador of Congresses in Macao.
I received the invitation from the Secretary for Economic Affairs and Finance of the Government of the Macao Special Administrative Region, Dr. Leong Vai Tac, that honoured me greatly. The mission of supporting the promotion of Macao as a privileged destination for holding business events and congresses, and at the same time promoting dental medicine, did not leave me indifferent.
I know this region well, I can see its potential. As the old Macao saying “he who drinks the water from the Lilau fountain, will not leave Macao”, I know well this constant desire to return, to see for myself the development and the growing dimension of Macao. It is a bit of this breathing in Macao that made me accept this invitation.
Macao is infinite in diversity. From the magnificent casinos, to the beaches, to the miscellany of cultures and gastronomy, to monuments, to the frenzy of people who come and go every day from Macao, our arms are not long enough to grasp this whole cultural, economic and Human dimension. Is there another place like this?
Macau já não é de Portugal, mas ainda há muito sabor português neste território chinês. Talvez por estes laços que teimam perpetuar aceitei o convite para ser Embaixador de Congressos em Macau.
Recebi o convite do Excelentíssimo Secretário para a Economia e Finanças do Governo da Região Administrativa Especial de Macau, Dr. Leong Vai Tac, que muito me honrou. A missão de apoiar a promoção de Macau como destino privilegiado para a realização de eventos empresariais e congressos, e em simultâneo promover a medicina dentária, não me deixou indiferente.
Conheço bem esta região, conheço o seu potencial. Como diz o velho ditado macaense “quem bebe a água da fonte do Lilau, não mais deixará Macau”, sei bem desta vontade constante de querer voltar, de ver o desenvolvimento e a dimensão crescente de Macau. É um pouco deste respirar Macau que me fez aceitar este convite.
Macau tem uma infinita diversidade de ofertas. Desde os magníficos casinos, às praias, a miscelânea de culturas e gastronomia, monumentos, o frenesim de pessoas que todos os dias entram e saem de Macau, enfim os nossos braços são curtos para apanhar todo este movimento, toda esta dimensão cultural, económica e humana. Haverá outro lugar como este?
As president of CNOP – National Council of Professional Orders, representing 16 professional orders and more than 320,000 professionals registered therein, we had a meeting with Portuguese Prime Minister, António Costa.
This Council was, until a few years ago, designated as National Council of Liberal Professions.
My reflection, as president of CNOP – National Council of Professional Orders, to the Portuguese Prime Minister António Costa was based on liberal professions and the need for a common definition of “liberal profession” both in Portugal and in Europe and a correspondent representation at a political level.
According to the European Economic and Social Committee where CNOP is represented:
“A liberal profession is characterised by: provision of a valuable intangible service that is distinctly intellectual in nature, based on advanced (academic) training; a service that is in the public interest; substantive and economic independence in executing tasks; provision of services in a personal capacity, on the provider’s own responsibility and in a professionally independent manner; a particular relationship of trust between the client and the service provider; a focus on providing the best possible service rather than on maximising profit; and compliance with precise, strict professional regulations and codes of professional ethics.”
From left to right, me, prime minister António Costa, and the host of the meeting, president of the Solicitors and Enforcement Agents Order, José Carlos Resende.
In the European Union, liberal professions play a significant role in establishing and maintaining key social infrastructure. Approximately one in six self-employed people work in sectors dominated by liberal professions, and that figure is rising. The same is true of one in six employees.
More than one euro in 10 of gross value added comes from sectors dominated by liberal professions.
The economic contribution of liberal professions to EU’s GDP is around 12.8% and accounts for more than 10% of employment.
In Portugal, liberal professions are an endangered species if not in the path to extinction. Take the example of the profession I represent: approximately 97% of dentists are liberal professionals, either employed or self-employed, with the autonomy and independence recognized by the profession.
We are 10.000 and account for the employment of 25,000 people, among dental assistants, technicians, hygienists and administrative assistants, etc.
Our income corresponds to 11 months work, and expenses to 12 or 14 months, including equipment, materials, insurance, taxes, etc. not to mention work hours.
We don’t have the classical protection with regards to unemployment, illness, maternity, retirement, or incapacity to work.
We need effective representation in social dialogue. Professionals regulated by Professional Orders, more than 320.000, have no place in the framework of social dialogue, as do unions, companies, commerce and private employers.
Liberal professions need to be heard, especially those represented by Professional Orders in Portugal.
A selected audience of representatives of the orders.
Group photo at the end of the meeting.
From the 10th to the 12th November Ordem dos Médicos Dentistas (Portuguese Dental Association) organized its annual congress, in Porto. This year we celebrated 25 years of congress, a milestone for Portuguese dental medicine. Already a recognized brand!
PDA 25th Congress (2016)
Total congress participants – 3 686
Number of scientific presentations – 161
Hands-on courses – 95
Number of entries at Expo-Dentária – 12 404
Since 1992, when the first Portuguese Dental Congresses took place, the affirmation and credibility of dental medicine as a regulated profession increased in Portugal over the years. During those years, Portuguese dentists shared the passionate dedication to dental medicine that made all the difference in the affirmation and growth of this Congress that nowadays is visited by more than 12 thousand participants.
It is always a huge effort, given that the organization is mostly composed by volunteers, but at the end we are filled with an enormous pride and feeling of mission accomplished!
OMD congress is also an important moment to create closer ties between colleagues from different parts of the world.
As such, we organized a round table discussion concerning “Regulation in Dentistry: Recognition of Professional Qualifications”, where we had as guests/speakers: Andrew I Spielman (Associate Dean for Academic Affairs NYU); Gilbert Bouteille, (President of the National Association of Dental Surgeons in France); Gerhard Seeberger (FDI – World Dental Federation Speaker); Marco Landi (President of the Council of European Dentists); Óscar Castro Reino (President of the Spanish General Dental Council); Cédric Grolleau (Jurist of the National Association of Dental Surgeons in France); Filipa Carvalho Marques (Director of OMD’s Legal Department), and me as OMD President.
Can health be seen as a common economic activity? It was the main idea and the question that launched the debate.
The opinions of the speakers in this short coverage video:
At the Opening Ceremony we had the presence of the Secretary of State Assistant and of Health, Fernando Araújo and guests from national and international institutions and ambassadors.
(…) “Even in 1963, the year I was born, Bob Dylan wrote in the chorus of the song that was to become a true anthem, “(…) times are changing …”
They were, of course! Maybe at a more sociologic level, regarding habits and behaviours.
Then, as now, times continue to change…
We are currently experiencing a time of profound changes, levered essentially by globalization, currently in course, the internet and new communication and information technologies, among others.” (…)
“For the times they are a-changing” we have to be ready!
The course of dental regulation in Portuguese-speaking countries was also another focus at OMD congress. Challenges faced by dentists of the Portuguese-speaking countries are very different but still very important to share experiences and opinions, in view of the population’s increasing demand for quality oral health care.
Portuguese-speaking Dental Association Forum: Representatives of the profession and industry from Brazil, Cape Verde, Mozambique and Portugal.
In addition to the scientific and social professional programme, Expo-Dentária occurs simultaneously, a dental equipment and material exhibition that boasts more than 12 thousand participants, and is currently the greatest oral health exhibition in Portugal. Expo-Dentária’s official opening was held in the morning with a flash mob for everyone’s surprise.
As a passionate runner, I highlight the moment when we received the Portuguese Winner Ultrarunner Carlos Sá at our congress. To overcome everyday challenges, we have to be resilient. Do not give up on obstacles. Carlos Sá, winner of the 2013 Badwater Ultramarathon, California (217 km) in 24:38min, is an inspiration.
CNOP (National Council of the Portuguese Professional Orders) was received in audience (April 28th 2016) by the recently elected President of the Portuguese Republic (election held last January), Marcelo Rebelo de Sousa, at his official residence, Palácio de Belém, in Lisbon.
As CNOP’s President, I would like to express my appreciation for the words that the President addressed to me and to all of the Portuguese Professional Associations, highlighting the important role of liberal professions and qualified professionals regulated by the Professional Associations in Portugal.
The President of the Republic stressed CNOP’s role as a social partner and the need to enhance this position.
All the Presidents of the Professional Associations present had the opportunity to present the President of the Republic their views regarding human resources training in the respective qualified professions and its impact in employability.
Lastly, Marcelo Rebelo de Sousa shared his detailed views on the current national and international politics.
The audience lasted approximately two and a half hours. At the end, CNOP’s President and President of the Portuguese Dental Association, offered the President of Republic, on behalf of CNOP, a case with the pins and logotypes of each of the Professional Orders.