Portugal’s February Run-Off Will Decide Funding for Hospitals and Schools

In a fortnight, Portuguese voters will return to the polls to decide more than the next occupant of Belém. The run-off pits two starkly different readings of the National Health Service (SNS) and the future of public schools against each other. António José Seguro wants the electorate to treat these pillars of the Estado Social as if they themselves were on the ballot, while André Ventura argues that presidential muscle should be used to force governments to "spend on ambulances, not bureaucrats".

What matters right now

• Run-off fixed for 8 February after no candidate cleared 50% on 18 January

• Seguro (PS) frames the vote as a choice about "saving" SNS and schools

• Ventura (Chega) promises a hard line on waste and a tougher stance on migration

• Public services face twin pressures: staff shortages and tight budgets

• Polls hint at a narrow contest; nearly 1 in 5 voters remain undecided

Why Portugal is heading back to the booths

The first round delivered a familiar Portuguese twist: a crowded field splintered the vote, leaving the socialist Seguro on 35.4% and the right-wing populist Ventura on 28.7%. Every other contender fell well short. Because the constitution demands an absolute majority, the country now gears up for only its second presidential second round since 1986.

Beyond the arithmetic lies a broader unease. Hospital waiting lists have swollen past 300 000 patients, classrooms still rely on substitute teachers, and strikes by nurses and educators punctuated 2025. Against that backdrop, Seguro is urging centre-left, green and liberal supporters to "lend" him their ballots so that "health centres and schoolyards also make it to the second half" of the contest. The phrase has become his new rallying cry.

Seguro’s argument: more euros, better governance

Standing in front of Lisbon’s Hospital de Santa Maria, the former PS leader pledged three moves if elected:

Nominate a health minister with cross-party backing within 30 days.

Press parliament for a multi-year funding pact that shields SNS budgets from short-term cuts.

Sponsor a constitutional revision to give priority status to public education spending—similar to the 1% rule already applied to science.

“Without predictable financing, we will keep losing doctors to Spain and teachers to early retirement,” he warned. Seguro’s camp believes a conciliatory presidency can broker deals that a fragmented Assembly has failed to deliver.

Ventura’s counter-offer: pressure and penalties

Campaigning in Ovar, Ventura held up an oxygen bottle to dramatise hospital shortages, vowing to be "implacable" with any government that delays equipment purchases. His team promises to publish quarterly "efficiency scorecards" and publicly shame the worst-performing hospital boards or school clusters. While he stops short of endorsing outright privatisation, he champions voucher schemes and private-sector partnerships as a way to “end the monopoly of mediocrity”.

Opponents call the plan populist showmanship, but Ventura’s message resonates with voters frustrated by endless queues at urgent care wards.

What a president can—and cannot—do

The Portuguese head of state is not a super-minister. Still, a determined occupant of Belém can:

• Veto legislation or demand constitutional review, slowing reforms they deem harmful.

• Promulgate decrees swiftly, giving green lights to bills that boost funding.

• Dissolve parliament in a crisis, forcing early elections and reshaping the policy map.

• Chair the Council of State, applying moral pressure.

The late Mário Soares famously used those levers to defend civil liberties in the 80s; Marcelo Rebelo de Sousa leveraged them to accelerate pandemic aid in 2020. Seguro insists he would use the same toolkit to ring-fence social budgets, whereas Ventura signals he would wield vetoes to block what he brands "corporate capture" of SNS funds.

Expert temperature check

Health economist Ana Escoval notes that Portugal already spends 9.5% of GDP on health, "but misallocation is our real illness." She applauds Seguro’s call for multi-year envelopes yet warns that "spending rules without reform risk feeding the beast, not curing it." In education, sociologist António Teodoro sees a demographic cliff: by 2030 nearly 40% of teachers could be over 60. "A presidential spotlight on the issue would help," he says, "but Cabinet and Assembly must supply the pensions and hiring plans."

The undecided bloc—and what could sway it

Pollsters at ICS/ISCTE put the still-floating vote at 18%—largely younger, urban and disillusioned after two years of inflation nibbling at wages. They list three late-campaign triggers:

• Emergency-room performance during the peak flu weeks ahead of 8 February

• Final-week TV debate on 1 February, already dubbed the "Clash of Care"

• Ability to mobilise emigrant ballots, which numbered 257 000 in 2021 but could surge through digital registration pilots

Calendar: what happens next

• 25 January – Official canvassing recommences

• 1 February – Prime-time debate (RTP, 21:00)

• 6 February – Silence period kicks in

• 8 February – Run-off day; preliminary results by 23:00

Bottom line

For a country that prides itself on a universal welfare state, the 2026 presidential run-off has turned into a de facto referendum on how—or whether—the public purse should keep prioritising hospitals and schools. Whether voters embrace Seguro’s incremental financing pact or Ventura’s watchdog-in-chief model, the outcome will dictate not just the tone in Belém but the pressure felt in every consultório and every classroom across Portugal.