Andorra to Overhaul Public Healthcare System After 40 Years and Strengthen Patient Safety Standards

The Government of Andorra approved a draft law on Wednesday, November 4, to modernise the Andorran Healthcare Service (SAAS), replacing legislation that has governed the public healthcare organisation since 1986.

The reform represents one of the most significant updates to Andorra's public healthcare system in four decades, introducing changes to institutional governance, healthcare management, professional recruitment and patient safety monitoring.

Presented by Health Minister Helena Mas, the proposed legislation aims to adapt SAAS to the growing complexity of medical services, increasing management requirements and the need for closer coordination between healthcare institutions.

“This is not about changing the healthcare model, but about modernising and strengthening it,” Mas explained, identifying quality of care, patient safety and the efficient use of public resources as the reform's main priorities.

The government believes the new legal framework will provide a more transparent, professional and accountable structure for managing the country's public healthcare services.

SAAS to Introduce a New Board of Directors

One of the central elements of the proposed reform is the replacement of the current Governing Council with a new Board of Directors, combining institutional representatives with professionals who have expertise in different areas of healthcare management.

The new governing body will include specialists in medical care, finance, research and innovation, with the objective of improving strategic decision-making and strengthening the organisation's long-term planning capabilities.

At the same time, the legislation will reinforce the responsibilities of the SAAS General Directorate, which will serve as the executive body responsible for the organisation's day-to-day operations.

According to the government, this revised structure will establish a clearer division of responsibilities between strategic oversight and operational management.

As a result, SAAS is expected to benefit from more effective resource allocation, improved accountability and greater institutional efficiency.

Mandatory Healthcare Quality Indicators and Stronger Patient Safety Controls

Another major component of the reform focuses on improving healthcare quality and patient safety across Andorra's public medical services.

Under the proposed legislation, SAAS will be required to implement and maintain a comprehensive quality management system based on recognised standards.

In addition, the organisation must develop specific programmes designed to prevent medical risks, strengthen patient protection and improve the reliability of healthcare services.

Crucially, the new law will require SAAS to establish measurable indicators for regularly assessing the quality of medical care, patient safety and health outcomes.

These indicators will allow healthcare authorities to monitor institutional performance more systematically and identify areas requiring improvement.

Furthermore, the information collected should support evidence-based decision-making and provide a clearer picture of how effectively public healthcare resources are being used.

Health Minister Helena Mas emphasised that the revised framework would introduce stricter accountability requirements and higher expectations regarding compliance with healthcare standards.

The government's objective is to ensure that the quality of medical services can be evaluated through consistent monitoring rather than relying solely on existing administrative procedures.

New Employment Framework to Attract and Retain Healthcare Professionals

The draft law also addresses the employment and contractual arrangements of healthcare professionals working with SAAS.

The proposed legislation will provide a clearer legal framework for different forms of professional collaboration, including both salaried employment and self-employed medical practitioners.

According to the government, this flexibility should help SAAS recruit, attract and retain qualified healthcare professionals, an important consideration for maintaining the continuity and quality of medical services.

The reform will also regulate the use of SAAS facilities and medical equipment by external healthcare professionals.

However, these arrangements will be subject to transparent procedures and safeguards designed to protect the delivery of public healthcare services.

The government intends to ensure that collaboration with external practitioners does not compromise the organisation's primary public-service responsibilities.

By clarifying the rules governing professional relationships, the authorities also hope to improve workforce planning and make the public healthcare system better equipped to respond to future medical staffing needs.

Greater Coordination Between SAAS, the Government and Andorra's Social Security System

The reform will also strengthen cooperation between the main institutions responsible for healthcare provision and financing in Andorra.

The legislation will formally regulate the Joint Healthcare Commission and establish dedicated coordination committees linking the government with SAAS and SAAS with the Andorran Social Security Fund (CASS).

These mechanisms are intended to improve strategic planning, resource management and coordination across the country's healthcare services.

In particular, closer institutional cooperation should help reduce administrative fragmentation and facilitate more consistent management of medical services.

The legislation will also clarify SAAS's relationships with healthcare institutions both within Andorra and abroad.

This includes cooperation in areas such as patient referrals, continuity of care, professional training and clinical collaboration.

Cross-border healthcare cooperation is particularly relevant for Andorra, given its geographical location and its established relationships with medical institutions in neighbouring countries.

Furthermore, the revised legislation will explicitly update SAAS's responsibilities to include preventive, diagnostic, therapeutic, rehabilitative and palliative care.

This broader definition is intended to reflect the range of medical services provided within a modern healthcare system.

Andorra's Healthcare Reform Must Still Receive Parliamentary Approval

Although the government has approved the draft legislation, the reform must still pass through Andorra's parliamentary process before becoming law.

Once adopted, the new framework will replace the existing legislation dating back to 1986, bringing the legal foundations of the Andorran Healthcare Service into line with current healthcare management requirements.

Health Minister Helena Mas described the initiative as a necessary step towards modernising the country's public medical infrastructure.

“With this law, we are taking a necessary step to provide SAAS with a 21st-century framework: clearer, more flexible and more transparent, but also more demanding in terms of quality, patient safety and accountability,” she stated.

Mas reiterated that the government's intention is not to replace Andorra's existing healthcare model, but to strengthen its operation and guarantee more responsible management of public resources.

The proposed changes place particular emphasis on professional governance, measurable quality standards and improved cooperation between healthcare institutions.

If approved by the General Council, the legislation will mark a significant milestone in the modernisation of Andorra's public healthcare system, establishing a new regulatory framework after 40 years under the existing law.