Portuguese paramedic union maintains September strike dates after INEM talks stall

Standoff over September strike action

Negotiations between Portugal's Ministry of Health, the National Institute of Medical Emergency (INEM), and the Pre-Hospital Emergency Technicians Union (STEPH) concluded on Wednesday afternoon without an agreement. Union leaders confirmed that two 24-hour strikes planned for 14 September and 28 September remain on schedule for now. Both dates fall on Mondays, the weekday that routinely registers the highest volume of emergency calls to the Portuguese medical dispatch network. Health Minister Ana Paula Martins spent over three hours mediating discussions between union representatives and INEM board members at the ministry in Lisbon.

Following the session, STEPH president Rui Lázaro outlined the union position regarding the upcoming dates.

For now, the strike remains scheduled, and if the counterproposal can be accepted by us and we see that the response INEM provides is not compromised and comes out reinforced, which is what we ask in the list of demands, we will gladly call it off.

Disputed ambulance fleet reforms

The dispute centres on operational restructuring plans adopted by the INEM directive council. STEPH opposes plans to convert Immediate Life Support (SIV) ambulances into light passenger vehicles, arguing that the change eliminates the ability to transport patients directly from intervention sites. The union is also demanding that INEM expand its emergency ambulance fleet through the end of 2027, maintaining a minimum baseline of two ambulances per municipality. In response, INEM leadership has repeatedly rejected claims that the reorganization reduces response capacity, maintaining that the structural changes will strengthen medical assistance.

Wednesday's talks produced partial movement on vehicle allocations. INEM leadership admitted the possibility of keeping nearly all 56 emergency medical ambulances (AEM) in active service rather than reassigning them to hospital administrations. Negotiators also discussed converting potential vehicle changes into localized pilot projects, particularly for Inter-hospital Ventilated Transport (TIV) and SIV units, before executing any nationwide fleet modifications.

Escalating leadership friction and legal action

The labor dispute follows weeks of heightened tension between union representatives and institute management. STEPH formally announced the September strike dates on 13 August 2026 after rejecting the restructuring measures. In an interview with RTP Antena 1 shortly after the announcement, INEM president Luís Cabral claimed the union was motivated by hidden party-political intentions. Lázaro rejected the accusation and initiated a criminal complaint against Cabral in response.

Despite the ongoing legal action, both sides agreed to continue technical discussions before the mid-September deadline. Minister Martins emphasized that the executive branch would maintain open channels throughout the negotiation period.

The government and the president of INEM have never refused, nor will they refuse, dialogue, given the enormous responsibility that INEM's mission entails and given the impact that any strike in the health sector has on the lives of Portuguese citizens.

Pending counterproposal and contingency plans

The Ministry of Health announced that INEM will deliver a detailed counterproposal addressing the union's demands within the coming days. Both parties plan to evaluate the technical framework next week before making a final determination on the strike notices. Martins confirmed that the government will establish mandatory minimum service levels if negotiations fail to produce a signed agreement before 14 September. The Portuguese emergency medical sector faced severe scrutiny during a previous strike held between 30 October and 4 November 2024, when failures in minimum service execution disrupted emergency response and 12 deaths were recorded.