Portugal's INEM emergency technicians call September strike and demand president's resignation over ambulance reforms

Workers demand resignation and call September strike

INEM workers held an extraordinary general assembly on Thursday, August 13, at the institute's Lisbon headquarters, described by union leader Rui Lázaro as the most attended ever. The assembly approved a resolution calling for the resignation of INEM president Luís Mendes Cabral and demanding greater worker participation in decision-making, more transparency from the directorate, and a change in the institutional relationship between management and representative structures. The workers also reaffirmed confidence in the Workers' Commission (CT), rejecting attempts to discredit its legitimacy and noting that it results from an electoral process independent of government or administration validation.

The Sindicato dos Técnicos de Emergência Pré-Hospitalar (STEPH) announced a two-day general strike for September 14 and 28, though Diário de Notícias reported the dates as September 14 and 18. Rui Lázaro, president of STEPH, said the strike is not about labor or salary issues but about what workers describe as the dismantling of INEM. He acknowledged the strike may cause disruptions but expressed hope that the government and INEM would be better prepared than during a strike 18 months ago.

Dispute over ambulance transfers and vehicle conversions

The core conflict centers on INEM's new organic law, which transfers 54 emergency medical ambulances from INEM to Local Health Units (ULS) and converts 44 Immediate Life Support (SIV) vehicles into light vehicles that can provide on-site assistance but cannot transport patients to hospitals. Workers argue these changes will result in the operational loss of approximately 100 ambulances. INEM president Luís Cabral has categorically denied the figure, calling it false.

Rui Lázaro illustrated the impact using the ambulance that transported former President Marcelo Rebelo de Sousa to hospital on Wednesday, August 12, based in Vila Real de Santo António. He said that vehicle is slated for conversion to a light vehicle in the coming months, and had it already been converted, the former president would have had to wait for another ambulance during a shortage in the Algarve region.

INEM president insists on reforms

Luís Cabral, speaking in an interview with RTP and Antena 1 published on the same day as the assembly, accused workers' representatives of destructive criticism and radical positions without the representativity they claim. He said he remains open to constructive criticism and dialogue, but warned that the reforms will continue.

Cabral stated he will remain as long as necessary to ensure the restructuring is implemented, while acknowledging it is up to the government to decide whether he continues. Rui Gonçalves, coordinator of the CT, described dialogue with INEM leadership as impossible and suggested the health minister should evaluate Cabral's tenure. The organic law is already in force as of August, though Cabral has not yet been formally appointed to the position.

Parliamentary review and previous strike aftermath

The Assembly of the Republic will discuss the new law after Livre, PCP, and Bloco de Esquerda requested parliamentary review. In June, STEPH delivered a manifesto to the Presidency of the Republic warning about the consequences of the changes, particularly that converting SIV ambulances into light vehicles would reduce the capacity to transport urgent and emergency patients, increasing arrival times at hospitals in some regions. The last INEM technicians' strike took place in late October and early November 2024, which triggered several investigations into a dozen deaths suspected of resulting from lack of INEM response. The union is now seeking support from doctors', nurses', and public sector unions for the September strikes.