Ambulance Strike Absolved in Alentejo Fatality as Watchdog Highlights Emergency Gaps

A quietly released watchdog report has reignited an uneasy question for many foreign residents: if you suffer a medical emergency in Portugal, will help arrive in time? The latest findings from the national health inspectorate suggest that one much-publicised death during last year’s ambulance strike was not directly caused by the walk-out—yet the broader data paint a more complicated picture of systemic strain.

Why this matters if you dial 112

For newcomers in particular, Portugal’s emergency pathway can feel opaque. When you phone the EU-wide number, calls are routed to the National Institute of Medical Emergency, better known as INEM. During an eight-day INEM strike that began on October 30 2024, the service faltered; one incident involved a 73-year-old man in Vendas Novas, a small town in the Alentejo region popular with wine-loving expats. The man died on October 31 2024 after an ambulance took longer than usual to arrive. Because several expatriate communities rely heavily on state ambulances outside Lisbon and Porto, any suggestion that industrial action could compromise care naturally triggers anxiety.

What the watchdog uncovered

Portugal’s Inspeção-Geral das Atividades em Saúde (IGAS) has now concluded that it is "not possible to establish a direct causal link" between the delay and the fatal outcome. Investigators acknowledged an "effective delay" but stressed that the patient’s survival odds were near zero owing to pre-existing conditions. The Vendas Novas file is one of eight investigations closed so far; in two other deaths, inspectors did tie fatalities to ambulance response delays. According to the 97-page document, both INEM dispatchers and regional hospitals have received official recommendations to refine triage protocols for high-risk calls.

The wider strike picture

On the busiest day of the walk-out—4 November 2024, when a general public administration strike overlapped—INEM handled just 2,510 of 7,326 emergency calls, leaving 4,816 unanswered. Internal metrics show the agency logged its slowest response time in five years. Fast-forward to this summer and the labour mood has improved: the STEPH union suspended its long-running administrative greve after signing a memorandum of understanding on 5 August 2025. The deal sketches deadlines to plug protocol gaps, hire staff and pursue work-time reorganisation across the pre-hospital emergency network.

Government and union reactions

Health Minister Ana Paula Martins thanked IGAS for "clarifying events" but conceded that "unacceptable delays" did occur. Union leaders were far less conciliatory; STEPH denounced the report as a "search for scapegoats" and accused officials of distorting reality. A professional association, SPEPH, has formally demanded every audit ever produced on strike-related delays, arguing that transparency is the only route to restoring public confidence and pushing forward systemic reforms.

Ongoing legal fallout

Parallel to the administrative probes, the Ministério Público is running six open inquiries into deaths recorded during the strike period. One case sits with prosecutors in Montemor-o-Novo, 15 km from Vendas Novas. Legal experts say any indictment would hinge on proving that dispatchers or managers crossed the threshold of criminal negligence—a high bar in Portuguese jurisprudence. Nevertheless, victims' families have begun consulting lawyers over potential compensation claims, suggesting a lengthy judicial timeline ahead.

Practical takeaways for residents

For the foreign community, the key message is that 112 remains the universal number and multi-lingual operators are available, though not always instantly. Seasoned residents keep the INEM-endorsed "MySNS" mobile app on hand, maintain private insurance for extended coverage, and familiarise themselves with the local corpo de bombeiros station. When calling, be ready to pinpoint your exact location, request an interpreter if needed, and, if possible, know the route to the nearest hospital should self-transport become the safest option. While the latest IGAS report may temper fears about one headline case, it underlines a broader truth: understanding how Portugal’s emergency grid works is still an essential piece of expatriate life.