Health Minister Faces Criminal Investigation Over INEM Strike Testimony

The Portuguese Parliament's inquiry commission on the National Institute of Medical Emergency (INEM) has voted to forward Health Minister Ana Paula Martins' sworn testimony to prosecutors, a procedural step that could trigger a criminal investigation into whether she knowingly misled lawmakers about her government's handling of a deadly emergency services strike.

The decision, taken on April 23, 2026, marks an escalation in what began as a probe into administrative failures and has morphed into a potential legal liability for one of the cabinet's senior figures. The commission split along party lines, with the right-wing Chega party voting for the referral, the Socialist Party abstaining to allow the motion to pass, and the Social Democratic Party (PSD) voting against it.

Why This Matters

• Criminal exposure: Providing false testimony to a parliamentary inquiry can carry prison sentences ranging from 6 months to 3 years under Portuguese law, depending on whether statements were intentionally misleading or constituted "qualified disobedience."

• Political fallout: If the Portuguese Public Prosecutor's Office launches a formal investigation, Martins could face sustained pressure to resign, potentially destabilizing the coalition government's health policy at a time of sector-wide strain.

• Precedent risk: This is the second high-profile referral in three years—former Infrastructure Minister João Galamba faced a similar process in 2023 over TAP airline testimony—signaling parliament's growing willingness to invoke criminal consequences for perceived ministerial evasiveness.

The Core Allegations: What Martins Said vs. What Documents Show

The controversy centers on whether the Health Ministry received and processed advance warning of the October-November 2024 strike by pre-hospital emergency technicians (TEPH)—a work stoppage that coincided with a broader public-sector shutdown on November 4, 2024, and has been linked by the Portuguese Health Activities Inspectorate (IGAS) to 12 deaths, three involving clear delays in ambulance dispatch.

During her testimony on April 21, 2026, Minister Martins stated she was not formally notified of the strike notice sent by the emergency technicians' union (STEPH) on October 9, 2024. She acknowledged that "management could have been better" and that her ministry "may not have realized" it could decree minimum service levels to maintain life-or-death coverage, but she stopped short of admitting direct knowledge of the looming walkout.

Yet Gustavo Carvalho, the former chief of staff to State Secretary for Health Management Cristina Vaz Tomé, testified under oath that all strike pre-notices arriving at the ministry were processed "immediately" and that the state secretary was always briefed, even when traveling abroad. IGAS inspection records indicate the formal strike notice was electronically delivered to multiple ministerial inboxes, including Vaz Tomé's office, on October 9, 2024—more than three weeks before the first shift was abandoned.

Chega deputy Pedro Frazão argued the discrepancy is irreconcilable. "Someone sitting in a ministerial office who claims not to have been informed of deaths occurring during a strike in progress at INEM simply defies credibility," he told the commission. "There cannot be untouchable ministers."

How the Vote Broke Down

The referral motion passed with a clear parliamentary split: Chega voted in favor of sending the testimony to prosecutors, seeking to escalate the accountability process. The Socialist Party (PS) abstained strategically—declining to actively support the motion but also refusing to block it, effectively allowing it to pass. PS deputy Sofia Andrade explained her caucus did not endorse Frazão's characterization of events but conceded that "some inconformities persist in the statements" Martins made. "If doubts exist, they should be analyzed by those with the power to do so, and therefore we will not block the request," she declared—a carefully worded abstention that demonstrated the party's concern while avoiding outright opposition.

The Social Democratic Party (PSD), which governs in coalition, voted against the referral. PSD deputy Miguel Guimarães dismissed Chega's arguments as a "fallacious exposition unsupported by scientific evidence" and protested the tone of the request, though he did not dispute the existence of inconsistencies.

The referral does not constitute an accusation. It directs the Portuguese Public Prosecutor's Office to review the testimony transcript and supporting evidence, then decide whether sufficient grounds exist to open a criminal inquiry under Article 348-A of the Penal Code (false declarations) or the offense of qualified disobedience.

What Happens Next: The Prosecutor's Calculus

Portuguese prosecutors have no statutory deadline to act on parliamentary referrals, though most are triaged within 60 to 90 days. If the Prosecutor's Office concludes that Martins' testimony was materially false and made with knowledge of its falsity, it can name her an arguido (formal suspect) and summon her for questioning. At that stage, ministerial immunity does not apply—members of government, unlike sitting lawmakers, do not require parliamentary authorization to be investigated.

Conviction for false declarations in a parliamentary inquiry setting carries a sentence of up to 3 years in prison or a fine. More commonly, first-time offenders in non-corruption contexts receive suspended sentences, but the political damage is immediate and often terminal.

The Broader INEM Inquiry: A Trail of Institutional Failures

The commission of inquiry, approved by parliament in July 2025 at the request of the Liberal Initiative (IL), was tasked with mapping political, technical, and financial accountability for INEM's operational meltdown. Its mandate covers the 2019–2024 period, spanning two governments and three INEM presidents.

Testimony heard over the past month has painted a picture of chronic understaffing, inter-agency miscommunication, and legal ambiguity around minimum service obligations during strikes. Former INEM President Sérgio Janeiro told deputies that the institute received a strike notice covering overtime refusal but not the simultaneous general strike, leaving management blindsided when multiple work stoppages overlapped on November 4, 2024. He attributed the "structural deficiency" in staffing to years of budget constraints and recruitment freezes.

Anabela Barata, the former chief of staff to State Secretary Vaz Tomé, testified on April 23 that her office received only "an email saying they intended to send a pre-notice," not the formal document itself, and therefore did not activate internal protocols. She insisted she informed superiors only of facts, not intentions—a distinction that deputies found unconvincing when confronted with email read receipts showing the full notice was opened by ministry servers.

Impact on Residents: What the Legal Wrangling Means for Emergency Response

For anyone living in Portugal who relies on INEM's 112 emergency dispatch system, the inquiry's findings carry immediate relevance. The November 2024 crisis exposed gaps in contingency planning that remain largely unaddressed. Minimum service regulations for health-sector strikes exist on paper (negotiated under Law 23/96), yet neither the ministry nor INEM invoked them during the most critical 72-hour window of the technicians' walkout.

The Portuguese Medical Order and several municipal governments have since called for mandatory staffing thresholds during emergency-service strikes, but no legislative action has been taken. In the meantime, INEM continues to operate with vacancy rates above 20% in key urban dispatch centers, according to union estimates.

The referral to prosecutors is unlikely to produce immediate reforms, but it may accelerate political pressure for clearer legal accountability and automatic triggers for minimum service declarations in future labor disputes. If Martins is formally investigated, her successor—or she herself, if she remains in office—will face intensified scrutiny over any further ambulance delays or dispatch failures.

Precedents: Portugal's Track Record on Ministerial Accountability

This is not the first time a serving or former minister has faced potential criminal liability for parliamentary testimony. In 2023, the PSD requested a prosecutorial review of then-Infrastructure Minister João Galamba's statements to the TAP airline inquiry, citing contradictions that could indicate false testimony or qualified disobedience. That case remains under prosecutorial review with no charges filed to date.

In 2021, parliament lifted immunity for several deputies investigated for fraudulent expense claims, demonstrating a bipartisan willingness to allow criminal process when evidence is compelling. The "Influencer" corruption probe of 2023–2024, which briefly entangled former Prime Minister António Costa, was ultimately dismissed, but it underscored prosecutors' latitude to investigate even top officials when allegations surface.

Legal experts note that false-declaration cases involving ministers are notoriously difficult to prosecute, as intent to deceive must be proven beyond reasonable doubt. Prosecutors typically decline to proceed unless documentary evidence or witness testimony directly contradicts the official's sworn account. The existence of email metadata and testimony from ministry staff may give this referral more traction than past cases.

The Political Clock: Can Martins Survive?

Health Minister Ana Paula Martins has so far resisted calls to resign, telling reporters after her testimony that she accepts "political responsibility for everything that happens in health" but sees no causal link between her actions and the deaths. Prime Minister Luís Montenegro has publicly backed her, calling the inquiry a necessary accountability exercise but warning against "premature conclusions."

Yet the Socialist Party's refusal to block the prosecutorial referral signals that Martins' position is shakier than government spokespeople suggest. If prosecutors open a formal investigation before summer recess, opposition parties are expected to table a no-confidence motion targeting her specifically—a procedural tool that, while unlikely to succeed in a coalition-controlled parliament, would keep the issue in daily news cycles.

For now, the Portuguese Public Prosecutor's Office holds the next move. Its decision—whether to investigate, defer, or dismiss—will shape not only Martins' political future but also the precedent for how rigorously ministers can be held to account when their testimony before parliament conflicts with the documentary record.