Portugal’s 112 Response Under Fire After Three Fatal Delays

Lives can end while the siren is still silent—a reality that became painfully clear this week after three separate 112 calls ended in death before an INEM ambulance reached the scene. The victims, aged between 68 and 78, waited far longer than the official targets allow, reigniting an old debate about Portugal’s emergency network and what must change for it to work when every minute matters.

Snapshot of a Week No One Wants Repeated

• Seixal: A 78-year-old man reportedly waited almost 3 hours for help.

• Quinta do Conde (Setúbal): A woman in her early 70s died after 40 minutes without medical support.

• Tavira (Algarve): A 68-year-old man’s call was logged, yet an ambulance arrived only 65 minutes later.

Authorities opened three separate investigations within 24 hours, while the President demanded "swift clarifications." For many families in Portugal, the question is simpler: why does the country’s blue-and-yellow emergency service so often arrive too late?

A Deadly Wait: 3 Calls, 3 Tragedies

Each fatality unfolded in a different part of the country, but the stories share strikingly similar timelines: a 112 dispatcher transferred the call to the Centro de Orientação de Doentes Urgentes (CODU); the clock kept ticking; no nearby ambulance was free. By the time a crew finally found its way through traffic or finished transferring a previous patient, vital seconds had stretched into fatal hours.

The tragedies also exposed an uncomfortable truth: Portugal’s official performance indicators for life-threatening events—8 minutes in urban areas, 18 in rural zones—are rarely met once demand peaks. Insider data seen by trade unions suggest that, during some weekend night shifts, fewer than 60% of high-priority calls are reached on time in Lisbon and the Setúbal peninsula.

Why the Ambulance Takes So Long

Several factors collide to create these delays:

Insufficient crews: Unions argue that low pay and burnout have pushed qualified Técnicos de Emergência Pré-Hospitalar (TEPH) toward private clinics or out of the sector altogether.

Outdated fleet: An audit by the Inspeção-Geral de Finanças last year found ambulances averaging 11 years on the road—well beyond the 6-year limit recommended in the ministry’s own guidelines.

Stretcher bottleneck: Paradoxically, many vehicles stand idle outside hospital emergency wards because their stretchers are being used as makeshift beds inside.

Call-centre overload: Until recently the CODU could field as few as 7 operators for the entire mainland during off-peak hours.

Every one of these weaknesses surfaced in the official 2025 internal report the public was never shown but which leaked excerpts confirm conceded that "lives may have been compromised."

Promised Fixes: From Hires to 275 New Vehicles

The government insists change is coming. Among the measures either implemented or funded:

• 149 additional call-centre staff hired last summer, increasing daytime coverage by roughly 45%.• A five-level triage algorithm that formally entered service on 2 January. It mirrors hospital colour codes, mandating, for instance, that the first resource reach a "Muito Urgente" case in 18 minutes or less.• The biggest fleet upgrade in a decade: €60 M for 275 new ambulances, rapid-response cars and VMER units—green-lit by the Cabinet last week.• A pilot self-service phone menu that quickly directs less critical situations to SNS 24, freeing human operators to focus on life-threatening calls.

Officials say some results will be visible "within months," but front-line crews caution that new vans mean little if there are no crews to staff them.

Voices From the Field

"We’re patching the roof while the house is still flooding," complains Ricardo Brás, spokesperson for the TEPH union, who points to ongoing pauses in recruitment caused by budget limits. Hospital São Bernardo emergency doctor Ana Lopes notes another concern: "Training matters as much as numbers. Half the new hires still lack full pre-hospital certification, which delays deployment."

At the other end of the spectrum, the association of private ambulance providers argues that the solution lies in "a mixed model," allowing licensed companies to cover basic life-support calls and freeing INEM for critical incidents—a model already standard in parts of Germany and Spain.

What Changes When You Dial 112 Tomorrow?

Under the new triage grid, every call is tagged P1 to P5:

• P1 (Emergent): immediate dispatch; life at imminent risk.• P2 (Very Urgent): first responder on scene within 18 minutes.• P3 (Urgent): arrival goal of 60 minutes.• P4 (Less Urgent): can wait up to 120 minutes.• P5 (Non-Urgent): redirected to SNS 24 or primary care.

Critics claim the system is "exactly the same with new labels," but health officials counter that for the first time every level now carries a performance target that will be audited monthly. Whether that transparency will translate to shorter waits remains to be seen.

The Political Stakes

Back-to-back fatalities turned emergency logistics into prime-time politics. President Marcelo Rebelo de Sousa pressed for "full disclosure" of call logs, while opposition parties want the health minister to testify in parliament. Any repeat incident risks tipping the debate from reform to outright restructuring—one scenario under discussion would see basic life-support handed to fire brigades and private firms, leaving INEM to coordinate rather than drive.

Staying Safe Until the System Catches Up

For residents who cannot control nationwide logistics, small steps can still save time:

• Call 112 only for life-threatening situations; use SNS 24 (808 24 24 24) for guidance on non-critical symptoms.• Keep your building’s door code or gate remote by the phone—dispatchers will ask.• If you live in a rural parish, note the precise kilometre mark or nearest landmark; GPS fails more often than you think.• Learn basic CPR; in cardiac arrest, chest compressions begun early can double survival odds.

The hope is that, by the time the new vehicles roll out and the triage software matures, such personal contingency plans will feel unnecessary. Until then, every Portuguese resident has a stake in ensuring the next siren is heard before it is too late.