Seixal's 3-Hour Ambulance Delay Exposes Gaps in Emergency Care

A tragedy in Seixal is once again forcing Portugal to look hard at the fragile state of its emergency-medical response. A man collapsed, relatives dialed 112, and an ambulance that should arrive in minutes only showed up when it was already too late. The episode has reignited an old debate: What is keeping INEM from meeting the response times it publicly promises?

What we know so far — in one glance

• Almost 3 h delay between the first 112 call and the arrival of an INEM ambulance.

• Victim was a 67-year-old resident of the parish of Amora, municipality of Seixal.

• Family members began chest compressions but were not able to restore a pulse.

• Setúbal district lost 2 permanent ambulance posts last summer due to staffing shortages.

• The Health Ministry has launched an internal inquiry; results expected within 15 days.

The incident that shook Amora

Neighbours along Rua da Liberdade heard frantic calls for help shortly after 17:00 on Monday. According to multiple witness statements collected by local firefighters, the victim had complained of chest pain while fixing a garden tap. His daughter rang 112 at 17:06. Call-centre records, viewed by this newspaper, confirm that the situation was coded as a “high-priority cardiac arrest.” Yet the nearest basic life-support unit was already on a run to Almada, and the more advanced car staffed with a physician had no doctor on duty.

When the ambulance finally turned the corner at 19:58, paramedics pronounced the man dead within minutes. The time stamps, now central to the official probe, show a gap far above INEM’s own eight-minute target for urban areas.

Why was no ambulance available?

Setúbal district has faced an acute shortage of both vehicles and qualified staff since the pandemic. INEM statistics released to parliament last month reveal that 18 % of shifts in 2025 were left uncovered because paramedics called in sick or no replacements could be found. Trade unions point to pay levels barely above the national minimum wage and the absence of a dedicated career path. The Government insists it has already authorised €5 M to recruit 200 new technicians, but the hirings are stalled by contractual negotiations.

Local context: Seixal’s growing population, shrinking cover

The municipality just south of Lisbon’s April 25 Bridge has added nearly 14,000 residents over the past decade, fuelled by a wave of commuters escaping capital-city rents. Yet INEM’s on-call fleet in the area has remained static at 3 ambulances since 2019. The two additional vehicles once based at Corroios were re-routed to Sesimbra last July after an internal reshuffle. Critics say the numbers simply do not add up for a conurbation that now approaches 170,000 inhabitants.

Voices from the ground

• “We kept asking the operator whether anyone was on the way. All she could say was ‘the request is logged,’” the victim’s sister told our reporter, still shaking.• The National Association of Emergency Medical Technicians argues that double-crewing each ambulance with fully trained staff is “mathematically impossible under the current budget”.• Seixal’s mayor, Paulo Silva, demanded an urgent meeting with Health Minister Ana Paula Martins, noting that his council had offered to co-finance an extra vehicle but never received a reply.

How INEM defends itself

A written statement from INEM headquarters stresses that Monday afternoon experienced an “exceptional spike in simultaneous emergencies” across Greater Lisbon, citing 138 red-code incidents in only 2 hours. The institute adds that a private ambulance was requested under the contingency protocol but was itself stuck in traffic at the A2 tolls. “We express our condolences to the family and will collaborate fully with the inquiry,” the note concludes.

Long-standing systemic issues

Analysts say Monday’s fatal delay illustrates three overlapping weaknesses:

Under-staffing, especially of specialty teams that include a physician.

Dispatch overlap: the same pool of ambulances covers densely populated municipalities that lack their own 24/7 posts.

Traffic choke points on the Lisbon–Almada–Seixal corridor, further worsened by ongoing bridge maintenance.

What to do while waiting for help

Cardiologists contacted by this newspaper remind readers that chance of survival after cardiac arrest decreases 7-10 % with every minute without defibrillation. They urge citizens to:

• Take a certified first-aid course; many local fire brigades in Setúbal offer weekend sessions.

• Locate the nearest public AED (automated external defibrillator) — shopping centres, train stations and some parish councils have them.

• Keep the victim flat and administer continuous chest compressions at roughly 100 beats per minute until a professional arrives.

Political fallout and next steps

Opposition MPs have already called for a parliamentary hearing. The Health Minister promised to deliver the inquiry’s findings before the end of the month and did not rule out disciplinary proceedings. Meanwhile, union leaders are planning a 24-hour strike on 21 January, which would be the third ambulance stoppage in under a year.

For residents of Seixal and surrounding areas, Monday’s heartbreak is no longer an abstract statistic. It is a human loss—and a stark warning that emergency-care reform can no longer wait.