All Nine Team Chiefs at Lisbon's Children's Emergency Department Resigned on Thursday Night, and the Reason Is Anaesthetists
The letter reached ULS Sao Jose at 21:53 and covers only their coordination roles. The group has 83 anaesthetists for seven hospitals, three emergency departments and all its surgery. The same day, official figures showed closure days falling sharply.
At 21:53 on Thursday night, the Unidade Local de Saúde (Local Health Unit, ULS) de São José received a letter signed by all nine team chiefs of the paediatric emergency department at Hospital Dona Estefânia, Lisbon's main children's hospital. They were resigning. The ULS confirmed the letter to the Lusa news agency on Friday, and confirmed the reason the doctors gave: constraints in anaesthesiology.
The resignations are narrower than they sound, and that narrowness is the point. The letter covers "exclusively the coordination and leadership functions" the nine performed in the emergency department. They are not leaving the hospital and they are not on strike. What they are refusing is responsibility for organising a rota they say they cannot make safe.
Eighty-three anaesthetists, seven hospitals
The arithmetic behind the letter is the ULS São José's own. It is the largest health unit in the Lisbon area, and it has 83 anaesthetists on its staff roll. Those 83 have to cover seven hospitals, three external emergency departments and the whole of the group's surgical activity.
The board's account is that the pressure is seasonal on top of structural: filling the August rotas was hard because staff were on leave, and hard in a deeper sense because there are not enough anaesthetists in Portugal. It notes that it was classified this year as a zona geográfica carenciada (designated shortage area) for anaesthesiology in the government order paying incentives to doctors recruited by local health units, says it has turned to service contracts and retired doctors, and expects the situation to ease "gradually" now the holidays are over.
None of this arrived without warning. Eight days ago the Sindicato dos Médicos da Zona Sul (Southern Zone Doctors' Union) told its members across the group to start filing formal declarations declining functional responsibility, naming Dona Estefânia as one of three hospitals where the shortfall was already reshaping the service. In May the hospital suspended its external paediatric surgery emergency for a weekend over the same specialty gap. In late August the Health Minister, Ana Paula Martins, conceded the shortage publicly, saying it showed up "a little all over the country, but everything is felt more in the Lisbon and Tagus Valley region".
The indicator says the opposite
The resignations landed on the same day the Direção Executiva do SNS (SNS Executive Directorate) released figures pointing the other way. Emergency departments across the national health service closed for 204 days in the first half of 2026, against 636 in the same period of 2025 and 892 in 2024. Paediatric closures fell hardest, from 122 days to 14. Nine tenths of what remains is obstetrics and gynaecology.
Both things are true at once. Closure days count the service that fails outright; they say nothing about a rota held together by transfers, borrowed staff and overtime, which is what the union and now the team chiefs are describing. It is the same gap between indicator and experience that surfaced when the minister called emergency waits better than two years earlier, a day after they passed eleven hours, and when the region's most pressured department went missing from the SNS portal for over a month.
What This Means for Expats
- The children's emergency department is open. A resignation from a coordination role is not a closure, and the nine doctors remain in post clinically. Dona Estefânia is still where a Lisbon paediatric emergency goes.
- Scheduled surgery is where this bites. Anaesthesiology cover constrains operating theatres before it constrains the emergency door. If your child has a surgery date at a São José group hospital, confirm it rather than assume it.
- Know the route before you need it. The SNS 24 line and the Manchester triage colours decide where a child is seen and how fast; calling first can route you to a unit that is not under strain.
- Watch for the board response. Whether it names replacement chiefs, or the nine withdraw the letter, will tell you which reading of the rota won.
The ULS expects normality to return with the end of the holiday season. The nine doctors who signed on Thursday evidently do not, and they have put that in writing.
