All of Portugal's Fire Brigades Now Have an INEM Emergency Ambulance, as 64 More Join to Make 581
From Thursday every fire brigade has a protocol with the INEM for a round-the-clock emergency ambulance. Each is paid 10,800 euros a month, and the brigades' associations ran a 125.6 million euro deficit in 2024.
Every fire brigade in Portugal now runs at least one emergency ambulance under contract with the INEM (Instituto Nacional de Emergência Médica, the national medical emergency institute), for the first time. From Thursday, 64 more ambulances joined the national emergency medical system, bringing the fire brigades' fleet within it to 581 vehicles across the country.
The 64 belong to fire brigades that until now had no protocol for a so-called PEM (Posto de Emergência Médica, or medical emergency post): an emergency ambulance crewed by the brigade's own firefighters, on call around the clock and dispatched by the INEM when someone dials 112. According to the Liga dos Bombeiros Portugueses (LBP, the League of Portuguese Firefighters), these ambulances deliver about 90 percent of all the pre-hospital emergency care given in Portugal.
"There is no brigade in the country without an agreement with the INEM, unless it has refused one," the INEM's president, Luís Mendes Cabral, told the Lusa news agency. He said the money to pay the brigades was secured for this year through the institute's own financial management.
How the brigades are paid
A 2024 memorandum between the LBP, the SNS executive directorate and the INEM set out a gradual move of every remaining "reserve post" to full PEM status, and the league said Thursday's step completes it. The change was marked with a ceremony at the Merceana volunteer fire station, in Alenquer, on Thursday afternoon.
The money behind the move was settled over the summer. Under an agreement reached at the end of June, the brigades receive 10,800 euros a month for each emergency ambulance, a fixed sum to cover crews and round-the-clock availability. That is about 2,000 euros more than under the previous protocols. Separate variable payments, for the kilometres driven and the equipment carried, are updated in line with inflation.
The LBP reported on 28 August that the health minister had approved the agreement, with effect backdated to 1 July and running to the end of the year. It also allowed any association that wished to do so to convert its reserve post into a PEM. The league said at the time that the deal did not change the fact that the INEM owed the associations more than 2.5 million euros for January to July.
Finances under strain
The brigades' wider finances remain stretched. On 28 September the LBP cited INE (Statistics Portugal) figures showing that the gap between the humanitarian associations' spending and investment and their income reached 125.6 million euros in 2024, 7.8 million more than in 2023. On the league's figures the shortfall has grown from 68 million euros in 2015, and it has asked for the numbers to be borne in mind as the 2027 State Budget is prepared for parliament.
Fuel is part of that pressure. Earlier this month two district federations said that none of the 1.01 million euros budgeted for three months of fire brigade fuel had reached them. The INEM's own ambulance crews, meanwhile, called off two September strikes earlier in the month.
For anyone who needs an ambulance, nothing changes in how to get one: call 112. Our guide to emergency numbers and services in Portugal explains which number to use and when.
