INEM 2025 Loss Widens to €7.6 Million as Transfers to Bombeiros and Cruz Vermelha (Red Cross) Climb 37.4% and 650-Plus Vacancies Drag on the Mapa de Pessoal

The Instituto Nacional de Emergência Médica (INEM, National Institute of Medical Emergency) closed 2025 with a €7.6 million negative result, a second consecutive year of red ink and a more than twenty-fold deterioration on the €340,000 loss booked in 2024. The figure surfaced on 9 June through INEM's 2025 Relatório de Gestão (Annual Management Report) and was reported by Público and Observador the same evening. Tutela had reinforced INEM's 2025 envelope and authorised use of a reserve cushion built up in earlier years; neither was enough to absorb the cost step inside the Sistema Integrado de Emergência Médica (SIEM, Integrated Medical Emergency System).

What Drove the Loss

The single largest line behind the deterioration is the 37.4% jump in transfers to partner organisations — chiefly the Associação Humanitária dos Bombeiros (volunteer fire brigades) and the Cruz Vermelha Portuguesa (Portuguese Red Cross) — that staff the bulk of INEM's vehicle fleet on the ground. The increase flows from the new SIEM financing model approved in mid-2024, which raised the per-call subsídio paid to each operator and broadened the basket of eligible activities. Personnel expenditure inside INEM itself climbed more than 26% over 2024 as the institute opened new posts and pushed through the salary-update cycle agreed for emergency-medical technicians.

The Mapa de Pessoal Hole

The 2025 report puts the workforce shortfall against the approved mapa de pessoal (staffing chart) at more than 650 positions, a slightly smaller gap than the 700-plus figure reported in the 2024 cycle but still large enough to keep the Centro de Orientação de Doentes Urgentes (CODU, Patient Triage Centre) and the differentiated-resource fleet under structural pressure. The same source filed by Público in late 2025 flagged that over 20,000 victims in 2024 did not receive INEM's maximum-care level — most often because a differentiated SIV/VMER vehicle was tied up or unavailable rather than because the call did not warrant it.

Cushion Is Almost Gone

INEM consumed most of the financial reserve accumulated during the post-pandemic budget pass-throughs to keep the 2025 negative result inside the €10 million corridor — a buffer it will no longer have in 2026. To pre-empt the gap, the Ministério das Finanças has earmarked an extraordinary €30 million transfer to INEM for the 2025-2026 settlement of subsídios to bombeiros and the Red Cross, on top of the regular Orçamento do Estado (State Budget) line. The transfer is meant to close the back-book of overdue invoices that the 2024 model swelled and to give the new INEM board time to renegotiate the SIEM contract framework before the next subsídio review at year-end.

What to Watch

The Tribunal de Contas (Court of Auditors) opened a separate audit of the SIEM 2024 financing model in March; the report is expected before the summer recess and will weigh into the Orçamento do Estado 2027 framing. INEM's new President, Sérgio Janeiro, told the Comissão Parlamentar de Saúde in late May that closing the staffing gap below 500 vacancies and migrating CODU to a unified despatch platform by end-2026 are his two operational priorities — both contingent on a finance arrangement that does not keep posting losses every year.