Portugal's INEM Refoundation Lands in Parliament — Ana Paula Martins Reads Ten Points to MPs as Bereaved Families Take the Stand on 22 April

Portugal's emergency-medical institute is about to be pulled apart and re-assembled. Over four hours before Parliament's Comissão Parlamentar de Inquérito ao INEM on Monday 21 April 2026, Health Minister Ana Paula Martins — prompted by PSD deputy Miguel Guimarães — read off a ten-point refoundation plan. The operative act is a new Lei Orgânica that converts the Instituto Nacional de Emergência Médica into an instituto público de regime especial, reinforces its management board, and rewires the national CODU dispatch network with a three-level response pyramid, shared triage with SNS24 and the 112 PSP call centres, and 300 new vehicles on order.

Wednesday 22 April puts the human cost on record: the commission hears Vítor João Ferreira, relative of victim Daniel João Ferreira, at 5pm, and Carla Rocha, widow of Vítor Sérgio Abreu, at 6.45pm. Both families say response-time failures cost a life.

The Ten Points, as Read Into the Record

The minister organised her testimony around a single list. Published reporting, chiefly Público's live transcription, captures the structure but not every bullet verbatim. The identifiable pillars are:

1. Change of legal status. INEM becomes an instituto público de regime especial, a category that gives the institute more autonomy on procurement, HR and contracting than the current classification allows. The new Lei Orgânica draft, the minister told deputies, “está pronta” — ready — and is awaiting alignment with the PRR (Plano de Recuperação e Resiliência) funding envelope before it goes to the Council of Ministers. The original target was end-January 2026; it has slipped by three months.
2. Expanded management board. The conselho diretivo grows to three members — a president and two vogais — up from the current two.
3. Three-level pyramid of response. Pre-hospital care is reorganised into a tiered structure, with the top layer handling the most serious cases and the lower layers absorbing the volume of non-life-threatening calls that currently clog the system.
4. New telephone triage models at CODU. The Centros de Orientação de Doentes Urgentes get a revised decision tree and digital tooling for the call-takers.
5. Co-location with 112 and SNS24. The PSP-run 112 centres and the SNS24 nurse line are to share physical space and a common triage taxonomy with CODU, so an emergency call can route across the three systems without a re-assessment from zero.
6. No privatisation of CODU. The minister reiterated a commitment made at her December 2025 Parliament appearance: CODU stays public.
7. Career review for pre-hospital emergency technicians. The revised carreira especial agreed with STEPH delivers salary uplifts and clarifies progression steps.
8. Fleet renewal. 300 new vehicles are on order across the INEM fleet and the SIEM partners — the Liga dos Bombeiros Portugueses and the Cruz Vermelha Portuguesa — under a reformulated subsidy model.
9. INEM as sole training authority. The institute becomes the exclusive trainer of Técnicos de Emergência Pré-Hospitalar, closing an ambiguity that allowed parallel training tracks.
10. Basic life support in schools. The government wants introductory first-aid and BLS modules in school curricula, training the general population to bridge the minutes before professional arrival.

A handful of these pillars — the legal re-classification, the three-person directorate, the no-privatisation pledge on CODU — were already in the public record from the minister's December testimony. The CODU-112-SNS24 co-location and the shared-triage taxonomy are new elements made explicit on Monday.

What the Commission Is Really For

The Comissão Parlamentar de Inquérito was constituted to investigate what went wrong in a string of high-profile INEM failures over the last three years — cases in which callers waited critical minutes on hold at CODU, or in which pre-hospital teams were dispatched to the wrong address. Audition 49, on 17 April, heard STEPH technicians who said previous witnesses had provided “untruths” about staffing levels. The same day, Chega requested a fresh hearing of Cristina Vaz Tomé, the former Secretary of State for Health Management. Her former chief-of-staff Gustavo Namorado de Carvalho was heard at 3pm Monday, immediately before the minister.

The mechanical engine driving the refoundation is a separate body — the Comissão Técnica Independente (CTI) chaired by retired Supreme Administrative Court judge Leonor Furtado, appointed in January 2025 by the Despacho co-signed by Finance Minister Miranda Sarmento and Ana Paula Martins herself. The CTI was given nine months to produce a new organisational model. Its final report, delivered in late 2025, identified “structural flaws” in INEM and underpins the ten-point plan the minister read on Monday.

The Missing Bullet: Human Resources

What deputies from PS, BE, PCP and Livre pressed hardest on — and what the minister's list conspicuously under-answered — was the human-resources baseline. INEM's own activity reports flag chronic shortfalls in CODU physician hours, in TEPH staffing on ambulances, and in the training pipeline. Without a larger complement, an elevated management board and a new IT triage will still bottleneck at the point the call is answered. The career review agreed with STEPH is the government's main response, alongside the “single training authority” pledge; the minister was less specific on net hire numbers and timetable.

The Liga dos Bombeiros Portugueses has meanwhile argued, through its public-affairs secretariat, that the fleet-renewal mechanism needs to reach corpos de bombeiros on the same disbursement terms as the largely urban SIEM posts — a distributional fight that will play out in the new subsidy regulations after the Orgânica is published.

Why 22 April Matters

The commission's hearings of bereaved families change the political weather. Carla Rocha, hearing at 6.45pm Wednesday, has been a public presence since her husband Vítor Sérgio Abreu's death; her testimony is expected to focus on what the family was told in the hours after the call and the subsequent administrative process. Vítor João Ferreira, hearing at 5pm, speaks for Daniel João Ferreira's family. Both are civilian witnesses; neither holds an administrative portfolio.

Past parliamentary inquiries — Tancos, BES, the 2017 fires — have shown that relatives' testimony tends to reset the tempo of a commission. Expect the final-report drafting calendar to firm up after Wednesday; the CPI is due to close its hearings in May and vote a final text in June.

The Political Stakes

For the PSD-CDS government, the refoundation is a two-track calculation. On one side is the Lei Orgânica — a technical statute the Council of Ministers will approve, Parliament will rubber-stamp in summary procedure, and the President will likely promulgate without friction. On the other side is the pre-election management of public memory: a CPI that extends into a June final report, with opposition parties using committee time to relitigate the specific deaths.

The opposition's opening is narrower than it looks. The CTI was commissioned under this government; the Orgânica was drafted under this government; the STEPH career review was negotiated under this government. What the opposition can still attack is execution speed — the slipped January deadline, the three hundred vehicles whose delivery schedule has not been made public, and the CODU physician vacancies that refuse to fall.

This article draws on Público's coverage of the 21 April hearing, RTP's summary of the December 2025 ministerial appearance, HealthNews on the CTI final report, and the Parliament's own hearing schedule for 21–22 April 2026 on the Assembleia da República website. Article last updated 22 April 2026.