Health Minister under mounting pressure after tragic failures

The government awarded the country’s medical air transport contract to a Malta-based company that had no helicopters or pilots at the time of signing.

Health Minister, Ana Paula Martins

Health Minister, Ana Paula Martins, is facing growing calls to resign following a series of high-profile failures in emergency services, particularly in obstetric care, that critics say reflect deep systemic dysfunction within the National Health Service (SNS).

Two pregnant women in the Setúbal region lost their babies last week under troubling circumstances, and a seriously ill man waited over five hours to be transferred from the Hospital of Covilhã to Coimbra.

One of the women had reportedly spent two weeks seeking care across five Lisbon hospitals before being admitted at Santa Maria Hospital, where her baby was stillborn.

The patient’s complaints went unheeded, according to the Observatório de Violência Obstétrica (OVO PT), which is now calling for the minister’s resignation.

The OVO accused the government of “band-aid solutions and opacity” and denounced the deterioration of maternal care, citing a lack of coordinated follow-up and reliance on “an under-resourced phone line” for pregnancy support.

The group stated bluntly: “The country needs to restore safety, dignity, and humanity in the SNS.”

Critics argue the minister has failed to address chronic understaffing, lack of coordination, and infrastructure weaknesses.

OVO pointed out that Lisbon and the surrounding region, home to nearly three million people, has experienced over a 40% increase in ER closures since 2023, with official data now harder to access due to what they describe as a strategic blackout.

Helicopter limitations

The Health Minister also faced scrutiny over the case of the Covilhã patient, whose emergency transfer by helicopter involved three different modes of transport due to aviation limitations.

Due to aviation limitations, the patient’s transfer involved three separate stages: an ambulance ride to a distant aerodrome, a helicopter flight to another remote airstrip, and a second ambulance transfer to the hospital in Coimbra.

Critics say this patchwork process is dangerously inefficient in time-sensitive emergencies.

Later, in a major revelation, Expresso reported that Portugal’s only night-capable emergency helicopter, the military Merlin EH-101, is too large to land on any hospital heliport in the country.

Two other helicopters used for daytime missions by the Air Force, the Koalas, face similar issues.

According to the former head of the civil aviation pilots' union, they also cannot land on hospital heliports due to their technical and safety limitations.

Malta company

Compounding the crisis, the newspaper also revealed that the government awarded the country’s medical air transport contract to a Malta-based company that had no helicopters or pilots at the time of signing.

The company was selected for offering the lowest bid and only began assembling equipment at the end of May.

The contract calls for four helicopters operating 24/7, but currently, only two are operational, and only during daylight hours.

The operator blames the delays on the government, which has yet to provide any public explanation.

As a temporary solution, the Health Ministry has turned to military aircraft, but these do not meet the system’s full transport needs.

Experts also note that the single-engine Koala helicopters are barred from flying over densely populated areas, preventing them from landing at major hospitals like Santa Maria in Lisbon or São João in Porto.

Meanwhile, a Black Hawk helicopter intended for emergency service remains grounded, still awaiting the installation of medical equipment.

The mounting logistical and operational failures have intensified pressure on the Health Ministry to explain how such a critical part of emergency care was allowed to fall into disarray.

Minister’s reaction

Martins, however, has refused to step down, stating she has a “clear conscience” and will not abandon her responsibilities while serving under Prime Minister Luís Montenegro.

“I will never flee from any mission entrusted to me. Taking responsibility means staying and solving problems,” she said.

She deflected responsibility over the aviation limitations to INEM for clarification, while both INEM and the Ministry of Defense failed to respond to media questions about emergency aviation capacity.

Meanwhile, she has insisted that she remains committed to reforming the SNS.

“The National Health Service is the cornerstone of healthcare for all, especially for those who need it most,” she said.

However, for many patients and healthcare advocates, that promise is sounding increasingly hollow.