Inem sign

Paramedics/ firefighters warn Portugal’s emergency medical services are failing

“It’s not just right to health at stake; it’s right to life…”

The associations of emergency medical technicians, firefighters and agents of civil protection have today reiterated their concerns over shortcomings in assistance provided by INEM (medical emergency service), insisting on the need for a parliamentary commission of inquiry.

The position of associations Fénix and ANTEM follows a report in Expresso  about a man at risk of having his leg amputated following a serious accident with an angle grinder.

“This is the second case of which we are aware in the space of a week (…) this new case that has come to light, which we very much regret, unequivocally underlines the incapacity and inoperability of the so-called SIEM (Integrated Medical Emergency System), promoting the transformation of what should be Emergency Medical Services into poor quality rescue services,” said a statement signed by the associations. 

On Friday, both associations criticised the reappointment of Luís Meira as president of INEM, calling then for the creation of a Parliamentary Commission of Inquiry.

The same day, Expresso published its: “A (chilling) story of shuttling between hospitals after a serious accident” – an event that took place very recently: “A man with an angle grinder stuck in his leg was sent to Guarda hospital, where there are no vascular surgery doctors. He was stabilised and transferred to Viseu hospital, with the angle grinder still attached” to his body. 

In terms of mileage, it means the injured man, in desperate need of specialist attention, was transported in one direction, only to have to retrace this trajectory and arrive, hours later, at the only hospital in the region equipped to deal with his injuries. He is now in danger of having his leg amputated. Would this have been the outcome had he been transported swiftly to the correct hospital? Expresso is not saying. The paper simply reports that the man, a forestry sapper, is no longer at risk of losing his life, “but he remains at risk of losing his leg. The torniquet applied (by the man’s brother in law, using a belt) to staunch blood flow will have been essential to stop a fatal hemorrhage, but the sooner it was removed, the more likely it would be to avoid injuries caused by a lack of oxygenation”.

Fénix and ANTEM believe the whole story shows rank incompetence: “The nerve centre of SIEM, particularly the Urgent Patient Guidance Centre (CODU), has been stagnating for too long, held hostage by an institute that is closed in on itself, unable to modernise and updatein order to guarantee the provision of a quality service to citizens and Portugal,” the organisations say, reiterating their position already voiced on Friday.

Today’s statement refers to INEM’s “repeated inability” to provide transport “to definitive care”.

Fénix – the acronym for the National Association of Firefighters and Civil Protection Agents and ANTEM (the National Association of Emergency Medical Technicians) reiterated what they call “INEM’s inability” to respond to emergency call-outs, resulting in “tragic events”.

Says Lusa, “for the organisations, not only is the right to health at stake, but also the right to life.

INEM’s repeated inability, through the CODUs, to provide transport for the patient to definitive care (a hospital unit with the appropriate facilities for the patient’s clinical condition), in accordance with the basic principles of Emergency Medical Services, which are recognised worldwide,” is one of an extensive list of situations that both associations consider show the service is “not to be working properly”, Lusa continues.

Portugal’s minister for health, Manuel Pizarro – a man uniquely absent on television screens through the summer, notwithstanding the number of strikes by doctors and ‘issues’ involving patient care – appointed INEM’s board of directors, reappointing Luís Meira as president for a five-year term.

“We can conclude that the Minister of Health probably made a mistake in reappointing the President of INEM – this (the man and the angle grinder) is one more case and one more proof of that. 

“If the reappointment is maintained, we can only assume that the Honourable Minister of Health will be co-responsible for all the adverse events that may occur with regard to INEM’s repeated inability to pursue its mission,” reads the statement which, says Lusa, will be sent to the President of the Republic, parliamentary groups, the Committee on Rights, Freedoms and Guarantees and the Health Committee of the Assembly of the Republic.

By coincidence, this latest warning came as ambulance services in Porto came to a halt for four hours from 4pm today, until 8pm, due to the lack of professionals available.

Monday marks the ‘return to parliament’ of Portugal’s battling parties after a summer ‘break’. PS Socialists, with their absolute majority, are fending off criticism from all sides – and in many areas – to the extent that their ‘trump card’ (of promising to lower income tax thresholds in the next State Budget) may not be enough to ease their passage into the autumn.

Source material: LUSA