INEM President Luís Cabral Signals Departure Amid Operational Reforms
Luís Cabral advocates for a non-medical management leader to oversee Portugal's emergency services.
1Leadership Transition Proposed
Luís Cabral, president of Portugal's National Institute of Medical Emergency (INEM), has signaled his intention to step down. After one year in office, he argues that the institute's next leader should be a management professional rather than a medical doctor to effectively oversee the organization's 330 million euro annual budget.
2Operational Response Challenges
The institute currently faces difficulties meeting response time targets for urgent P1 cases. Cabral attributes these delays primarily to inefficiencies in the activation of rescue teams. He emphasizes that the organization is actively working to resolve these bottlenecks through a comprehensive technological modernization program currently being implemented across the national network.
3Winter Preparedness Strategy
To bolster response capacity for the upcoming winter, INEM has increased the number of ambulances contracted from local fire departments by one hundred compared to last year. While the institute aims for a more robust performance, Cabral has currently ruled out the privatization of emergency services through external private sector companies.
4Addressing Staffing Deficits
Despite recent recruitment efforts, the institute continues to struggle with a shortage of pre-hospital emergency technicians. This deficit is particularly acute in the Lisbon and Algarve regions, where retention remains a significant challenge. Cabral advocates for increasing the INEM tax on insurance policies to improve overall emergency service quality.
5Helicopter Service Oversight
Regarding the Emergency Medical Helicopter System, the institute is currently enforcing penalties against Gulf Med, the private operator, due to contract non-compliance. Cabral is seeking permanent collaboration with the Portuguese Air Force to stabilize these operations and ensure that critical medical transport services remain reliable for patients across the country.
6Protest Intervention Protocol
Addressing concerns regarding response times during housing protests, Cabral clarified that safety is the primary operational principle. Teams are trained to evaluate risks before entering volatile environments. He noted that INEM maintains specialized tactical intervention units that work alongside police to ensure patient access without compromising the safety of medical personnel.
7Union Agreement Implementation
Following a near-strike in September, INEM reached a public agreement with the emergency technicians' union. The plan includes hiring 200 new technicians this year and ensuring no reduction in field resources. The conversion of Immediate Life Support vehicles into lighter units is being phased in gradually to maintain service continuity.
8Data-Driven Resource Allocation
The selection of areas for vehicle transformation is based on clinical governance and operational data. Decisions prioritize locations with high activation volumes and frequent simultaneous calls. This strategy ensures that when a vehicle is upgraded, there is a corresponding reinforcement of local fire department resources to maintain total coverage capacity.
9Improving Response Metrics
The institute has implemented a five-level prioritization system to better manage medical emergencies. While the goal for P1 cases is an eight-minute response, current averages are closer to twelve minutes. Cabral notes that the focus is on reducing the time spent on call triage and the manual activation of rescue teams.
10Technological Infrastructure Upgrades
To reduce bureaucratic delays, INEM has deployed new information systems, including updated servers and tablets for field teams. This digital transition allows for direct dispatching, bypassing the need for multiple phone calls. These upgrades are designed to streamline the activation process and provide teams with real-time data from the initial triage.
11Call Center Efficiency
The time taken to answer emergency calls has improved significantly, now consistently meeting the twenty-second target. This progress follows a major physical and human resource expansion of the three CODU centers. These improvements are essential for handling the anticipated surge in call volumes during the upcoming winter flu season.
12Institutional Future Outlook
As Cabral prepares for his departure, the focus remains on structural stability and inter-institutional cooperation. By working closely with the Executive Directorate of the National Health Service, INEM aims to mitigate hospital stretcher retention issues. The goal is to leave a modernized, data-driven organization capable of managing future public health demands.
Original article: Observador — INEM President Luís Cabral Signals Departure Amid Operational Reforms