A cascade of resignations is further destabilizing the Amadora-Sintra Health Unit (ULS), one of Portugal’s largest healthcare providers, following a series of leadership departures adn a recent maternal death examination. The clinical director for primary healthcare stepped down from overseeing hospital care this week, prompting four deputy directors to also submit their resignations. The situation underscores mounting pressures within the Portuguese public health system and comes as the ULS remains without a permanent president after Carlos Sá resigned in November 2025 . The governance is working to maintain services during the transition, but the staffing upheaval raises concerns about patient care continuity.
The clinical director for primary healthcare at the Amadora-Sintra Health Unit (ULS) has stepped down from his additional responsibilities overseeing hospital care, triggering a wave of resignations among his leadership team. The move comes amid ongoing instability within the health system following a recent case involving a maternal death and the subsequent departure of the ULS president.
Mário Rui Machado Cruz resigned “from the cumulative and temporary exercise of executive functions as clinical director for the hospital care area,” according to a message sent to all ULS professionals. He will continue in his role as clinical director for primary healthcare, as originally appointed by the Ministry of Health.
In addition to Cruz’s resignation, four deputy clinical directors for hospital care – João Tiago Serra, José Marcus Eulálio, Catarina Luís, and Tereza Diniz da Costa – have also submitted their resignations, the ULS administration confirmed.
The administration acknowledged the current “institutional context,” including the previous clinical director’s resignation and the former president’s departure, is creating “natural discomfort and increased constraints” in managing and operating the organization. The case highlights the challenges facing the Portuguese healthcare system.
“However, this body has remained fully committed to the exercise of its responsibilities, in strict respect for its powers and institutional duties,” the administration stated in the message to staff.
To ensure continuity of care, the administration has directed the resigning officials to remain in their positions until replacements are found and a new organizational structure is established. The move underscores the urgency of the situation and the need to maintain healthcare services.
The administration said it is “closely monitoring the situation” and is working to ensure the continued regular operation of hospital care, despite the current challenges.
The administration expressed its gratitude to all professionals for their dedication, professionalism, and sense of responsibility, reiterating its commitment to institutional stability, patient safety, and ongoing support for teams.
Carlos Sá, the former president of ULS Amadora-Sintra, was appointed to the position in March 2025 but resigned in early November 2025 following a case involving a patient’s death during childbirth. A replacement has not yet been named.
