Complaints regarding the operation of the central emergency department at Hospital Santa Maria are long-standing, with staff reporting that proposed solutions were ignored by the Board of Directors. Sources describe a critical situation with daily patient volumes reaching 350, insufficient senior medical staff, and a lack of nursing support, which compromises patient safety. Following the replacement of the service director, João Gouveia, eight team leaders resigned and three doctors terminated their contracts. While the Board of Directors claims to have increased human resources spending by 50% over the last five years and disputes the severity of the staffing shortages, hospital sources warn that further departures are likely if structural issues remain unaddressed.