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A. Trains:

You are right regarding the state of the trains. Portugal had not received new trains for over +20 years. But this will change soon(*).

1. Cascais Line: This line is a unique and problematic case because it uses a different voltage from the rest of the country (1.5 kV DC vs. 25 kV AC). Because of this, the trains are technological "islands" that cannot run on other lines and vice versa. Modernisation works (approx. €100 million) are currently underway to change this voltage and integrate the Cascais line into the national network. The voltage conversion will be completed by the end of this year. Stations will be modernised between 2026 and 2028. New trains(*) will replace all current ones operating there, which will take place between 2027 and 2029.

1. Oeste Line (Caldas and Torres Vedras): This line was neglected for decades. Currently, it is finally being electrified and modernised, which explains the constant delays and bus replacement services. This is expected to be completed in 2027/2028.

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(*) The Railway Plan: The government recently approved the purchase of 195 new trains from Alstom, specifically intended for suburban and regional services. However, these trains will only begin to arrive in bulk between 2026 and 2029. Until then, CP (the national operator) continues to "work miracles" with carriages from the 70s and 80s. Many of these new trains are destined for the Cascais and Oeste lines.

The Fertagus Line (as per your link): This is a different issue. Before the €40 pass was introduced, travelling from Setúbal or Coina to Lisbon (+50 km) was quite expensive (passes could exceed €140). The drastic price reduction to everyone (previous government by Antonio Costa)  led to:

1. The number of annual passengers jumping from approximately 20 million to 32 million.

1. Many people who previously used cars or buses switched to the train, saturating an infrastructure that was not designed for this volume.

1. The company states it would need at least 2 to 4 more trains to ensure that all rush-hour services run with 8 carriages. As the concession was recently extended (until 2031) under a "financial rebalancing" framework, there was no immediate investment in new rolling stock, which keeps the service "bottlenecked." A solution for this line is still awaited ... 2027? Link below:

B. Public health:

There are currently several large-scale hospital projects at various stages of completion in Portugal. Some are progressing at a steady pace, whilst others have only recently seen their tenders launched.

Here are the key highlights for the coming years:

1. Lisbon Oriental Hospital (HLO) – Marvila, Lisbon

This will be the largest hospital in the country, replacing the services of six existing hospitals in central Lisbon (such as São José and Curry Cabral). Construction officially began in October 2024. It is scheduled to be operational by 2028, featuring approximately 879 beds.

2. Alentejo Central Hospital – Évora

A vital project for the southern region, intended to replace the current Hospital do Espírito Santo. According to the most recent 2026 updates, the completion forecast has been adjusted to 2027.

3. Algarve Central Hospital – Faro/Loulé

After decades of anticipation, the process made significant progress in early 2026. Construction is expected to take about three years, with the hospital projected to open in January 2031.

4. Seixal Hospital

A long-standing demand to relieve the pressure on the Garcia de Orta Hospital (Almada). There is no fixed date yet, as it depends on the tender process, but work is expected to start in late 2026 or 2027.

5. Funchal new Hospital

The new hospital in Funchal, officially known as the Hospital Central e Universitário da Madeira (HCUM), is currently the largest public infrastructure project in the country. The project is divided into three main phases. The first two phases (excavation and structural work) are essentially complete. The physical structure and finishes are expected to be finished by 2027 or 2028. The goal for the hospital to be fully operational and open to the public is currently set for late 2029 or early 2030.

In addition to these new hospitals, several expansions are underway, such as at the Setúbal Hospital, the IPO Coimbra (Cancer Institute), and the Burn Unit in Coimbra.

Thanks JohnnyPT. Let's hope all of the above projects will be completed as planned and within the financial means of the country. I would have preferred better maintenance (the trains look horrible with all those taggings) and a continuous upgrade over a longer duration.  But, so be it. For those not needing to go to Lisbon or Porto regularly and who own a car things are manageable.

Not an answer to your questions but Google Street View in Portugal does some trains giving a view as if standing on a flat carriage, this is Caldas da Rainha a train on the local line going North.

We know Portugal for only 15 years (I assume JohnnyPT knows it for much longer). and we see improvements in some areas (mainly Lisbon and Portugal), but mostly in touristy areas. Improving trains, roads (not the motorways, which are great), healthcare and power infrastructure would benefit the normal Portuguese (and the expats). I am suspicious that lost of the railway improvements will mostly benefit Alstom (or Siemens) and less so the Portuguese. Even after modernization, a train ride from Caldas or Torres Vedras to Lisbon will take twice as long as taking the bus. Unfortunately, I think that many projects supported by the EU are more beneficial for the EU than for Portugal.

However, I might be wrong and too old or whatever.

There is significant investment in new hospitals, all of which are needed in the planned locations. The new hospitals in Funchal and Évora are well advanced (see videos above). The new one in Lisbon is still in the initial phase (land clearance, first foundations, etc.). The problem with public healthcare is not the facilities, but rather the shortage of doctors, who prefer the private sector (they earn more and have less hassle...).

This decade will be one of investment in railways, not only in high-speed rail but also in improving urban and suburban transport. It will also see the ports of Sines and others, connected to the national network. A further 2 billion euros is set to be invested in 200 new trains, in addition to all the investment in local and national railways.

I think all this investment will benefit the country and its people. It’s a shame it wasn’t done sooner (for various reasons: the subprime crisis, troika years, some politics crises, incompetent politicians, 8 years of a government that did almost nothing in railways and public services, and so on...)

@TGCampo

The public health care system has certainly degraded over time. Those using private health care don't notice it at all. We have a local resident friend who has been waiting for a routine knee operation for 2 years. If he goes private he can have it done within 2 months. We enjoy the fact that the toll roads are in great shape and allows us to travel between cities quickly; it costs, but I find it's worth every Euro. Local roads on the other hand leave much to be desired. In my town of Peniche, one of the streets has not been  re-paved in 30 years, it's a patch upon patch. Same can be said for many other streets in town. Fundamentally, there's lack of funding everywhere.

@manuel6246

I see that lack of funding as well, which is why I wonder why high speed trains are even on the agenda. For these Capex and Opex are very high and there is hardly any connection in Europe which is making money. I would prefer seeing money spent on electrical infrastructure and the national road network (for example).

I don't see any mention to the contrary, so presumably the Oeste line will continue to be one track.  That makes frequent runs tricky, because trains can pass each other going the opposite direction only in stations or other places where there's a side track.  Current departures between Alfarelos and Caldas da Rainha are 3 or more hours apart, and that isn't likely to change unless they're desperate enough to try that bypass juggling.

Electricity will be nice, though.  I have ridden along there only a couple times, but when a car happens to be getting the diesel exhaust it's pretty nasty.