The health ministry wants to merge Bulgaria's 27 emergency medical centres into a single national body under the Air Emergency Medical Service Centre. About 200 administrative staff could lose their jobs.

The draft decree is open for public comment until 3 December. If approved, the new body must be ready by 1 January 2027.

On 4 November, the Health Ministry published the draft merging 29 separate legal entities, including the national training centre, into one.

The ministry says the number of emergency crews will not fall, their work will not get harder and ambulances will not take longer to reach the scene. People will still call 112 for emergency help. Calls will go to the National Emergency Medical Centre, which will pass them on to the regions.

Emergency workers are unhappy and fear what the change will mean for patients. Crews say the current 27 centres know their own areas, which matters when help has to come fast. They ask how calls will be handled and whether bringing them all into one place will slow help down. They also say it is still unclear how the staff shortage will be filled, whether there will be new ambulances and equipment, and what will happen to low pay.

Mima Stancheva, a paramedic at the centre in Straldzha, described hard shifts, heavy workloads and a lack of crews. Her colleagues are retirees, some left recently, and no new people are coming. She says the reform will not solve the problems. It could deepen the staff shortage and make things harder for centres in remote places, she says, because the administration in Yambol is closer and easier for the crew to reach than a centralised body would be.

In Sandanski, two emergency crews cover more than 50 towns and villages. The ambulance used there two years ago is still on the road and again needs repairs. Valentina Dzhevalekova, a head nurse, says restructuring should be done with the people who go out into the field. Helicopters fly at set times and to set places, she said, while people wait for an ambulance that should not lose a single minute.

The Paramedics' Union backs cutting duplicate administrative posts. Its chair, Iva Pehlivanska, says the change should be part of a wider reform that improves emergency care and the running of the centres.