Madrid has become the epicenter of health negotiations these days Following the announcement of an agreement between the Ministry of Health and the Forum of the Medical Profession, which seeks to avert the planned national doctors' strike against the reform of the Framework Statute of the statutory staff. The agreement introduces commitments on professional classification, on-call duties, retirement and channels of communication, although it does not imply, for now, the automatic cancellation of the strikes.
The agreement comes after months of tension and intermittent contacts between the Government and medical unions, having a second week of strike scheduled from March 16 to 20. The Health Ministry maintains that the text agreed upon with the Forum allows the conflict to be resolved within an institutional framework, while the professional organizations insist that any decision regarding postponements or suspensions rests exclusively with the Strike Committee.
Who has sat down at the table and what has been agreed upon
The interlocutor chosen by the Ministry has been the Forum of the Medical Profession of Spain (FPME)This group comprises the Spanish Medical Association (OMC), the State Confederation of Medical Unions (CESM), the Federation of Scientific Medical Associations of Spain (FACME), the National Conference of Deans of Faculties of Medicine, and the State Council of Medical Students (CEEM). This bloc represents the professional, scientific, academic, and student spheres of the medical profession.
The Ministry of Health emphasizes that the agreement with the Forum does not break the previous agreement reached with the generalist unions. (SATSE-FSES, CCOO, UGT and CSIF) on the reform of the Framework Statute, but rather complements it. The new measures agreed upon with the medical entities will be incorporated into the already registered bill during its parliamentary process, maintaining the integrity of the text signed at the negotiating table.
The department headed by Mónica García emphasizes that All actions will be implemented through legal changesThe agreed measures will be added to the draft of the Framework Statute and will be linked to an in-depth review of the Law on the Regulation of Health Professions (LOPS), always in coordination with the autonomous communities and with the organizations of the sector.
From the professional perspective, the Forum values the meeting as a first step towards opening a stable channel for dialogue that reflects the particularities of medical practice —training, responsibility and central role in clinical care— beyond what is currently contemplated by the basic regulations for statutory personnel.
More voice for doctors regarding their working conditions
One of the central aspects of the pact is the Strengthening the direct participation of the medical profession in defining its working conditionsThe Ministry of Health assumes that doctors will have a clearer role in the negotiations, through their union representatives and new technical spaces for dialogue within the National Health System (NHS).
To make this possible, the Ministry commits to expand the functions of the Professional Forum provided for in the LOPSThis figure is already contemplated in the law but has been little developed until now. Furthermore, similar bodies will be promoted in the autonomous communities, so that there is a stable structure for dialogue at both the state and regional levels.
In parallel, the following is expected: creation of specific technical working groups in health servicesUnder the Basic Statute of Public Employees (EBEP), these forums will be geared towards addressing issues that particularly affect certain healthcare professions, with special attention to the medical profession, thus strengthening the channels of technical and professional dialogue that the group has been demanding.
The recurring complaint from doctors in recent months has been the lack of a stable and independent negotiation environment from which to address their specific demands. The new framework does not establish an exclusive Framework Statute for physicians, as some organizations had requested, but it does grant them greater weight in the NHS's negotiating structure.
Sources within the Forum point out, however, that there is a clear separation of roles: The Forum acts as a space for broad representation of the professionWhile the strictly labor-related aspects and decisions regarding strikes fall under the purview of the Strike Committee, which primarily includes medical unions.
New professional classification adapted to the MECES
Another key part of the agreement focuses on the Reorganization of the professional classification of medical personnel within the Framework StatuteThe Ministry undertakes to adapt this classification to the Spanish Qualifications Framework for Higher Education (MECES), which categorizes university and postgraduate degrees.
In practice, this will involve to explicitly distinguish between MECES 3 and MECES 2 qualificationsThis includes specialized healthcare training programs lasting at least four years. This move aims to align the professional structure of the National Health System (NHS) with the actual training level of physicians and to properly recognize the importance of specialization.
Additionally, the Ministry of Health announces the start of a comprehensive review of the LOPS with several objectives: to update the functional and professional classification of the different health categories, to adjust the regulations to the current training pathways and to strengthen the frameworks of specialization, participation and continuing education throughout the professional career.
This rethinking of the LOPS also aims to provide answers to historical demands regarding professional development, balance between categories and recognition of skills in a context where the NHS faces problems of generational change, territorial dispersion of staff and increased complexity of care.
Difficulty of on-call duty and improvement of pay
Long on-call shifts have been one of the biggest points of contention between the Health Ministry and doctors. The agreement reached expressly acknowledges the hardship associated with these shifts and modifies its remuneration treatment within the Framework Statute.
According to the Ministry, the financial compensation for on-call shifts will become a dual componentOn the one hand, the current continuous care supplement is maintained; on the other hand, a specific supplement linked to night work is added, designed to better reflect the conditions in which continuous health care is provided and the impact it has on the personal life and health of the professional.
This adjustment is interpreted as a step forward in the recognition of the physical and emotional burden that doctors bear These shifts are particularly problematic in environments with tight staffing, high patient volume, or 24-hour service. Medical organizations have repeatedly pointed out that current pay does not reflect the responsibility or the strain these shifts entail.
The Ministry of Health frames this change within a broader strategy of Improving working conditions to stem the brain drain, both towards other European countries and towards other work environments, and to make the professional career in the NHS more attractive, at a time when many autonomous communities are warning of difficulties in filling certain positions.
Early retirement and other future commitments
Along with changes in participation, classification, and on-call duties, the agreement incorporates a specific commitment regarding early retirement for certain healthcare activitiesThe Ministry will study the possibility of bringing forward the retirement age in those positions where there are circumstances of special risk, burden or hardship.
This analysis will be carried out, as the Ministry of Health has specified, in accordance with Social Security regulations and the framework defined in Royal Decree 402/2025which regulates the reduction of the retirement age for certain groups. A timetable and a final proposal have not yet been established, but the opening of this debate is assumed to be part of the package of reforms linked to the Framework Statute.
All these measures—strengthened professional participation, a new classification adapted to the MECES, recognition of the arduous nature of on-call duties, and a study of early retirement— They will be integrated into the draft Framework Statute during its parliamentary processThe Ministry insists that the process will be carried out in coordination with the autonomous communities and with representative organizations of the sector.
From a political perspective, Mónica García's department describes the result as an agreement that contributes to the stability of the public health systemRemember that it is linked to the text already worked on at the negotiating table and that the Government's intention is to continue negotiating with all actors —general and medical unions, colleges and scientific societies— to give a lasting legal framework to the commitments made.
The strike is still on: the role of the Strike Committee
Despite the gesture of rapprochement, The labor dispute is not over.The organizations that make up the Strike Committee—CESM, Andalusian Medical Union (SMA), Metges de Catalunya (MC), Association of Doctors and Higher Graduates of Madrid (AMYTS), Medical Union of the Basque Country (SME) and Independent Doctors Union of Galicia (O'MEGA)—have reiterated that the strike schedule It remains the same.
CESM, which is part of both the Medical Profession Forum and the Strike Committee, has been especially clear: He does not consider the pact with the Forum to be equivalent to a labor agreement with the MinistryTheir spokespeople point out that the only way to call off the strike is through formal negotiations with the Committee itself, directly addressing the demands put forward in the call for action.
Among the demands of that Committee are, in addition to improvements in pay and working hours, the creation of a specific negotiation framework for medical professionals at the state and regional levels, with their own system of representation. Medical unions maintain that, without this distinct framework, the group will continue to be at a disadvantage compared to other professional groups when it comes to setting their working conditions.
The Forum, for its part, offers itself as mediator to rebuild bridges with the Ministry and to facilitate further meetings with the Strike Committee in the coming days. Their stated objective is to move towards solutions that address the doctors' demands without harming patients, whom they consider the core of their professional commitment.
Given this scenario, the agreement between the Ministry of Health and the Forum is interpreted as a relevant movement but still insufficient to deactivate the mobilizationThe coming weeks will be marked by the parliamentary processing of the Framework Statute, the implementation of promises regarding retirement and on-call shifts, and, above all, by the ability of the parties to turn this initial approach into a labor agreement that satisfies the Strike Committee and stabilizes the situation in the National Health System.
