La Doctors' strike over the Framework Statute This has sparked one of the most serious labor disputes the public healthcare system has seen in decades. Thousands of doctors across the country have taken to the streets and begun a series of strikes to protest the reform promoted by the Ministry of Health. does not recognize the specific nature of their work, their training, or their responsibility within the National Health System (NHS).
The conflict is not simply about a salary increase. Medical unions are talking about “discrimination”, “mistreatment” and “institutional disregard” They warn that the model the new Framework Statute seeks to consolidate will perpetuate precarious employment and accelerate the exodus of professionals to other countries and private healthcare. One clear objective is on the table: a separate statute or, at the very least, a state-level negotiating table exclusively for doctors and medical professionals.
How and who is calling the doctors' strike?
The conflict has crystallized into a indefinite strike with one week of strikes per monthframed as a fundamental battle. The strike days are scheduled for the weeks of February 16-20, March 16-20, April 27-30, May 18-22, and June 15-19, with the union's commitment to prolong the mobilizations if no significant changes are made to the regulations.
The call for applications stems from a state strike committee It is comprised of the Spanish Confederation of Medical Unions (CESM), the Andalusian Medical Union (SMA), Metges de Catalunya (MC), the Association of Doctors and Higher Graduates of Madrid (AMYTS), the Basque Medical Union (SME), and the Independent Galician Doctors' Union (O'MEGA). These organizations represent the majority of doctors in the public healthcare system and present themselves as the specific voice of the profession in relation to class-based unions of the Negotiation Scope.
The prelude to this indefinite strike was a large demonstration in Madrid, under the slogan “For a specific statute for doctors and medical professionals”, which brought together, according to the Government Delegation, some 5.000 people coming from all the autonomous communities. That march, from the Congress of Deputies to the headquarters of the Ministry of Health, was conceived as starting gun for a calendar of protests which could last for months.
During the demonstration, slogans were chanted directed at the Minister of Health, Mónica García, and the rest of the government, with messages such as “Monica, negotiate or go back to your consultation.”“Montero, put up the money” or “Pedro, tyrant, don’t wash your hands of this.” The doctors emphasize, however, that the protest is not pursuing a partisan objective, but is focused on the care and working conditions they consider essential to sustain the public system.
Why doctors reject the new Framework Statute
At the root of the conflict is agreement reached on January 26 between the Ministry of Health and the unions SATSE-FSES, CCOO, UGT and CSIF to finalize the draft reform of the Framework Statute, the basic regulation governing the working conditions of all NHS staff, which had not been updated for more than two decades.
Medical unions maintain that the The Negotiation Committee has approved the text without genuine participation from the profession.They denounce that medical representation at that table is very limited —in some cases below 20%— and that the voice of the doctors has been “diluted” in the face of organizations that do not represent their interests nor know in detail their daily reality in consultations, operating rooms and on-call shifts.
The Ministry of Health defends the agreement, emphasizing that the new Statute introduces general improvements for all healthcare groups, such as advances in professional classification, early retirement and work-life balance, in addition to a theoretical reduction of working hours and on-call shiftsThe Ministry insists that creating a rule exclusively for doctors would "break the cohesion" of the system and generate inequalities between categories.
For the strike organizers, that interpretation is insufficient and, in some respects, misleading. They believe that the text “neither worsens nor truly improves our conditions” and that It barely incorporates any partial measures, such as the proration of on-call shifts in specific situations, without addressing the major underlying problems: excessive working hours, mandatory on-call shifts, lack of remuneration recognition, and the absence of a professional career truly adapted to Medicine.
Demand for its own statute and a specific negotiating table
The political and labor focus of the protest is the demand for a separate negotiation sphere for doctors and medical professionalsThe organizing groups are not demanding the right to decide on salaries or shifts for nurses, administrative staff, or other categories, but they are demanding that Everything that exclusively affects the practice of medicine should be discussed with its representatives. and not at a generalist table.
Union leaders such as Angela Hernandez (Amyts), Mercedes Tallón (OMEGA), Victor Pedrera (CESM) or Xavier Leonard (Metges de Catalunya) agree that the profession lives a “false closure” situation After years of meetings without real progress, he believes the agreement reached by the Ministry consolidates the "historical discrimination" against doctors compared to other healthcare professionals by failing to specifically recognize their level of specialization and the utmost responsibility they assume for each patient.
The unions insist that This is not a privilege or a capricious corporate demand.but rather to adapt the regulatory framework to a work reality that has no equivalent in the rest of the NHS staff. They point out that a specialist doctor accumulates, at a minimum, six years of undergraduate studies, MIR exam preparation, and between four and five years of specialized training, in addition to a legal and clinical responsibility that “is not reflected in the current regulations.”
The proposal from these groups involves a Own Medical Statute or a really specific chapter within the framework of the regulations, they demand a differentiated professional classification, a system of working hours and on-call duties aligned with European standards, and clear rules on retirement, mobility, and professional development. Among other things, they call for a New A1 category exclusively for doctors and medical professionals and the creation of a medical and professional consultation table where these matters can be negotiated in a stable manner.
Working hours and on-call duties: the core of the conflict
If there is one point on which all the testimonies agree, it is that the regulation of working time This is the heart of the dispute. In practice, a doctor's day in the NHS combines regular working hours and an additional day of mandatory on-call duty which can lead to working 24 hours straight and far exceeding the hours worked by other healthcare categories.
Currently, the workload of medical professionals is around 48 hours per week on average, according to the unions, and the draft of the Statute would place it at 45 hours long.Doctors believe this supposed advance is far from the 35 hours per week that are being implemented for other public health professionals and denounce that the text maintains broad exception clauses for “service needs” which, in practice, returns them to the starting point.
The most controversial element is on-call duty. Doctors emphasize that a large part of the system relies on it. mandatory supplementary work schedule, with many consecutive hours, at night and on weekendsIn a doctor's working life, this translates into more hours, more nights, and more years of effective work than any other civil servant, without equivalent compensation in terms of rest time, social security contributions, or retirement benefits.
The compensation for these on-call shifts is another source of discontent. Medical unions emphasize that, in many autonomous communities, On-call hours are paid at a rate below the value of an ordinary hourly rate.which they describe as "the imposition of cheap overtime." They also denounce that They do not contribute adequately to retirement.Although they do pay income tax, they point out that the obligation to be on call extends to very advanced ages —in many cases up to 55 years old—, whereas in other European countries it is more limited.
The organizing groups demand a Maximum working hours of 35 hours per week, mornings and weekdaysand that anything exceeding that amount be considered excess working hours, voluntary, well paid and with full recognition in social security contributionsThe stated objective is to approach European standards of rest and safety, both for professionals and for patients.
Professional classification, training and responsibility
Another major open front is the professional classification proposed by the new Framework StatuteMedical unions criticize the text for "mixing categories in the same numbering" and placing professionals with very different training backgrounds and responsibilities on the same level, such as a nurse with a specialty and a doctor without one, without clearly differentiating the weight of the medical act in clinical decision-making.
Representatives of the profession point out that, after the Under the Bologna Process, the Medicine degree has the status of a Master's degree., an academic recognition that, in his opinion, This does not translate into a legal or remunerative framework. of the regulation. Furthermore, they point out that the doctor is, ultimately, the person most responsible for the patient in an emergency, in a primary care consultation or in an operating room, and that this specific responsibility should be unequivocally reflected in the Statute.
Along with the classification, the specialized healthcare training and professional development They are also at the heart of the debate. Unions are demanding guarantees for residency periods (MIR, FIR, and BIR), with working conditions that prevent abuses justified by "service needs," and real protection for tutors, whose teaching and clinical dedication, they claim, is currently neither recognized nor adequately compensated.
Doctors link these deficits to the loss of attractiveness of the public systemThey speak of a growing disaffection, especially among younger professionals, which is pushing many to opt for private healthcare or emigrate to other European countries where on-call shifts are better regulated, working hours are more reasonable, and career advancement offers greater incentives. "A mistreated doctor is also a mistreated patient," some union spokespeople summarize.
Nationwide protests and regional demands
The doctors' strike over the Framework Statute has a marked state characterBut it unfolds across a healthcare system where powers are devolved to the autonomous communities. For this reason, many regional organizations have taken advantage of the national strike to to drag their own conflicts to the negotiating table with the health departments.
In communities like AragonCESM Aragón and FASAMET have promoted, in parallel to the state strike, five days of regional strikes for all doctors and medical professionals of the Aragonese Health Service. In addition to the common demands, there are specific requests such as the equalization of working conditions and pay with other regions, the improvement of Primary Care, the recovery of the professional career and the increase in the price of the hour of on-call duty, which the unions place among the lowest in the country.
En MadridThe weight of the protest is especially visible. The capital hosted the initial large demonstration and has a full schedule of events planned. daily concentrations in hospitals and health centers during the first week of strikes. Amyts, the largest union among Madrid doctors, also points out that a [unclear] is still pending in the region. new open and permanent career model, the review of supplements, a clear system of early retirement due to hardship and risk, and the creation of a specific medical and professional consultation table.
In other autonomous communities, such as Castilla-La Mancha, Murcia, the Balearic Islands or the Canary IslandsThe unions have called their own strikes and demonstrations to demand compliance with agreements signed in previous years, emergency plans to reduce waiting lists, increased staffing levels, and improved pay for doctors in training. In all of these actions, the organizations emphasize that A large part of the issues raised —up to 80%, according to CESM Murcia— can be resolved at the regional level. without needing to wait for state legislative changes.
Throughout the week of the strike, demonstrations are planned in front of hospitals and health centers in Aragon, Balearic Islands, Canary Islands, Valencian Community, Murcia, Extremadura, Castile and León, Castile-La Mancha, Madrid, Basque Country, Catalonia, Andalusia and GaliciaIn many cases, these are brief gatherings at midday, designed to raise awareness of the conflict without neglecting essential services.
Minimum services and guarantees for patients
One of the most sensitive points for public opinion is the Impact of the strike on healthcareMedical unions have reiterated that their intention is not to harm patients and that Urgent and non-deferrable attention will be guaranteed. at all times, with minimum services in emergency, ICU, childbirth, oncology and other critical areas.
Even so, the organizations acknowledge that the strikes will have effects on scheduled appointments, non-urgent surgical procedures and diagnostic testsIn a system already experiencing saturation, they warn that waiting lists may lengthen in some services and that appointments scheduled for those days will be suspended or rescheduled.
Paradoxically, one of the points of contention between unions and regional governments is precisely the scope of minimum servicesIn regions such as the Valencian Community, La Rioja, and the Basque Country, medical organizations have denounced orders that, in their view, establish coverage so high that it leaves the strike without real content, with percentages of healthcare activity that equal or exceed those of holiday periods such as summer.
The unions point out that the The right to strike is a fundamental right They demand that minimum services be adjusted to criteria of necessity and proportionality. In places like the Basque Country, they have asked for the removal of ambiguous terms like "undeferrable" from the orders that regulate these minimum services, because they believe that They open the door to interpretive abuses. when determining which tasks should be performed during the shutdowns.
From the institutional side, the Ministry of Health and the regional health departments claim that their priority is to guarantee continuity of care and to avoid risks to the population, and they maintain that the approved minimum services fulfill that obligation. Several medical organizations have announced that they will go to court if they detect violations of the right to strike or “abusive” appointments of professionals as essential services.
A conflict that goes beyond wages
Although the public debate usually focuses on salaries and working hours, the protagonists of this Doctors' strike over the Framework Statute They insist that the conflict is broader. They speak of a a healthcare model that, in his opinion, rests on the exploitation of the doctorwith endless workdays, lack of professional recognition, few incentives for stability and increasing healthcare pressure that deteriorates the doctor-patient relationship.
During the demonstration in Madrid, the social dimension of the protest was clearly evident: entire families accompanying the medical professionalsChildren carrying signs asked for “fewer on-call hours and more playtime” or wondered why their parents didn't want them to follow in their footsteps. Patients also came to thank their doctors for their work and demand “better care” to ensure quality public healthcare.
Medical unions frame the strike as a “Last option” after years of meetings, parliamentary appearances and partial strikes They claim they have failed to change the direction of the reform. They assert that they have held dozens of meetings with the Ministry and with parliamentary groups, and that they have unsuccessfully exhausted all available avenues of negotiation before calling this prolonged protest.
The Minister of Health, for her part, defended the agreement reached with the unions in the Negotiation Area and invited the doctors to to channel their demands through parliamentary initiatives or those of the autonomous communities themselvesOn several occasions, he has flatly rejected the idea of creating a statute exclusively for doctors, arguing that it would break the cohesion of the NHS and create unfair comparisons with other professionals.
In this institutional standoff, doctors warn that the outcome will determine not only their working conditions in the coming years, but also the capacity of the public system to retain talent, reduce waiting lists and provide safe and continuous careThey fear that if the conflict is resolved in a false way, the exodus of doctors to other countries or to the private sector will increase, further straining the public healthcare system.
The doctors' strike over the Framework Statute has thus become a turning point for the profession and for Spanish public healthcare.On one side, a group demanding a legal framework adapted to the unique nature of their work and to European standards; on the other, an administration advocating for a common text for all healthcare personnel and a segment of the unions willing to support it. Caught in the middle, patients and families anxiously watch this power struggle, which, as the doctors themselves warn, could determine whether the National Health System (NHS) manages to strengthen itself or enters a phase of decline that is difficult to reverse.
