The Spanish public healthcare system is heading towards an indefinite strike that will affect every Tuesday. starting next January 27stAfter nearly three years of failed talks between the Ministry of Health and the unions within the Framework Statute Negotiation Framework, the breakdown in dialogue has crystallized into an unusual united union front that brings together the main public healthcare unions.
The organizing groups assert that They see no other way out than sustained mobilization. to force a change in the wording of the new Framework Statute for statutory staff. They believe that the draft being promoted by Minister Mónica García's team leaves out key issues and creates a divide between professional groups, jeopardizing both working conditions and the quality of care.
Who is calling the strike and who is affected?
The call comes from the five organizations with representation in the Scope of Negotiation of the Framework StatuteSATSE-FSES, FSS-CCOO, UGT Public Services, CSIF, and CIG-Saúde. These unions represent, they emphasize, to 100% of the statutory staff of the National Health System (NHS), including both health and non-health categories.
The strike is planned as indefinite and recurring every TuesdayThe initiative, which began on January 27 and will continue "as long as necessary," calls on all public healthcare personnel to participate, from doctors and nurses to administrative, technical, and support staff, with a potential impact on hospitals, health centers, and other healthcare facilities across all autonomous communities.
The unions justify this decision by stating that, after the last meeting held on November 6thThey have not received another official summons or a new full draft, and maintain that the only relevant information they are getting about the negotiations is through the media. This situation is interpreted as a sign of paralysis and lack of political will on behalf of the Ministry.
Underlying reasons: an “incomplete and unfair” Framework Statute
The core of the conflict centers on the reform of the Framework Statute for statutory staffThis is a fundamental regulation governing the employment relationship of hundreds of thousands of professionals within the National Health System (NHS). Unions assert that the proposed legislation from the Ministry of Health fails to guarantee real improvements for all staff and leaves unresolved issues they consider "essential."
Among the main complaints, the organizations denounce that the Ministry “He has no intention of agreeing to a fair, useful and beneficial text for all workers.”, and that intends to close the negotiation by considering "more than 99%" of the articles agreed when, in his opinion, strategic issues such as professional classification, working hours and retirement still need to be resolved.
Another fundamental criticism concerns the way the reform is being handled. The unions speak of “disloyalty” and “violation of the legitimate space for negotiation” They denounced that the Ministry has held meetings and offered specific proposals to exclusively medical unions outside the scope of the Ministry, which they interpret as an attempt to fragment the group and prioritize sectoral interests.
The unions' "non-negotiable" demands
The organizers of the strike have been specifying in various press conferences and statements what elements they consider red lines in the new Framework StatuteTheir position is that without these points there will be no agreement and the mobilization will continue indefinitely.
First, they demand that the rule clearly establish basic remuneration linked to the new professional classification frameworkIt's not just about reorganizing categories, they explain, but about ensuring that this change is accompanied by a salary structure consistent with the training, responsibility, and functions performed.
Another central axis is the workdayThe unions are demanding a "decent and adequate" working day that allows for a balance between work and family life, with a uniform limit of 35 hours per week throughout the StateThey believe this measure should be explicitly included in the basic law, avoiding the large differences that currently exist between regional health services.
The third set of demands focuses on the voluntary early and partial retirementThe organizations demand that the new Statute guarantee effective mechanisms so that older professionals can reduce their working hours or bring forward their retirement under reasonable conditions, taking into account the hardship, on-call duties and care workloads accumulated over the years.
Finally, they demand that the regulation promote a coordinated government action that involves other ministries with overlapping responsibilities—Labor, Civil Service, Social Security, and Finance. In his opinion, the Ministry of Health has “abstained” from its responsibility to lead this inter-ministerial work, which would demonstrate a certain weakness within the coalition government.
Accusations of “parallel negotiations” with doctors
One of the elements that has generated the most tension is the perception that the Ministry of Health has prioritized a specific dialogue with medical unions Outside the scope of negotiation, SATSE-FSES, CCOO, UGT, CSIF and CIG-Saúde have been denouncing for months that meetings have been held and drafts have been sent to organizations such as CESM or the Andalusian Medical Union to try to stop their calls for strikes.
Union spokespeople for the sector claim that these “Parallel tables” constitute disloyalty towards those who obtained their representation through union elections and who speak on behalf of all statutory staff. In their view, the Ministry had “hindered, hampered, and delayed” the official negotiations while advancing with concrete proposals directed only at medical professionals.
This situation has led to a complex scenario: on the one hand, an indefinite strike of all NHS staff every Tuesday starting January 27th; on the other hand, several days of strikes called by medical unions at the state and regional levels to demand their own statute that regulates only their working conditions.
The unions in the sector insist, however, that Their demands also include the specific needs of doctors and the other categories, and that no group has been left out of their proposed articles. That is why they view with suspicion the attempt to channel the doctors' requests through a separate avenue outside the common negotiation process.
The Ministry's argument: maximum powers and historic reform
The Ministry of Health defends a very different view of the process. In several official statements, it has emphasized that the current draft of the new Framework Statute It includes “all those demands that fall within its area of competence”, following a technical and political dialogue process in which they claim to have held more than 60 meetings with unions, strike committees, autonomous communities and other stakeholders.
According to the Ministry of Health, the text would have reached “the maximum possible development within the limits of a basic state law”, establishing a common framework that respects the constitutional distribution of powers and the autonomy of the autonomous communities. Blocking its approval now on issues that fall outside that framework, the Ministry argues, would mean “losing a historic opportunity” to modernize a law that has not been reformed for two decades.
The department headed by Mónica García emphasizes that It cannot set specific salary amounts or bonuses.because they depend on each health service and budget laws; nor can it directly grant early retirement, as this is a responsibility of Social Security, nor impose a 35-hour work week, since the duration of the workday is a matter that corresponds to each autonomous community.
Along the same lines, the Ministry of Health points out that overly detailed regulations on shifts, on-call duties, or specific staff allocations could to be appealed to the Constitutional Court because it encroaches on regional powers, so the law should be limited to setting a basic framework and leaving some room for adaptation to health services.
What improvements are included in the draft of the new Framework Statute?
While acknowledging that it cannot meet all requests, the Ministry maintains that the text presented Yes, it introduces relevant changes for the entire staffAmong the most notable measures is a package aimed at reducing temporary employment and better organizing career paths within the NHS.
On the one hand, there is the obligation to convene Public Employment Offers (OPE) at least every two yearswith new limits on temporary contracts and control mechanisms to prevent unstable contracts from becoming chronic. There is also a commitment to complete digitization of the selection and merit accreditation processes, with the aim of making them more agile and homogeneous across communities.
Regarding mobility, the draft anticipates annual transfer competitions based on an open and permanent competition systemso that professionals can change their destination without having to wait long periods, as has happened in some health services where calls for applications have been spaced out for years.
Another key aspect of the project is the reorganization of the professional classificationAbandoning the traditional reference to the EBEP groups and adapting the structure to the MECU/MECES training scheme. The Health Department assures that this change will not entail salary losses or modifications to healthcare functions, and that it will serve to better align training, skills, and responsibilities.
The text also reinforces the role of the training, teaching and research within the statutory link, so that these activities have explicit recognition in the functional planning of the centers and are not relegated to a secondary role compared to daily care activity.
Working hours, on-call duties and work-life balance: limits to overload
One of the most visible aspects of the Ministry's proposal has to do with the regulation of working hours and on-call dutiesWith the stated intention of reducing workload and improving rest for healthcare staff, some of the measures presented by the Ministry of Health as key achievements of the reform are concentrated here.
The draft sets a Maximum weekly working hours of 45 hours For statutory staff, this limit falls below the 48-hour cap established by the European directive. This figure does not satisfy those demanding 35 hours nationwide, but the Ministry defends it as a significant improvement over the current situation.
In parallel, it is established that the The maximum duration of on-call shifts will be reduced from 24 to 17 hours.In addition, mandatory days off and rest periods, both before and after on-call duty, they will not be able to generate hourly debtThis should translate in practice into a proportional reduction in the ordinary working day and greater protection against marathon working days.
The text also incorporates the figure of the “excessive workload”This requires prevention services to intervene when persistent overwork is detected and to propose corrective measures, ranging from staff reinforcements to shift reorganizations. With this, the Health Ministry aims to prevent excessive workloads from becoming normalized as a structural issue.
Regarding work-life balance, the Statute introduces regulated rights to flexible working hoursThis includes the obligation to communicate shifts with sufficient advance notice and the inclusion of specific measures in the centers' equality plans. Furthermore, protection against particularly arduous nights and shifts is strengthened for professionals with health problems, pregnant women, and staff with dependent children, expanding the existing exemptions for those over 55.
Another point especially valued by some groups is the structured recognition of shift overlap timeThis time is considered key to ensuring the proper transmission of clinical and organizational information. It will need to be regulated and negotiated, preventing it from remaining an invisible task assumed de facto without any reflection in the workday.
A healthcare system under pressure and a politicized conflict
The climate in which this indefinite strike in the public health system has erupted is already quite volatile. delicateThe unions warn that the system suffers from deficits that were exposed during the pandemic and that have not been resolved: lack of reinforcements in high-demand episodes such as the flu, saturation of emergency rooms, growing waiting lists and layoffs of thousands of professionals hired in recent years.
Union leaders point out that Healthcare is sustained thanks to a constant overexertion of the staff, with long shifts, consecutive on-call shifts, and difficulties in balancing work and family life. From their point of view, this situation is "pushing public healthcare towards a point of no return" if profound changes are not made to work organization and job stability.
In this context, it is not only the unions in the Negotiation Area that have been activated. Medical organizations are also maintaining their own calls for strikeswith strikes lasting several days to demand a specific statute, improved pay for on-call shifts, changes in how these shifts are counted for retirement purposes, and a maximum 35-hour workday with any excess hours agreed upon and paid separately.
The conflict has also spilled over into the political arena. The opposition is demanding that the government... withdrawal of the current draft and the start of new, “serious, dialogued, and consensual” negotiations with regional governments, unions, and professional organizations. The reform is accused of being improvised, lacking economic foresight, and jeopardizing the stability of the healthcare system itself.
Meanwhile, the Ministry insists that the process is not closed and that Improvements can still be introduced during the parliamentary processalways within the limits of their respective powers. The Ministry of Health appeals to the “collective responsibility” of the trade unions to avoid blocking a reform that, in its view, represents a significant step forward compared to the Framework Statute in force since 2003.
Nevertheless, the gap between the two sides remains significant: the unions emphasize that their demands represent the entire staff and that the professionals' patience "has run out," while the Ministry maintains that it has gone as far as the law allows. Barring a shift in the coming weeks, the timeline points to... a start to the year marked by recurring strikes in public healthcare, with a direct impact on the organization of services and on the daily lives of patients and workers.