El New Framework Statute for healthcare personnel This has become one of the most significant regulatory changes in recent years for the National Health System (NHS). After more than three years of meetings, drafts, and tensions, the Ministry of Health and the main unions in the sector have finalized a text that updates a regulation that had remained virtually unchanged for more than two decades.
The agreement entails a major shift in the working conditions of nearly one million workers of the National Health System (NHS), with improvements in working hours, on-call shifts, work-life balance, retirement, career development, and job security. However, it comes accompanied by an open conflict with medical unions, who consider the content of the text insufficient for their members and have opted to maintain a strike. indefinite strike.
A historic agreement after years of negotiation
The Ministry of Health and the trade union organizations of Scope of Negotiation —SATSE-FSES, FSS-CCOO, UGT, and CSIF— have signed the agreement on the draft bill for the Framework Statute for Statutory Personnel of the Health Services. This is a text that, according to Minister Mónica García herself, It hadn't been renewed for 22 years. and which has been the subject of intense technical and political work.
The signatory unions emphasize that they have achieved modify more than 70% of the current StatuteThe process incorporates “more than 100 improvements” that, in their view, modernize the regulations and adapt them to the current reality of the National Health System. The process has included dozens of meetings within the Negotiation Framework, demonstrations, and threats of a general strike in the public health sector, which acted as leverage to unblock the most contentious issues.
The minister has insisted that the text is the result of a broad agreement with the most representative organizationsAnd that the Ministry has primarily played a mediating and listening role: it has gathered demands from professionals, healthcare centers and patients, trying to avoid “fragmented statutes” by categories that could break the multi-professional logic of the system.
The agreement, however, has not been unanimous: the Galician union CIG-SaúdeThe medical community, with its prominent medical presence, has distanced itself from the agreement, deeming some elements of the text insufficient. Furthermore, medical organizations outside the scope of the agreement have opted for a strategy of open confrontation.
Professional reclassification and recognition of qualifications
One of the most sensitive parts of the new framework is the professional classification linked to academic qualificationThe regulation introduces a scheme that groups all health professions according to their level of training, with the aim of correcting historical imbalances, especially in the case of nursing.
With the new design, All Bachelor's degrees fall under the same professional groupPositions requiring a master's degree or specialist qualification are in a higher group, while those requiring a doctorate are at the highest level. The General Council of Nursing emphasizes that, finally, "the same degree will grant the same professional classification," closing the gap between former graduates and those with diplomas following the European harmonization of university studies.
For nursing, this change It partially breaks the so-called "glass ceiling" which limited their professional development and their ability to be on par with other university-level healthcare professions. The importance of their skills and responsibilities within the National Health System is recognized, something that, according to the group, has been pending for years despite the adaptation to the European Higher Education Area.
However, reclassification does not automatically imply a salary increase. The text stipulates a specific negotiation process regarding the new remuneration modelThis process must take place in parallel with the parliamentary proceedings of the Statute. The unions consider it essential that, in addition to the Ministry of Health, ministries such as Finance and Public Administration, as well as the regional governments, participate in this debate, since they bear the brunt of the expenditure.
Working hours, on-call shifts and breaks
Another central section of the new Framework Statute relates to the regulation of working hours and on-call dutiesThis is one of the most sensitive points for professionals. The regulation establishes a maximum weekly working time of 45 hours for those on call, lower than the thresholds that have been applied in many health services.
In the specific case of on-call duty, the Statute It ends 24-hour shifts as a general rule.A maximum of 17 consecutive hours is set, with the possibility of extending to 24 only in exceptional circumstances and with express consent. Furthermore, the number of monthly on-call shifts is limited—with a typical maximum of five—and it is guaranteed that on-call hours will be counted as effective working time for the purposes of weekly calculation.
The text also introduces mandatory rest periods and days off linked to on-call dutyTo prevent professionals from working consecutive shifts without adequate recovery time, the days before and after a shift are considered part of the total calculation, which requires reorganizing shifts and staffing levels in many departments to comply with the limits.
The Ministry claims that, for the first time, a intervention mechanism in situations of persistent overloadThis means that public authorities must take action when excessive workloads are detected. For the unions, these changes represent a step forward in occupational health, although they warn that their practical implementation will depend on the resources provided by the regional governments.
Work-life balance, weekly working hours and retirement
The new Framework Statute also strengthens the bloc of reconciliation of personal, family and work lifeThis is an aspect that professional organizations considered insufficiently developed in the previous regulations. The implementation of a 35-hour workweek in all health services is being strongly promoted, with the aim of standardizing working hours across all autonomous communities.
In parallel, a organization of the most flexible workdaywhich takes into account the protection of particularly vulnerable groups. Exemption from night shifts is contemplated for professionals over 55 years of age, pregnant women, breastfeeding mothers, or those with reduced working hours for childcare, without reduction in pay.
The unions also highlight the possibility of recognizing the “overlap of workdays” (the time when professionals from different shifts coincide to transfer information) as effective working time, something that until now was not regulated homogeneously and that generated comparative disadvantage between territories and categories.
In the area of retirement, the regulation opens the door to voluntary access to partial retirement For statutory staff, it stipulates that, after the necessary studies, reduction coefficients for the retirement age may be established for certain particularly arduous positions, thus facilitating early voluntary retirement. Furthermore, it guarantees that on-call shifts will be properly counted for Social Security contributions.
Stable employment, career path and research
One of the stated objectives of the Framework Statute is to reduce the High structural temporary employment in the NHSTo this end, the text requires that public job offers be announced at least every two years and that these processes be resolved within a maximum period of 18 months, avoiding endless calls that prolong instability.
It is also reinforced voluntary mobility through open and permanent transfer competitionsThis measure, implemented annually, aims to facilitate work-life balance and life planning for professionals by allowing them to change their postings without having to leave the system or string together temporary contracts in different autonomous communities.
Regarding career development, the Statute provides an additional level that communities can implement It also stipulates that recruitment processes must be at least annual. Furthermore, it guarantees that the career level recognized within a health service will be maintained, with corresponding salary implications, when the professional moves to another region—something unions consider crucial to avoid “penalties” for moving within the public system itself.
The text also introduces the figure of the statutory research staff It also more clearly recognizes research and teaching activities as part of actual work. The aim is to boost R&D within the National Health System and prevent professionals' involvement in research projects from depending solely on precarious contractual arrangements or those outside the statutory framework.
Impact on occupational health and plans to address aggression
The new regulation pays special attention to the occupational health and risk prevention related to healthcare work. Among the obligations for the administrations are measures to improve safety in the centers, both physical and organizational, as well as specific programs of psychological support in contexts of high healthcare pressure.
The implementation of plans to address attacks on healthcare staffThis is a growing problem that unions see as an absolute priority. These plans must include clear protocols for action, legal and psychological support, and public awareness campaigns.
The Statute incorporates, across the board, the following: tools for the periodic assessment of working conditionswith union participation, to identify scenarios of overload or risk. The idea is that the regulation should not only establish rights on paper, but also require administrations to periodically review whether they are being respected.
The signatory organizations emphasize that all these improvements, in addition to impacting the health of workers, They have a direct effect on the quality and safety of care which benefits the public, by reducing fatigue, chronic stress and professional abandonment.
Political procedures and the role of political parties
The agreement in the Negotiation Framework is only the first stage of a legislative itinerary still longThe draft bill must first be approved by the Council of Ministers, which will authorize the formal start of its processing. From there, the required reports will be requested from ministries such as Finance, Economy, Civil Service, and Social Security.
The text will also be analyzed in the Government Delegate Commission for Economic Affairs (CDGAE)where its budgetary impact and its compatibility with other public policies will be examined. Once this phase is complete, a public consultation and information process will begin, allowing organizations and individuals to submit comments.
Once these contributions have been incorporated—or rejected—the Framework Statute will return to the Council of Ministers for a second approval It will then be sent to the Congress of Deputies, where the parliamentary process will begin. The Chamber's arithmetic and the political context will determine the timing and scope of any potential amendments.
Both the Ministry and the signatory unions emphasize that their objective is to achieve approval during the current legislatureThey have announced that they will intensify contacts with the various parliamentary groups. Organizations such as the General Council of Nursing are calling on political parties to show "vision" and sensitivity towards the needs of healthcare professionals.
The unions' view of the Negotiation Scope
The organizations that have signed the agreement —SATSE-FSES, FSS-CCOO, UGT and CSIF— agree that the Statute is “a full stop”It is not the end of the road. They consider it a common basis that sets minimum standards throughout the State and opens the door to developing further improvements in the sectoral working groups of each health service.
SATSE emphasizes that the text includes more than a hundred modifications in matters such as staff rights, professional classification, working hours, work-life balance and partial or early retirementIts president describes it as a "decisive" moment to begin translating demands into visible changes in the workplace.
UGT highlights that the new Statute "Progress, modernize, update and innovate"While strengthening legal certainty and regulating labor relations, the organization insists that this is not an improvised document, but rather the result of more than three years of work, with a particularly intense final phase marked by dozens of meetings and sustained union mobilization.
CCOO and CSIF emphasize that The Statute is of a general nature and not fragmented.They argued that the public healthcare system functions as a multi-professional machine in which improvements must benefit all staff. According to these unions, accepting specific statutes for each job category would have weakened the coordination of the National Health System and the collective bargaining power of the workers.
The rejection by medical unions and the indefinite strike
Faced with the support of the unions in the sector, the Medical groups maintain a clearly critical stanceOrganizations such as the State Confederation of Medical Unions (CESM), Amyts, Metges de Catalunya, the Andalusian Medical Union (SMA), the Medical Union of the Basque Country (SME) or O'MEGA consider that the Statute does not respond to the specificities of the profession.
These unions have called a indefinite strike with weekly work stoppages From mid-February until at least June, in addition to demonstrations and other mobilizations, they denounce that the text "was created without consulting doctors," that their situation remains worse than that of other categories, and that the regulation of on-call shifts is insufficient and discriminatory.
Their main demand involves the creation of a specific Statute for the medical communityThey demand a specific negotiation framework that takes into account their training, professional responsibilities, and the nature of their workday, especially regarding on-call shifts and workload. They also demand that these on-call shifts be voluntary, better paid, and with greater protection against fatigue.
The Minister of Health, for her part, maintains that the The new statute incorporates many of the demands raised. by these groups and notes that dozens of meetings have been held with their representatives. Even so, he admits that their request for a text specifically for doctors has not been addressed and encourages them to channel their proposals through parliamentary means, either through legislative initiatives or via political groups.
The new Framework Statute for healthcare personnel outlines one of the most ambitious changes in the NHS's labor regulations this century: it updates outdated legislation, improves working hours, limits on-call shifts, strengthens work-life balance and career development, promotes job stability, and more clearly recognizes the diversity of qualifications and roles. All of this takes place in a context where the support of the majority of unions coexists with opposition from the medical community and with parliamentary proceedings still pending, which will ultimately determine how much of this broad package of measures reaches the daily practice of healthcare centers intact.
