Decreto-Lei 115/2026 Tightens the Médico Tarefeiro Outsourcing Regime From 1 July — 60-Km Internato Catchment, Two-Year SNS Re-Entry Block and 48-Hour No-Show Penalty Frame the €250M Spend

Decreto-Lei n.º 115/2026 (Decree-Law 115/2026), published in the Diário da República (Official Gazette) on Tuesday, 16 June, rebuilds the contracting regime for so-called médicos tarefeiros (task-doctors, i.e. physicians hired on service-provision contracts rather than as Serviço Nacional de Saúde — National Health Service — staff). The diploma enters into force on 1 July 2026 and gives hospital boards until 31 December 2026 to adapt all live prestação de serviços (service-provision) contracts to the new framework.

The reset is the Ministério da Saúde's (Health Ministry) most explicit attempt yet to bound a category of spending that hit roughly €250 million across the SNS in 2025 — a 17.3% increase on 2024 — and that now binds more than 4,600 professionals into shift rosters across emergency rooms, intensive-care units and chronic-disease consults.

What the diploma actually changes

Three structural rules sit at the centre of the new regime:

• Two-year re-entry block. Physicians who left a Serviço Nacional de Saúde (SNS) post within the previous two years cannot be re-engaged through a prestação de serviços contract. The clause is designed to stop staff doctors resigning to return at the higher hourly rate of the tarefeiro market.
• 60-km internato catchment. Newly specialised doctors — those who have just completed their internato (specialist training) — must apply when SNS vacancies open within 60 kilometres of the unit where they completed training, on pain of two-year ineligibility for service contracts.
• Médicos sem especialidade carve-out. Non-specialist doctors can only be contracted on an exceptional basis to cover urgência (emergency) services and only under direct supervision of a specialist.

Two further incompatibilities matter for unit-level rostering: physicians who have declared themselves exempt from emergency duty at their SNS unit are barred from contract work, and doctors who have already reached the 250-hour annual supplementary-work cap cannot top up via tarefeiro shifts elsewhere.

The 48-hour rule

Where doctors do contract under the new regime, the diploma introduces a hard penalty for no-shows. Any tarefeiro who fails to attend a scheduled shift without communicating the absence at least 48 hours in advance loses 50% of the value of the next contracted shift. SPMS (the SNS shared-services IT operator) and ACSS (Central Administration of the Health System) have a one-month adaptation window to update payroll and rostering systems to track the deduction.

Reaction and what comes next

The Federação Nacional dos Médicos (FNAM — National Federation of Physicians) read the diploma as an acceleration of the very outflow it is meant to slow, warning that the tighter incompatibility regime will push doctors toward the private sector and toward emigration rather than back into SNS staff roles. The Sindicato Independente dos Médicos (SIM — Independent Physicians' Union) has also questioned whether the 60-km catchment can survive a constitutional challenge on freedom-of-movement grounds.

The Direção Executiva do SNS (SNS Executive Board) and Health Minister Ana Paula Martins have framed the move as a transparency and cost-discipline measure rather than a hiring squeeze, with the 31 December 2026 transitional deadline keeping pressure on Conselhos de Administração (hospital boards) to renegotiate live contracts in the second half of the year. For expat residents who rely on SNS hospital and emergency cover, the immediate operational read is unchanged through the summer; the shift-coverage stress test arrives in autumn, once the new rules bind every active tarefeiro contract.