Health Minister Offers Locum Doctors Without a Specialty a Route Onto SNS Staff, but Their Hourly Pay Is Still Undecided

Portugal's Ministério da Saúde (Health Ministry) says it has no intention of pushing hired doctors out of the Serviço Nacional de Saúde (National Health Service, SNS), and has offered to look for a way to bring those without a medical specialty onto permanent staff. What it did not do, after a meeting of more than three hours on Friday, was say how much it will pay them by the hour from now on.

The doctors in question are the médicos tarefeiros, physicians who work SNS rosters, mostly in emergency departments, on service contracts rather than as employees. Friday's meeting with Health Minister Ana Paula Martins was their association's first in about ten months.

What the ministry offered

In a statement after the meeting, the ministry said: "The Government does not intend to exclude from the SNS the doctors who today provide care under service contracts." It said it wants to "create conditions" for them to join the staff of public health units.

The sticking point is doctors without a specialty. Under current law, the SNS cannot give an open-ended contract to a doctor who is not a specialist, and the transitional window that let hospitals hire tarefeiros on staff contracts, which closed on 30 September, did not cover them. The ministry said it cannot award a specialty on its own, since that power belongs to the Ordem dos Médicos (Medical Association), but is "available to work on a solution", including a possible transition phase.

Nuno Figueiredo e Sousa, president of the Associação de Médicos Prestadores de Serviço (Association of Service-Providing Doctors, AMPS), told Lusa the meeting produced "a project" and a path towards "a gradual, responsible and careful integration" of hired doctors. He said the minister would talk to the Ordem about crediting non-specialists' years of experience when they apply to train in a specialty.

Speaking to Observador, he said the association also asked that specialists joining the staff start at a career step reflecting their service rather than at the bottom, and proposed service contracts of three to five years so hospitals can count on full rosters.

The figure still missing

Pay was not settled. The portaria (ministerial order) that will set new rates for service-contract doctors was promised for October and has not been published. According to Observador, the official table, dating from 2016, sets 22 euros an hour for non-specialists and 26 euros for specialists, while AMPS puts the average actually paid at 43 euros. Observador reports that the Government intends to cut the hourly rate, as a further reason for doctors to choose a staff post over hired work.

"It is very likely that the rope will snap," Figueiredo e Sousa told Observador. He said he did not mean a strike but doctors leaving for the private sector or for jobs abroad, and that his colleagues "are not willing to accept a cent below" current rates.

How much the SNS relies on them

The Conselho das Finanças Públicas (Public Finance Council), in its June report on the SNS in 2025, found that public health units bought 6.6 million hours of medical services last year, 6 percent more than in 2024, at a cost of 265 million euros. Of those hours, 86.9 percent (5.7 million) came from tarefeiros.

The hours are concentrated where hospitals struggle to recruit. The local health units of the Algarve (470,000 hours), Médio Tejo (388,000) and Oeste (359,000) bought the most, 18.4 percent of the national total between them. For patients there, the rate the portaria sets will bear directly on whether emergency rosters stay full this winter.

The ground rules behind the dispute were set out in our earlier report on the unpublished pay order and Decreto-Lei n.º 115/2026. For the wider picture of emergency cover, see our piece on the people who live more than an hour from an emergency room.