Health Ministry sets minimum services for the indefinite medical strike by SMU

The Regional Ministry of Health and Dependency Care has established, by order, the minimum services in the health institutions of the Extremadura Health Service (SES) in view of the indefinite strike called by the United Doctors Union (SMU), the first phase of which extends from November 16 to 28. The regulation, signed on November 12 by Minister Sara García Espada, is published in the Official Gazette of Extremadura (DOE) number 219, corresponding to Friday, November 13, 2026, with the official reference 2026050134.

The call is supra-regional in scope and is addressed to all medical personnel of the National Health System, including personnel in training through the residency system, regardless of whether their service relationship is statutory, civil service, or contractual. The Order of November 12, 2026 is issued in application of article 10.2 of Royal Decree-Law 17/1977, of March 4, and in accordance with article 92 of Law 1/2002, of February 28, of the Government and Administration of the Autonomous Community of Extremadura.

An indefinite strike unfolding in phases

The strike will begin at 08:00 hours on Monday, November 16, 2026 (08:00 local time in the Canary Islands) and the first phase will continue until 08:00 hours on Saturday, November 28, 2026. The SMU has announced that the start and duration of each subsequent phase will be communicated to the administrations ten calendar days in advance, pursuant to article 4 of Royal Decree-Law 17/1977.

The preamble justifies the intervention based on the essential nature of healthcare assistance, linked to the right to health protection under article 43 of the Spanish Constitution, and the doctrine of the Constitutional Court. It also cites the Supreme Court ruling of May 26, 2003, regarding proportionality and ruling no. 1,523/2021, of December 17, from the Contentious-Administrative Chamber, issued in cassation appeal no. 2208/2020, which allows for the inclusion of resident internal doctors in the minimum services.

Applied criteria and minimums in Primary Care

The order sets the minimums based on the extension of the working day for ninety-six continuous hours and five criteria:

• Guarantee of urgent care.
• Protection of vulnerable patients.
• Avoidance of critical delays in diagnoses and treatments.
• Compliance with health regulations.
• Impact on the functioning of hospitals.

In Primary Care, the following is established:

• In centers with PAC or accessory PAC, continuous care under holiday regime.
• In health centers without PAC, one doctor for emergency care exclusively.
• In centers with four or more UBAs, two doctors and one pediatrician where there are two or more.
• In socio-sanitary centers, one doctor on ordinary working hours for emergencies.
• 100% of the Primary Care Emergency and Urgency services and the medical personnel necessary for urgent medicalized secondary interhospital transport.

Operating rooms, critical units and hospitalization

In Hospital Care, the usual scheduled on-call shifts for weekends and holidays are maintained, as well as 100% of the medical personnel of the Hospital Emergency Services. Personnel are guaranteed in dialysis, resuscitation and critical care, hemodynamics and pathological anatomy (intraoperative samples), and in pharmacy, laboratory and diagnostic imaging for urgent examinations.

• Operating rooms: already scheduled oncological surgery, urgent surgery, major surgery with special prior preparation, interventions with prepared autotransfusion, and those whose postponement would affect clinical evolution.
• Radiotherapeutic Oncology and Onco-Hematological Day Hospital, Pediatrics, Palliative Care and HIV: initiated or new treatments with urgent indication.
• Outpatient Clinics: high obstetric risk and scheduled follow-up for Oncology and Oncohematology.
• Hospitalization: 33% of professionals on ordinary working hours, with a limit that prevents exceeding the actual staff of that shift.
• Socio-Sanitary Mental Health Centers: 33% of psychiatrists on ordinary working hours.

In Continuous Care, the minimum services are 100% of the corresponding personnel, and internal resident doctors occupying on-call positions are also considered minimums during the ordinary working day in the centers where they are trained. In Public Health, one doctor is designated at the Regional Neonatal Screening Center.

Validity and means of appeal

The order enters into force on the day of its signing, without prejudice to its publication in the DOE, and extends its effects during the days of the call, expiring upon the cancellation of the call. The same minimums will be maintained in subsequent phases that may be communicated with the same object, reasons, and convener. Against the regulation, which ends the administrative route, an optional appeal for reversal may be filed before the head of the Ministry of Health and Social Services within one month, or a contentious-administrative appeal within two months.

The order arrives five days before the start of the strike and affects both Extremaduran medical personnel and public healthcare users, who will see scheduled non-urgent activity limited while emergencies, oncological treatments, and care for critical patients are maintained.

Source: Official Gazette of Extremadura, no. 219, November 13, 2026, section I (official reference: 2026050134).