Health Ministry sets minimum services for medical strike at one third

The Regional Ministry of Health and Social Welfare of the Junta de Castilla y León has established the minimum services that Sacyl centers must maintain during the indefinite strike called by the United Doctors Union (SMU). The measure is detailed in ORDER SAN/1233/2026, dated November 11, published in the Official Gazette of Castilla y León no. 220, dated November 13, 2026 (reference BOCYL-D-13112026-220-30, pages 259 et seq.). The strike affects all medical personnel, including personnel in training under the residency system, and its first day of inactivity will be November 16.

The text is based on the notice submitted by the SMU on November 5, 2026, which proposes a strike of an indefinite nature and national scope: it includes medical personnel from the health services of seventeen autonomous communities, including Castilla y León, as well as centers managed by the National Institute of Health Management in Ceuta and Melilla, regardless of whether their service relationship is statutory, civil service, or contractual.

The strike will begin at 08:00 hours on Monday, November 16, 2026, and will extend, in its first phase, until 08:00 hours on Saturday, November 28. Subsequent phases must be communicated to the labor authority and employers with a minimum notice of ten calendar days, in accordance with Article 4 of Royal Decree-Law 17/1977, and the call will remain in effect until its cancellation by the union’s board of directors. The order is based on Article 28.2 of the Constitution, Article 10 of the aforementioned royal decree-law, and Article 40 of Law 21/2002, of December 27, and cites doctrine from the Constitutional Court and the Supreme Court regarding the balance between the right to strike and the protection of health. It is signed by the regional minister Alejandro Vázquez Ramos, in Valladolid, on November 11, 2026.

One third of the workforce and total coverage in critical areas

The order calculates that the set of minimum services represents approximately one third of the total workforce, a percentage that increases because the strike covers the night shift, where the minimums reach “practically 100%” as they are already designed with a minimum proportion of staff. In specialized care and health emergencies, some units reach 100% of the personnel planned for each day due to the serious risk to the health and survival of the patient.

100% attendance is required in hospital services of urgent or critical activity:

• ICU
• Medical and Radiotherapeutic Oncology
• Dialysis
• Operating Rooms in cases of invasive surgery
• Day Hospital
• Hospital Pharmacy
• Pregnancy and childbirth care and breast cancer screening

The order also maintains full assistance for patients displaced from other towns or centers and for those requiring examination with prior preparation.

No continued care points in Primary Care

In ordinary Primary Care consultations, the activity of a Sunday or holiday is applied as a reference, but with one express exception: Continued Care Points (Puntos de Atención Continuada) will not open, because they remain closed on an ordinary working day in the morning and “it would be contradictory to agree to their opening precisely on the occasion of the strike.” Therefore, the ordinary morning shift of a working day is maintained.

Urgent care, emergencies, and intensive care of the Regional Health Management (Gerencia Regional de Salud) will be provided without a reduction in functions and services. A minimum is guaranteed among inspection personnel to maintain the essential validation of prescriptions without delay, and in the Hemotherapy and Hemodonation Center, the sufficiency of blood components and neonatal screening are preserved.

Annex figures and resources

The annex details the minimums per morning, afternoon, and night shifts for the Monday to Friday periods between November 16 and 27. Among the largest volumes are:

• León: 165 specialist graduates on the morning shift and 14 hospital emergency doctors
• Salamanca: 162 specialists and 11 emergency doctors
• Valladolid Este (HCUV): 148 specialists
• Burgos: 145 specialists
• Valladolid Oeste: 145 specialists
• Palencia: 76 specialists
• El Bierzo: 50 specialists
• Ávila: 46 specialists
• Segovia: 42, Soria: 34, Aranda de Duero: 19, Zamora: 17 plus 8 on call, Miranda de Ebro: 12 and Medina del Campo: 17

In the Health Emergencies Management (Gerencia de Emergencias Sanitarias), three physicians for the morning and three for the afternoon are set in the CCU-SACYL, one physician per shift in each of the 23 provincial UME, one physician in the seven HEMS and in the 21 mobile UVI TIH. The text warns that essential services may not be disrupted by strikes of the designated personnel and reminds that the order exhausts the administrative route: a contentious-administrative appeal may be filed before the Contentious-Administrative Chamber of the High Court of Justice of Castilla y León, based in Valladolid, within two months, or a motion for reconsideration within one month.

Impact for patients

The order conditions healthcare across the entire autonomous community for at least twelve days: patients with critical scheduled treatments—oncological, dialysis, or surgical—will maintain their sessions, but outpatient consultations and deferrable activities will be adjusted according to the designated teams, and Continuous Care Points (PAC) will remain closed on working days. The Regional Ministry justifies the scope of these minimums based on the territorial extension of Castilla y León, population dispersion, and aging—factors that, in its view, make it necessary to guarantee continuity of care.

Source: Official Gazette of Castilla y León, no. 220, of November 13, 2026, section I.D Other provisions, page 259 (official reference: BOCYL-D-13112026-220-30).