Health Ministry sets minimum services for the November healthcare strike

The Regional Ministry of Health of the Community of Madrid has established the minimum services for the strike called by the Assembly Movement of Health Workers (MATS) in the health centers of the Madrid Health Service (SERMAS), scheduled for November 11 and 12. This is done through Order 1776/2026, dated November 6, by the Regional Minister of Health, published in the OFFICIAL GAZETTE OF THE COMMUNITY OF MADRID number 270, dated November 10, 2026, in section I.C (Other Provisions), pages 173 to 178. The decision comes after negotiations with the Strike Committee concluded without an agreement.

The regulation is based on Article 28.2 of the Constitution, which recognizes the right to strike and provides guarantees for essential services, and Article 43, regarding health protection. The order also cites the doctrine of the Constitutional Court established in judgments 11/1981, 26/1981, 51/1986, 53/1986, 27/1989, and 43/1990, Article 10 of Royal Decree-Law 17/1977, of March 4, on labor relations, Article 41 of Law 1/1983, of December 13, and the delegation of powers of Order 655/2025, of April 22.

A two-day call and a failed negotiation

MATS notified the labor authority on October 19, 2026, of its decision to call a strike in SERMAS. According to the call, the strike would take place from 8:00 PM on November 10 until 8:00 AM on November 12. However, the Strike Committee clarified that the strike affects the statutory and contractual staff of the centers affiliated with the service and that it begins in the last shift prior to 00:00 hours on the 11th, covering the last shift that begins that day and ending when said shift concludes the following day.

On November 5, 2026, the Strike Committee was convened to negotiate the minimum services, resulting in “no agreement” in their determination. The preamble emphasizes that in the setting of minimums, there must be “a reasonable proportion” between the sacrifices imposed on the strikers and those suffered by the users, without emptying the content of the right to strike.

Hospitals: Sunday staffing and 35 percent cap

In hospital centers, the minimum services correspond to the staff providing services on Saturdays, Sundays, and/or holidays and to the medical staff with a scheduled on-call shift each day of the strike. Additional minimums have been added in special units:

• Dialysis, Emergencies, Resuscitation, and Critical Care
• Hospitalization, Operating Rooms, Day Hospital, and Oncology
• Pediatrics, Palliative Care Units, and Pharmacy
• Laboratory, Diagnostic Imaging and Other Explorations, and Radiotherapy
• Pathological Anatomy, Hemodynamics, Admission and Archives, and Organ Extraction and Transplantation

In any case, minimum services may not exceed 35 percent of the total existing staff in each Management.

Primary care, emergencies, and transfusions

In the Primary Care Healthcare Management, the minimums are as follows:

• Health Centers with four or more Family Doctors: two Family Doctors, one Pediatrician, two Nurses, and one Administrative Assistant per shift.
• Centers with fewer than four Family Doctors: one Family Doctor, one Pediatrician, one Nurse, and one Administrative Assistant per shift.
• Home Care Support Teams (ESAD): one Physician and one Nurse in each team.
• Continuity of Care Centers: 100 percent of Physicians, Nurses, and Orderlies according to the planning of each center.
• Administration: 10 percent of administrative staff, with at least two staff members in each Human Resources department.
• Alcalá de Henares First Aid Station: one Doctor and one Nurse.

In SUMMA 112, healthcare professionals will maintain 100 percent of the service staff according to the schedule of the strike day, in units such as mobile ICU, Rapid Intervention Vehicle (VIR), Home Assistance Unit (UAD), Advanced Nursing Life Support, Extra-hospital Emergency Center, medical helicopters, or Fleet and Logistics Management. In the Transfusion Center, staffing per shift is detailed as: one doctor and three nurses in internal donation, six Higher Technicians in Clinical Laboratory in fractionation and distribution, five in Serology and Special Techniques, and two hematologists plus one immunologist on the morning shift. In Mental Health Centers, one center manager, one Nurse, and one Orderly/Control Assistant.

Residents, overlap with the general strike, and validity

Personnel in training are also subject to minimum services:

• Hospital care: 35 percent of residents on ordinary shifts and 100 percent of those with a scheduled on-call shift.
• Primary care: one resident per center and shift where up to three coincide; two where four or more coincide.
• SUMMA 112: 100 percent on ordinary and complementary shifts.

The order warns that the criteria, schedules, and centers coincide with the general strike on November 11 called by CCOO, UGT, CGT, CO.BAS, CNT, and the Confederación Intersindical, therefore the Managements will designate the same professionals for both calls and will notify the minimum services individually and reliably. The regulation comes into force on the day of its publication, extends throughout the call, and is extinguished if the call is cancelled; an optional appeal for reversal may be filed before the Minister of Health within one month, or a contentious-administrative appeal within two months. Signed by delegation, the Director General of Human Resources and Labor Relations, Miguel Ángel Rodríguez Roiloa.

The scope of the order is twofold: it marks the care that patients will receive during two days across the entire public network and, at the same time, determines which part of the staff may support the strike, in a context of coincidence with the general strike on the 11th. For users, the minimums guarantee emergencies, dialysis, oncology, childbirth, palliative care, and transplants; for the organizers, the 35 percent limit in hospitals and the reinforcements in special units restrict the possible adherence to the protest.

Source: OFFICIAL GAZETTE OF THE COMMUNITY OF MADRID, no. 270, November 10, 2026, section I.C (Other Provisions), pp. 173-178 (official reference: BOCM-20261110-40).