Health Ministry sets minimum services ahead of indefinite medical strike starting Monday

The Regional Ministry of Health of the Community of Madrid has established by order the minimum services that will govern the indefinite strike called by the United Doctors Union (SMU) in the public health centers and institutions of the Madrid Health Service. The regulation, Order 1817/2026, of November 13, is published in the Official Gazette of the Community of Madrid (BOCM) number 274, of Saturday, November 14, 2026, in section I.C of “Other Provisions,” and enters into force on the day of its publication. The strike begins at 8:00 AM on Monday, November 16, 2026, and its first phase extends until 8:00 AM on Saturday, November 28.

Call without agreement with the strike committee

The SMU notified the Labor Authority, via a letter dated November 5, 2026, of its decision to call an indefinite strike affecting medical personnel, including personnel in training under the residency system, regardless of the statutory, civil service, or labor nature of their service relationship.

On November 12, 2026, the Strike Committee was convened to negotiate the minimum services, resulting in “no agreement.” The order recalls the doctrine of the Constitutional Court (judgments 11/1981, 26/1981, 51/1986, 53/1986, 27/1989, and 43/1990) regarding the need for a “reasonable proportion” between the sacrifices imposed on the strikers and those suffered by the users.

The scope includes centers attached to Sermas and seven linked centers:

• Fundación Alcorcón University Hospital
• Fuenlabrada University Hospital
• the UCR
• Villalba Hospital
• Infanta Elena Hospital of Valdemoro
• Rey Juan Carlos Hospital of Móstoles
• Torrejón University Hospital

35% cap in hospitals and reinforced services

In hospital centers, the minimums correspond to the personnel who work Saturdays, Sundays, and holidays and to the scheduled on-call shifts, with additional reinforcements in units such as Dialysis, Emergencies, Resuscitation, Critical Care, Operating Rooms, Oncology, Pediatrics, Palliative Care, Pharmacy, Laboratory, Radiotherapy, or Hemodynamics.

The order also sets an express limit: minimum services “may not exceed 35 percent” of the total health personnel staff of group A1 of each Management. In the event of a respiratory virus epidemic situation, centers may set additional minimums in the units involved in that care.

Primary Care, SUMMA 112, and residents

In Primary Care, two family physicians and one pediatrician are established per center and shift when there are four or more family physicians, and one family physician and one pediatrician when the staff is smaller. Each Home Care Support Team (ESAD) will have one physician, and the Care Continuity Centers will maintain 100% of the planned medical staff.

In the SUMMA 112 Management, the minimums reach 100% of the medical personnel and A1 higher-degree graduates with service obligations at the emergency coordination center, mobile ICU, Rapid Intervention Vehicle, Home Assistance Unit, Extra-hospital Emergency Centers, medical helicopters, Psychology Unit, and Occupational Risk Prevention Service.

For resident personnel, 35% is set for ordinary hospital shifts and 100% for complementary shifts with scheduled on-call duties; in Primary Care, two residents per center and shift when there are four or more, and one when there are three or fewer; in SUMMA 112, 100%. The Transfusion Center will have one physician on the morning and afternoon shifts, two hematologists and one immunologist in the morning, and on-call availability for a hematologist and immunologist from 3:30 p.m.

Nominal designation and appeal process

The Managements must designate “expressly and nominally” the personnel covering the minimum services and notify them individually and reliably. The order warns that strikes by those assigned to these minimums will be considered illegal according to Article 16 of Royal Decree-Law 17/1977, of March 4.

Against this regulation, which exhausts the administrative route, an optional appeal for reversal may be filed before the Regional Minister of Health within one month, or a contentious-administrative appeal within two months. The text is signed by delegation by the Director General of Human Resources and Labor Relations, Miguel Ángel Rodríguez Roiloa, under Order 655/2025, of April 22.

The scope of the order is relevant for thousands of professionals and for the entire population with public healthcare in the region: it determines how many doctors will be in consultations, operating rooms, emergency departments, and emergency devices for at least two weeks, and comes after Health had already regulated in October the minimums for other medical calls, such as those established by orders 1649/2026 and 1650/2026, of October 22.

Source: Official Gazette of the Community of Madrid, no. 274, of November 14, 2026, section I.C “Other Provisions,” pp. 6-12 (official reference: BOCM-20261114-1, Order 1817/2026).