The issue has been a hot topic in recent days. Following the death of a pregnant woman who was discharged from Amadora-Sintra—a case that put the Minister of Health at the center of a new controversy—the ‘war’ between the government and freelance doctors is now dominating the news in the sector, after it was disclosed that a group of over a thousand freelance doctors are preparing to paralyze emergency services.
These doctors, who are not contracted to the National Health Service (SNS), have organized through WhatsApp with the intention to halt emergency services at public hospitals for at least three days when the government issues a diploma aiming to reduce their hourly wages.
On Thursday, the movement of freelance doctors rejected the possibility of a general strike in emergency services for now, stating they first want to see the government’s proposed legislation on the new service provision regime. Meanwhile, a group of these professionals has launched a petition to legitimize their leadership in requesting a meeting with the Ministry of Health—with 745 signatures collected by 9:00 a.m. this Friday.
The chairman of the Order of Doctors, Carlos Cortes, has urged the Ministry of Health to meet with the freelance doctors, warning that if the planned strike takes place, its impact on emergency services “will be very significant.”
What exactly are freelance doctors? How much do they earn and what is the cost to the state? Here is an in-depth look at why they might dramatically halt emergency services for several days.
Who are freelance doctors?
A freelance doctor is a professional who provides services to public hospitals without a contractual link, instead being paid by the hour for each task performed.
This arrangement offers greater flexibility and the potential for higher hourly wages than those of doctors contracted to the SNS, who earn at most 36 euros per hour.
According to several contracts available on Portal Base, the hourly pay for freelance doctors averages between 22 and 60 euros, officially not reaching 100 euros.
What is at stake with this (potential) strike?
The initiative comes after the Council of Ministers approved the decree-law that will regulate the hiring of freelance doctors for the SNS.
Although the final text is not yet public, it was presented to medical unions during negotiations with the authorities.
From the information released thus far, the new legislation is expected to prevent doctors from detaching from the SNS (through resignation or retirement) to work as freelancers by imposing a waiting period of up to three years.
Newly specialized doctors who do not apply for or accept positions may also be barred from providing services to the SNS.
The decree-law will provide exceptions for proposals thoroughly justified by Local Health Units (ULS) to ensure patient care is not compromised.
Costs of the SNS with freelance doctors
Between January and August 2025, the SNS spent 162 million euros on freelance doctors, marking an increase of 25.7 million euros (19%) compared to the same period the previous year, according to data from the Central Administration of the Health System (ACSS).
Doctors account for the majority of the SNS spending on service provisions, which totaled 174.7 million euros over eight months.
Fifteen years ago, the Ministry of Health spent around 91 million euros contracting doctors through companies.
During the specialty debate on the State Budget for 2026, the Minister of Health, Ana Paula Martins, announced that the government plans to save 100 million euros with freelance doctors, one of the budget cuts making up over 10% in goods and services acquisition next year.
“We have an estimate of around 100 million, but I really can’t guarantee it,” said Ana Paula Martins, in the Assembly of the Republic.
What does the government say?
The Minister of the Presidency, António Leitão Amaro, stated this week that the government will maintain the planned changes for freelance doctors, citing a national consensus on the need to change the current situation.
The issue concerns the regulation of medical work in service provision approved by the Executive at the end of October, which aims to standardize the compensation of these health professionals and foresee a regime of incompatibility.
On Thursday, following a move by freelance doctors to launch a petition to legitimize their leadership in requesting a meeting with the Ministry of Ana Paula Martins, officials stated they had not yet received any meeting requests.
It is notable that with this new regulation, the government aims to minimize the pay discrepancy between SNS-contracted doctors and freelance doctors, most of whom are hired by task to ensure emergency service coverage by hospitals.
