Spain's health minister isolated as all 16 regions refuse to vote on medical statute, leaving doctors' strike unresolved

A meeting that ended before it began

The extraordinary plenary of the Interterritorial Council of the National Health System (CISNS), convened at the request of the autonomous communities themselves, collapsed within minutes on Wednesday. Representatives from 16 regions and the autonomous cities of Ceuta and Melilla read a joint statement at the opening of the session and then declined to participate in or vote on any of the remaining agenda items. The Basque Health Minister, Alberto Martínez, acted as spokesperson for the bloc, declaring that the minister "has been left alone" and "does not have the support of the professionals, the unions, or the autonomous communities."

The minister has been left alone. She does not have the support of the professionals, she does not have the support of the unions, and she does not have us, the autonomous communities.

Catalonia was the only region that did not sign the joint document, though its health department issued a statement clarifying that it "shares a good part of the reflections expressed" and that not adhering "does not imply disagreement with its content." Catalan Health Minister Olga Pané was unable to attend the meeting due to medical leave.

The core dispute: who is responsible?

The conflict centres on the reform of the Estatuto Marco, the regulatory framework governing working conditions for Spain's healthcare professionals. The Ministry of Health, led by Mónica García, approved the reform without securing consensus from medical unions, triggering a series of strikes—the next of which is scheduled to begin on Monday, marking the fifth doctors' strike this year. The regions argue that since the ministry holds exclusive normative authority over the Estatuto Marco, the responsibility for the resulting conflict lies squarely with García. The ministry counters that many of the strikers' demands—such as limits on on-call hours, implementation of a 35-hour working week, and early retirement provisions—fall within the competences of the autonomous communities.

Today the autonomous communities could have unblocked the conflict by assuming their share of the competences. They decided not to.

Accusations fly after the failed session

In a press conference following the meeting, García accused the regional health ministers of behaving "like the dog in the manger, neither resolving nor letting others resolve." She expressed disappointment that the councillors had "decided to look the other way" and insisted she would not "renounce" the Estatuto Marco, arguing that doing so would mean "betraying" her colleagues. The Madrid health minister, Fátima Matute, described García as "a Trojan horse that is blowing up the system" and called for a "state pact" to address what she termed "the worst doctors' strike in history."

A Trojan horse that is blowing up the system.

The regional bloc's joint document urges the ministry to "urgently reopen a process of real, effective, and constructive dialogue" and to "immediately promote structural and sustained measures" to address the structural deficit of healthcare professionals. Carlos Fernández Carriedo, acting spokesperson for the Castilla y León regional government, summarised the regional position: "Reflect—not everyone can be wrong."

What comes next

With no agreements reached and positions unchanged, the doctors' strike is set to resume on Monday. The ministry maintains that the Estatuto Marco will not be withdrawn, while the regions insist they cannot resolve a conflict whose regulatory roots lie outside their competences. The standoff leaves Spain's public health system facing continued disruption, with regional governments warning of growing waiting lists and increased care pressure on remaining staff.