Portugal publishes rules for temporary doctors amid warnings of rural care collapse

The new legal framework

Portugal’s Decree-Law 115/2026, published in Diário da República on 16 June, regulates the hiring of doctors as service providers in the National Health Service (SNS). It enters into force on 1 July, with a transition period until 31 December for existing contracts to be adapted. The government aims to reduce a spending line that reached almost 250 million euros in 2024, according to the same article.

Penalties and evaluations

A core change is a 50% penalty on the next shift’s pay if a temporary doctor fails to show up without at least 48 hours’ notice. The decree also introduces periodic performance evaluations by hospital clinical directors, covering quality of care and contract compliance. Contract renewal will depend on a positive evaluation, and contracts are capped at three years. The measure targets incidents like the closure of obstetrics emergency at Hospital Garcia de Orta in summer 2024 due to a last‑minute no‑show.

Incompatibilities and exceptions

The law bars hiring doctors who left the SNS in the last two years, specialists who refuse to apply for vacancies within 60 km, and those exempt from emergency duty or who have already worked the legal overtime limit (250 hours). Non‑specialists may only be contracted exceptionally for emergency services under specialist supervision. However, after strong criticism from the medical community, the final version dropped a prohibition that would have prevented SNS staff doctors from working as temporary providers in other public units, a ban that the president of the Association of Temporary Medical Service Providers (AMPS), Nuno Sousa, had called a “homicide”. The decree also includes an escape valve for underserved hospitals, where entire services often rely on temporary doctors.

Reaction from medical associations

The National Federation of Doctors (FNAM) accused the government of accelerating the exit of doctors from the SNS.

“Many of these doctors will opt for the private sector or abroad, actually in a more accelerated way than what happens today.”

She argued that the decree ignores the reality of interior regions and the Algarve, where temporary doctors sustain services like obstetrics, anesthesiology, radiology, paediatrics, orthopaedics, cardiology and internal medicine. Without them, many services “will not have the scale to function” and patients will suffer. FNAM also questioned the lack of an impact study and the capacity of oversight bodies to audit large market‑dominant companies.

Transition and next steps

The government must still publish a ministerial order defining fee levels. During the three‑month transitional window, contracts that do not yet comply may be signed; existing agreements must be aligned by year‑end. AMPS lamented that its key demand, integration of temporary doctors into SNS permanent staff, was left out of the final text.