Doctor Strike in Guimarães Closes Evening Clinics: February to June 2025

The Northern Doctors' Union (SMN - Sindicato dos Médicos do Norte) has launched an open-ended overtime strike across primary care clinics operated by the Alto Ave Local Health Unit (ULSAA) in Guimarães, Braga district—a labor action that union leadership says is designed not to hurt patients, but to protect them from a management structure relying on physician burnout instead of proper scheduling. Local Health Units (ULS) are regional health authorities that manage hospitals and primary care clinics across Portugal.

Why This Matters

• Extended hours clinics shuttered: The Guimarães Extended Care Service (SAC) has been completely closed since the strike began on 19 February 2025, forcing routine cases into hospital emergency departments.

• Strike duration: The work stoppage covers all voluntary overtime shifts through 30 June 2025, affecting doctors regardless of rank or employment contract.

• Disciplinary threats alleged: Union officials claim the ULSAA administration has threatened striking physicians with formal proceedings, escalating tensions between labor and management.

• Health Minister on notice: SMN president Joana Bordalo e Sá has directly challenged Health Minister Ana Paula Martins to intervene, warning the government risks complicity if it allows the situation to continue.

The Core Complaint: Planning Failure, Not Staff Shortage

Speaking outside the Hospital Nossa Senhora da Oliveira in Guimarães, Bordalo e Sá framed the dispute as a management competence issue rather than a traditional labor grievance. "When an administrative board fails at scheduling and adopts an intransigent posture, it tries to impose overtime as the standard operating procedure," she told reporters. "The people who suffer are always the patients, who end up in hospital emergency rooms instead of being cared for by their family doctors at health centers."

The union's position hinges on a fundamental distinction: overtime work is meant to cover unpredictable surges, not to paper over chronic understaffing or disorganized shift rotas. "Day-to-day consultations in health centers cannot be sustained through physician exhaustion without guaranteeing quality or safety," Bordalo e Sá emphasized. "If we have robust primary care—family doctors working effectively in teams—we prevent unnecessary trips to the emergency department."

How the Strike Works in Practice

The SMN delivered its strike notice on 5 February, triggering a 132-day total boycott of supplementary shifts that began at midnight on 19 February 2025 and runs through the end of June 2025. The action covers every physician working in ULSAA primary care facilities, from junior residents to senior consultants, and applies to all forms of voluntary overtime: daytime extensions, night coverage, weekends, and public holidays.

Union officials confirmed that the Guimarães SAC—a critical extended-hours clinic designed to relieve pressure on hospital emergency rooms during evenings and weekends—has been fully shut down since the strike commenced. Other clinics in the ULSAA network are operating "under significant constraints," according to Bordalo e Sá, though specific facility names were not disclosed.

Allegations of Coercion and Disciplinary Threats

The union president accused ULSAA management of attempting to "coerce" physicians and issuing "threats of disciplinary proceedings" against doctors who honor the strike. While the SMN did not provide documentation of specific threats, Bordalo e Sá stated that such tactics have only hardened the union's resolve. "This strike will continue unless there is a different attitude from this administration," she declared.

Portugal's labor law framework generally protects the right to strike, including the refusal of voluntary overtime, but public-sector strikes in essential services are subject to minimum service requirements to safeguard patient safety. The SMN has not clarified whether ULSAA has invoked these provisions or whether any doctors have been formally disciplined.

What This Means for Residents

If you rely on ULSAA primary care in Guimarães or surrounding municipalities, expect reduced access to after-hours consultations through at least the end of June 2025. The closure of the SAC means that non-urgent evening and weekend health concerns will either go unaddressed or force patients into hospital emergency queues, where wait times are typically longer and resources stretched.

For chronic disease management, prescription renewals, and routine check-ups, the strike does not directly affect standard weekday clinic hours. However, any appointment slots that were previously carved out through voluntary physician overtime will vanish from the schedule.

Patients with urgent but non-life-threatening conditions (e.g., minor infections, sprains, medication adjustments) now face a binary choice: wait for a weekday family doctor appointment or present to the Hospital Nossa Senhora da Oliveira emergency department, where triage protocols may result in multi-hour waits for cases deemed low-priority.

Government Under Pressure to Act

Bordalo e Sá made a pointed appeal to Health Minister Ana Paula Martins, arguing that the minister's office is fully briefed on the dispute and cannot plead ignorance. "The Health Minister now has responsibility in this situation, because she knows what is happening," the union president said. "If she does not resolve this, she becomes complicit in everything that is unfolding here."

The statement represents an escalation in rhetoric, shifting blame from local hospital administration to the Lisbon-based Ministry of Health. It also signals that the SMN views the Guimarães case as a test of broader national policy: whether Portugal's restructured Local Health Units will be permitted to substitute systematic overtime for adequate staffing and intelligent shift planning.

ULS Alto Ave Silent on Dispute

The ULSAA administration has not issued a public response to the strike or the union's allegations. A request for comment remains unanswered. The silence leaves key questions unresolved, including:

• Whether ULSAA has attempted to negotiate an alternative staffing model or increased base hiring to reduce overtime dependency.

• What contingency plans, if any, exist to restore SAC operations or mitigate emergency department overflow.

• Whether the alleged disciplinary threats are formal proceedings or informal management warnings.

Absent a statement from hospital leadership, patients and policymakers are left to interpret the dispute through the union's lens alone.

Broader Context: Primary Care Under Strain

The Guimarães strike unfolds against a backdrop of chronic primary care fragility across Portugal. Approximately 1.8 million residents lack an assigned family doctor, and many health centers operate with vacancy rates exceeding 20% for general practitioner posts. In response, administrators have increasingly leaned on voluntary overtime, temporary contracts, and locum physicians to maintain clinic hours—a stopgap approach that the SMN argues is both unsustainable and clinically dangerous.

The union's "protect patients by stopping overtime" framing may seem paradoxical, but it reflects a strategic calculation: short-term service disruption is preferable to long-term system collapse driven by physician burnout and exodus from primary care roles. By refusing to normalize overtime, the SMN hopes to force administrations—and the Health Ministry—to confront the staffing crisis with structural solutions rather than Band-Aid measures.

What Happens Next

Unless the ULSAA board reverses course or the Health Ministry intervenes, the Guimarães overtime ban will remain in effect through the end of June 2025. The closure of the SAC clinic is likely to become the most visible impact, potentially driving measurable increases in emergency department volume at the Nossa Senhora da Oliveira hospital.

For ULSAA patients, the practical advice is straightforward: plan ahead for any non-emergency medical needs, schedule weekday appointments well in advance, and prepare for longer waits if you do require urgent care outside business hours. The strike does not affect emergency services themselves, but it eliminates one of the key pressure-relief valves designed to keep hospital ERs from overflowing.

Whether this labor action spreads to other Local Health Units—or remains an isolated dispute in Guimarães—will depend heavily on how the standoff resolves and whether the Health Ministry signals tolerance or intolerance for overtime-dependent staffing models across Portugal's restructured health system.