Spine surgeries halted at Porto hospital after payment rule change leaves surgical teams without pay
A regulatory change has brought additional spinal surgeries to a halt at one of Porto's largest hospitals, leaving patients on waiting lists facing longer delays and more pain. The Unidade Local de Saúde de Santo António (ULSSA) confirmed that orthopedic and neurosurgery teams have stopped performing extra procedures after a June decree slashed the money available to pay them.
What happened
The dispute centres on Portaria n.º 281/2026/1, published on 29 June. The regulation changed how the National Health Service calculates payments for additional surgical activity — procedures performed outside normal working hours to reduce backlogs.
The decree now requires the cost of implanted medical devices to be deducted from the overall payment before surgical teams are remunerated. For procedures using expensive implants, such as scoliosis surgery and other spinal operations, the money left for staff can be zero, the ULSSA told the Lusa news agency.
In response, orthopedic and neurosurgery teams declined to work under these conditions, forcing the hospital to suspend additional surgeries in these specialties.
Impact on patients
The Sindicato dos Médicos do Norte (SMN) warned that the halt reduces capacity precisely when waiting lists need to be cleared.
In September, only 193 additional surgical programmes are scheduled across all specialties at ULSSA — roughly one-third of the hospital's usual activity, the union said, citing an internal circular. The reduction stems directly from the suspension of orthopedic and neurosurgical production.
Patients already waiting for spinal surgery now face what the union called "more suffering, dependency and uncertainty." Families shoulder extra caregiving duties and lost income while relatives remain in pain.
Nationally, the situation adds pressure to a system already strained. At the end of 2025, more than one million people were waiting for a specialist consultation and approximately 264,000 for surgery in Portugal's National Health Service.
What continues and what stops
Hospital administrators stressed that urgent and cancer surgeries continue uninterrupted during normal hours.
"The ULS de Santo António continues to ensure surgical activity carried out during normal working hours, including all urgent and oncological interventions," the administration said.
But additional surgeries — the extra sessions historically used to tackle waiting lists — have stopped for these spinal procedures. The hospital said it is legally bound to apply the payment rules and must respect the right of professionals to decline this work regime.
Government response
The Health Ministry and the Executive Directorate of the National Health Service are aware of the problem and seeking a solution, the ULSSA said.
The issue has spread beyond Porto. Hospital Garcia de Orta in Almada also cancelled all additional orthopedic surgeries, and other hospitals across Portugal face similar dilemmas.
Under pressure from medical professionals, the Government eventually suspended the payment cuts, maintaining previous values until 2027. But for patients at ULSSA waiting for spinal surgery in September 2026, the interruption is already real.
What changes now: Patients awaiting non-urgent spinal surgery at ULSSA should expect longer waits. The hospital continues to perform emergency and cancer operations, but procedures to relieve chronic pain from scoliosis and other spinal conditions are on hold until the payment dispute is resolved.
