Among the services that must be provided on the day of the general strike are "emergency situations, as well as all those situations that may result in irreparable/irreversible or difficult-to-repair damage, medically justified."

Minimum services cover surgical centres of emergency services, inpatient services that operate permanently and home hospitalisations, as well as palliative care, intensive care, haemodialysis, and cancer treatments according to priority.

Also covered are procedures for voluntary termination of pregnancy essential to comply with the legal time limit for termination, as well as organ retrieval and transplants, and medically assisted reproduction procedures, if non-performance would compromise the procedure.

Interventional radiology on a preventative basis, treatment of chronically ill patients using biological products, administration of drugs to chronically ill and/or outpatient patients, urgent parenteral nutrition services, and immunohematology services linked to blood donors are also included in the minimum services.

Also under minimum services will be the continuation of treatments such as chemotherapy, radiotherapy, or nuclear medicine programs, as well as complementary services that are indispensable to the performance of these services (medications, diagnostic tests, collections, sterilization), "to the extent strictly necessary".

Treatments with daily prescriptions on an outpatient basis (such as dressings) and treatment of complex wounds will also be minimum services, as well as services related to breastfeeding.

Regarding the workers required to provide minimum services in each health unit, it was determined that they must be equivalent to those scheduled on Sundays and holidays for each shift (morning, afternoon, night).

The arbitration tribunal also states that, for minimum services, health units can only resort to workers who join the strike if the number of non-striking workers is insufficient.

“Too broad”

In this decision, the arbitrator representing the workers, lawyer Filipe Lamelas, was outvoted – that is, he disagreed with the decision – because he considered the minimum services to be too broad.

One of the arguments in his dissenting opinion is that, since minimum services are already defined in the collective bargaining agreement for doctors, defining minimum services above those for other professionals – especially nurses and technicians – makes them impractical in many cases.

"Ultimately, in this ruling, minimum services are decreed for activities and/or services that will not operate because there is no such obligation to provide minimum services for doctors in these activities and/or services," reads the document available on the CES website.

Regarding the workers designated to ensure minimum services, Filipe Lamelas also disagreed, arguing that there is a Minimum Services Agreement, established even with the General Secretariat of the Ministry of Health, which stipulates that in a general strike, the workers are equivalent only to those scheduled "on Sundays, during the night shift, during the normal holiday period."

"In this sense, even if the court considered it its obligation to rule on the means necessary to guarantee the provision of minimum services in the general strike in question – which seems debatable – it should never do so in terms different from those stated therein," stated the arbitrator for the workers' side.

The CGTP and UGT unions have decided to call a general strike for December 11th, in response to the draft labor law reform bill presented by the government.

This will be the first strike bringing together the two trade union confederations since June 2013, when Portugal was under the intervention of the 'troika'.