Doctors in Alicante are calling for special remuneration for work beyond their regular hours, including additional exemptions from mandatory on-call duty.
Health Minister Mónica García recently sparked debate by claiming that doctors earn, on average, the same as politicians—a statement she later walked back, acknowledging that doctors should earn more and that working conditions vary significantly across Spain’s autonomous regions. She also admitted that poor working conditions persist in the sector.
Her remarks come amid growing tension over the preliminary draft of the new Framework Statute, which has prompted doctors to threaten a general strike in May. The proposed statute fails to address long-standing demands, such as limiting mandatory on-call duty, reducing the maximum workweek to 48 hours, and recognizing on-call pay as overtime.
€12,000 Annually from On-Call Duty
On-call shifts significantly impact a doctor’s salary, often comprising over a fifth of their total earnings. A study by the Granada Medical Union, which compares salaries across Spain, reveals that in Alicante, doctors who take on-call shifts earn €841 more per month—nearly €12,000 annually—compared to those who do not.
The study categorizes doctors into four professional profiles. For a full-time doctor with ten recognized three-year service increments and the fourth paid career level (or the highest level recognized by the Health Service), monthly net earnings in an Alicante hospital can reach €4,737 (€7,322 gross). This is slightly above the national average but below the Basque Country’s maximum of €5,140 per month. Without on-call duty, this salary drops to €3,896 per month.
At the lower end of the scale, a newly employed temporary doctor (typically 30 years or older, after completing the MIR residency program), with only one recognized three-year service increment and no paid career level, earns between €2,691 per month without on-call shifts and €3,607 with them.
Mandatory, But Not a Right
On-call duty is an obligation for hospital doctors, not a right. If a department or specialty does not require it, doctors cannot request to take on extra shifts. However, they are generally required to perform on-call duty unless they are over 55 or have a health-related exemption.
On-call shifts take place outside regular working hours, typically from 3:00 PM to 8:00 AM the following day, as well as 24-hour shifts on weekends and holidays. Paradoxically, these hours are paid at a lower rate than standard work hours.
In the Valencian healthcare system, overtime pay is €15.92 per hour on weekdays and €17.02 on holidays—almost half the gross amounts of €28.94 and €30.94, respectively. This discrepancy arises because Spain’s progressive tax system increases withholding rates as income rises, disproportionately affecting earnings from on-call duty.
Calls for Fair Compensation
The study’s authors argue that the significant additional workload of on-call duty is not fairly compensated and is further penalized by the tax system. They note that the nature of on-call work has evolved from a system where doctors were on standby to an intensive, uninterrupted workload that places considerable mental and physical strain on healthcare professionals.
