NHS spending on temporary doctors rises by 11% and now exceeds 200 million euros

The NHS's spending on service-providing doctors (better known as day laborers) broke a new record in 2024. Spending increased again last year and surpassed the 200 million euro barrier for the first time - it rose to 213.3 million euros , according to data from the Central Administration of the Health System (ACSS), sent to Observador.

This represents an increase of 11% compared to the 191.8 million spent on doctors providing services in 2023. The increase in expenditure in this item has, in fact, been galloping. In 2022, expenditure on doctors providing services was 160.5 million euros — which means that, in just two years, expenditure increased by 33%. In 2018, just six years ago, expenditure was half of what it is today (around 108 million euros).

“Over the last year, the NHS has seen an increase in the need to contract services, a direct reflection of the challenges faced by the health system ,” says ACSS.

Accompanying the increase in expenditure is, of course, the number of hours worked by these professionals, who work by the hour. According to ACSS data, doctors providing services worked around 5 million and 147 thousand hours in 2024, an increase in relation to the 4 million and 137 thousand euros worked in the previous year.

The evolution of spending on contract doctors is worrying, warns the president of the Portuguese Association of Hospital Administrators. “ We are very concerned . The NHS uses contract doctors because there are not enough of them on staff”, explains Xavier Barreto, adding that the excessive use of these professionals makes the provision of care less “efficient” and worse. “The service is less efficient, and may be of lower quality.”

“It is different to have task workers and people on staff. A task worker is not part of the staff, many do not have a speciality, they are not integrated into the teams ”, says the person in charge. “There are many emergency services, particularly in the south, where more than half of the shifts are provided by service providers”, guarantees Xavier Barreto, stressing that this situation “reflects the lack of capacity of the NHS to hire more professionals”.

In total, the NHS spent around 231 million euros on service providers last year, across all professional categories. Doctors accounted for the vast majority of expenditure (around 92%). The remainder was spent on nurses (4%) and other unspecified professionals.

SNS spent more than 100 million euros on services provided by doctors until June

Compared to 2023, there was an increase in NHS spending on service providers in all professional categories. €231 million was spent in 2024, 12% more than the €205.6 million in 2023.

The increase in spending on staff doctors is a natural consequence of the difficulty in filling the emergency department shifts in NHS hospitals. With the departure of professionals from services (particularly in the Internal Medicine specialty, but also in specialties such as Surgery, Anaesthesiology, Obstetrics or Paediatrics), it is increasingly difficult for hospitals to have sufficient human resources to ensure that emergency departments are open without interruption.

Therefore, the solution has been to use service providers (not linked to the hospital), which results in increased expenses — since these doctors charge a much higher hourly rate than the amount paid to doctors on staff .

This Wednesday, in an interview with Antena 1, the Minister of Health considered that the use of contract doctors “is a harmful factor within the NHS”. Ana Paula Martins said she was committed to ending the contracting of these services — a task that, judging by the growing scale of the use of contract doctors, may not be achieved in the near future.