Eleven Portuguese regions struggle to keep doctors, and the medical council's fix starts with income tax
The study presented in Guarda names the Azores, Beja, Bragança, Castelo Branco, Évora, Faro, Guarda, Madeira, Portalegre, Vila Real and Viseu. The proposals run from income tax deductions and property tax relief to extra holiday.
Portugal’s medical council went to Guarda to present a study and came back with a closed list. Eleven territories are hard to staff with doctors: the Azores, Beja, Bragança, Castelo Branco, Évora, Faro, Guarda, Madeira, Portalegre, Vila Real and Viseu.
The complaint attached to the list is about method. The work, coordinated by council president Carlos Cortes with doctors from several specialities, argues that the response so far has come in scattered, temporary and reactive measures. Patch this month’s rota, then hold the same conversation again next month.
What the council is asking for
Almost nothing on the list concerns base pay, and that is deliberate. The thinking is that a doctor does not move to Bragança because of the salary scale. A doctor moves if the life around the job adds up.
Hence the tax component: deducting mortgage interest on a main home from income tax, larger deductions for rent, and a cut or temporary exemption from municipal property tax during the first years of residence. Hence too a relocation payment, access to cost-controlled housing, a company car and support for travel.
Then comes the half that trades in time rather than money. The council wants extra holiday days as compensation for the wear, more days for unpaid service commissions, service time weighted more heavily towards career progression, easier access to training and more flexible hours. It also proposes protocols between the health ministry and municipalities to guarantee minimum living conditions, including refurbishing council-owned property.
The doctors’ map is not the teachers’ map
The two are worth setting side by side, because the state is solving the same problem in two professions using almost opposite maps.
The 750-euro supplement for teachers who defer retirement applies this school year in eight pedagogical zones, all of them inside Greater Lisbon, the Setúbal Peninsula and the Algarve — the whole of the Alentejo dropped out, as we found by comparing the annexes of the two orders. The rule written into the order setting the 2026/27 list is regional: it counts the NUTS III region with the most unfilled timetables, not the individual school.
The medical council’s list runs the other way. Beja, Évora and Portalegre are on it. So are Bragança, Guarda, Vila Real, Viseu and Castelo Branco. Neither Lisbon nor Setúbal appears. The single point where the two maps touch is Faro.
They are not comparable criteria, and that should be said plainly: one measures unfilled teaching timetables, the other measures difficulty placing clinicians. But the practical effect is that a teacher and a doctor moving to the same Alentejo municipality find entirely different incentives waiting for them, and neither scheme talks to the other. Elsewhere in the country, the health service spent August opening its first privately run state health centre.
Image: Hipersyl / Wikimedia Commons (CC BY 4.0)
