Health service hotline staff claim pay is docked for going to lavatory

Workers answering calls for Portugal’s SNS24 health hotline have accused telecoms company Altice of deducting pay for time spent eating, drinking water or using the toilet – describing a working model they say is “unsustainable” and risks affecting the quality of patient care.

Speaking anonymously to Jornal de Notícias, several operators – most of them nurses working as independent contractors – said every minute they are unavailable to answer calls is automatically deducted from their pay.

“If I stop for half an hour to eat, I won’t be paid for those minutes,” one operator said. “That often means professionals are taking calls continuously for seven or eight hours without going to the toilet or eating.”

Another worker confirmed that basic necessities such as drinking water or using the bathroom result in lost earnings.

“We are people, not machines. Every worker needs minimum breaks to protect their wellbeing, their health and the quality of their work,” said the worker.

According to all staff spoken with, their availability is monitored through a computer system, with any period spent away from the phone recorded and deducted from final remuneration.

The workers also challenge their employment status, arguing they are effectively working under “false self-employment” arrangements. Although hired as service providers, they say they follow company-defined schedules and operate under conditions similar to permanent employees, with limited flexibility beyond notifying the company of days when they are unavailable.

Altice, which operates the SNS24 call centre under contract, rejects the criticism, stating that operators are self-employed professionals providing services, often alongside other occupations.

The company said work schedules are organised “in coordination with the service providers, taking into account their availability and preferences”, but declined to comment specifically on claims that bathroom and meal breaks are unpaid.

Because they work under service contracts rather than employment contracts, operators receive no paid holidays, holiday or Christmas bonuses, nor any other employment benefits. They are paid €10 gross per hour, rising to €11 for shifts worked on-site.

Workers argue the hourly rate does not reflect the responsibility of providing frontline clinical advice to members of the public. Initial training lasts four days, or 28 hours – with part of that programme reportedly dedicated to Meo, Altice’s telecommunications brand.

The complaints extend beyond employment conditions. Operators also described difficulties transferring emergency calls to Portugal’s national emergency medical service, INEM.

“One of our colleagues had to guide cardiopulmonary resuscitation over the phone because INEM wasn’t answering,” said one.

Earlier this month, SNS24 operators joined a nationwide general strike for the first time. They also compiled testimony from around 150 colleagues describing what they called a “potentially critical” situation marked by excessive waiting times, insufficient staffing and increasing difficulty responding promptly to urgent and emergency cases.

Asked about the allegations, Shared Services of the Ministry of Health (SPMS), which oversees SNS24, said the organisation of the service is the responsibility of the private operator. However, it stressed that the contractor remains legally obliged to comply with Portuguese labour legislation and is subject to labour inspections where appropriate.

These latest allegations are likely to intensify scrutiny of employment practices at one of Portugal’s most important public healthcare services, amid growing concerns over staffing levels, working conditions and the very resilience of the country’s health advice hotline.

Source: Executive Digest, citing Jornal de Notícias