Lisbon: Doctors in Portugal walked out of hospitals and medical centres on Tuesday at the start of a two-day strike over the impact of government austerity measures on the health service.
The sector - which has been hit by cutbacks since the country entered an international bailout in 2011 - is being ordered to make a further 300 million euros ($408 million) of savings this year.
One union said it expects half of all public sector medical staff could take part in the strike, with a protest called by the National Federation of Doctors (FNAM) planned in Lisbon on Tuesday afternoon.
Medical staff are critical of deteriorating working conditions in public hospitals, job losses, pay cuts, and the longer working hours that have come as the sector has had to make savings.
"Doctors in the field are very angry, so we think that the turnout will be good," said Mario Jorge Neves, the FNAM vice-president.
A minimum level of service has been guaranteed in emergency rooms, intensive care units and radiotherapy units, but the action is expected to lead to the cancellation of thousands of medical appointments and surgery sessions.
The 1974 Carnation Revolution, which led to the end of decades of dictatorship, helped enshrine the right to free universal health care in the constitution.
But since 2011, the charges for visiting an emergency department have doubled to 20 euros ($27), while going to a local doctor now costs five euros. The waiting list for surgery is currently months long.
"The national health service was one of the great achievements of the 1974 April revolution, we must defend it," said Maria Merlinde Madureira, the FNAM president.
Portugal exited a three-year international bailout programme in May, after receiving 78 billion euros ($106 billion) from the European Union and the International Monetary Fund in exchange for a series of stringent reforms in the country.
The strike is being supported by the College of Physicians but another medical union, the Independent Union for Doctors, said its members will not be taking part to give "dialogue with the government a chance".
Health Minister Paulo Macedo has been critical of the strike. "Doctors are not going on strike in their private practice. So it is patients who cannot afford to go elsewhere who will suffer," he said.