Tuesday, 9 November 2021

The Spanish Health System, Mostly


Like the British with their NHS, the Spanish are also fond and supportive of their own national health, the SNS or Sistema Nacional de Salud as defined by the Spanish Constitution (explained here) in 1986 (wiki).

Expatica says here: ‘Around 90% of Spaniards use the public healthcare system, which is called the National Health System. However, it is very decentralized with service delivery organized at regional level. The system is overseen by the Spanish Ministry of Health, which develops policy and oversees the national health budget…’. In short, each autonomous region runs its own bureaucracy within the health system.  

And, it’s relatively easy on one’s pocket – as the World Health Organisation says: ‘Spain’s health system is more likely to protect people from financial hardship than health systems in most other European countries’, although, as here, some families are suffering from medical prescriptions and dental bills. The copago system, where the patient pays part of the prescription, can cause financial issues.

But (and there’s always a ‘but’), times are hard and the administrations have problematic finances: in short, cuts are evident everywhere (yes, yes: more taxes!)

This is usually noted by the time between an appointment with one’s local doctor (the atención primaria) and the trip to the specialist.  Weeks or months, depending. A short-cut is to turn up at the Emergencia at the public hospital, who will give immediate hands on treatment as necessary.

It’s also the case that the Spanish medical attention is very good, with first-rate doctors and dedicated nursing staff. Those of us who have been through the system will probably acknowledge this.

Cuts arrive in staffing, equipment, standards, medicine and so on. The conservative regional governments are more inclined to push private hospitals and consultants while the socialist regions might (a trifle unwillingly) encourage the public system. Certainly, the private companies, the health insurance people and our friends at ‘Big Pharma’ are all for private health.


From the cuttings:  ‘The waiting lists in the Madrid health care system grew by 35% in 2021. Almost 800,000 citizens of the Community "wait up to six months to be called"’ says El Huff Post here.

This tends to annoy the health workers as well. From 7Días we read that the health service in Extremadura are ready to strike over their long hours and regional government cuts.

But some good news too: ‘The Government repeals the Aznar law that encouraged the privatization of the Spanish health system. The draft of the Health Equity, Universality and Cohesion Law establishes public management as a "preferred formula" for health services but does not close the door to outsourcing’. elDiario.es here.

Sometimes the public hospitals will send patients to the private ones, but more often, it’s the other way around. Certain equipment is prohibitively expensive and not every hospital has, for example, proton therapy machines (Amancio Ortega has just donated ten of these to the public health).

Finally, as the Covid issue begins to recede, some politicians want to mount inquiries into the high number of deaths in the residencies for seniors during the first wave of the crisis. Other politicians – perhaps understandably – don’t want the subject to be opened. Here the Parlament decides against an investigation (Catalunya Press) and here, Madrid does the same (InfoLibre).

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