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Health Care in Spain
By m.p. - May 9, 2007 - 6:05 PM
ALSO SEE : • Eight month prison sentence for man who attacked doctor in Málaga - May 16, 2008 - 8:34 AM
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The 1978 Constitution establishes public health care as the right of every citizen:
“The right to protection of health is recognised.
It is incumbent upon the public authorities to organise and safeguard public health by means of preventive measures and the necessary benefits and services. The law shall establish the rights and duties of all concerned in this respect.”

Free health care is provided to all contributors to Spain’s Social Security system (seguridad social), and their dependants. All those working as employed or self-employed in Spain, whether they are Spanish nationals or not, are required to pay into the system: the employer makes the largest portion of the payment in the case of an employee.
Public health care is also available to the retired, both to Spaniards and to those from other European Union countries who now legally reside in Spain.

EU non-resident visitors to Spain are covered for accidents or illness by the European Health Insurance Card, which must be obtained before arriving in the country. The patient may be charged a contribution towards the cost of treatment.

Spanish law requires that treatment be made available to all patients in an emergency situation, even if they are not normally eligible for public health care. The national emergency number is 112.

The health system is run by Insalud (the National Health Institute), with management in some autonomous communities devolved to the regional health service.

Primary care is provided by the health centres (centro de salud or ambulatorio), where patients are assigned to the list of a general medicine doctor when they register: the médico de cabecera. The number of health centres per centre of population varies according to population figures: smaller towns may have just one, while larger towns may have several.
Each patient is issued with a health card, or tarjeta sanitaria, which must be presented for all appointments. Applications for the tarjeta sanitaria should be made at the local health centre: it will then be sent on directly by post.

Prescriptions issued by the primary health centres are presented at local pharmacies (farmacias), which are usually identified by a green cross displayed above the building. The cost is subsidised by the state - that does not apply, however, for prescriptions issued by the health centre’s emergency department.
The pharmacies operate on a rota system to provide a 24-hour service: the duty schedule for the town is displayed in the window of each pharmacy.

There is an extensive private health sector in Spain with a network of doctor’s surgeries, clinics and hospitals across the country: some doctors work in both sectors. Latest estimates put the number of people with private health insurance at 15% of the population, using it either in conjunction with the free care offered by the public health system, or as an alternative for those who are not eligible for the latter.
Many choose not to take out insurance and will pay for a consultation with a private doctor when they think it necessary.


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