Spanish Health Care – How Good is Health Care in Spain?

The most important thing to appreciate about Spanish health care is that it is not necessarily free to you – just because you are an EU national. This is a common misconception. Spanish health care is ‘free’ only to those who are tax resident or properly registered pensionistas (people over the age of 65). In either case, you must apply for your SIP (Sistema de Informacion Poblacional) card. This is your individual Spanish health card and is needed whenever you attend a Spanish doctor or hospital. It is something that you can apply for yourself or (more easily!) through the services of a gestor.Certainly, you should note that having a NIE number or having inscribed yourself on the Central Register of Foreigners (Centro Register de Extranjeros) will not automatically provide you with free healthcare in Spain. To be tax resident is also not a ‘negative’ function. You must either actually be paying tax to the Spanish state or making an annual Spanish tax return to be considered as tax resident. The mere fact that you are deemed to be tax resident after 183 days within the country does not mean that you are tax resident and thereby gain free healthcare in Spain – if you make no effort to pay any tax!Spanish health care from the State is generally considered very effective.  There are some 800 hospitals and 2,700 medical centres (Centros de Salud) throughout the country with almost every village having a doctor (medico) who will attend his medical centre daily (even if it is just for a few hours before he goes to the next village or district).  Normally a nurse (enfermera) will be in attendance and sometimes, as a patient, you can see your Spanish doctor the same day.However, note that children under the age of fourteen must be treated in specific children’s health centres in Spain which are staffed by specialist paeditricians. These are normally located in the nearest town of any size.Meanwhile, there is a network of Spanish hospitals with accident and emergency departments (urgencias) throughout the country which operate in a very similar way to that of the UK. You are normally seen by a member of the triage staff promptly and then treated as quickly as necessary given your degree of injury.My family have now lived in Spain for over six years and we have relied upon the state for almost all our Spanish health care needs. Whilst we have been fortunate to have experienced excellent health whilst living here, we have been through A&E twice (a road accident and serious sudden illness) and our daughter has been attended to by our local Spanish children’s clinic. On each occasion we have been left stunned by the quality and efficiency of the health care provided.Indeed, access to a consultant doctor seems much better than it was in the UK and in our (perhaps subjective) judgment state health care in Spain seems better than that of the UK. This is a view that has been expressed many times by local (Comunidad de Valencia) ex-patriot friends of ours who have, between them, suffered a full range of health problems in Spain – from minor to life threatening.Of course, Spain is an enormous country with 17 different autonomous regions and two autonomous cities. It is therefore difficult to provide an accurate qualitative assessment beyond one’s own experience. So, different areas may provide different levels of excellence. However, it is safe to state that if you are thinking of moving to Spain then you can rely upon state Spanish healthcare for all your and your children’s needs.One problem with Spanish health care is the language barrier for anyone not reasonably fluent in Spanish. Interpreters are not supplied in Spanish hospitals or Spanish clinics. This means that when you are feeling most vulnerable you can encounter real difficulties in being understood – or understanding your attending doctor. Whilst some doctors in Spain do speak English this can never be taken for granted.In fact, usually, within areas of high density ex-patriots (such as along the Spanish coastline) there are interpreters available. If you tap into these communities, invariably someone knows of a person who will interpret for you and attend an appointment with you (albeit normally for a fee).If you do not wish to use Spanish state health care then you can take out private health insurance in Spain to provide you with any necessary cover. All the major health care insurance companies have facilities available in Spain. There are also private ‘walk-in’ clinics and hospitals in some of the towns.  We used one of these (in Gandia) on one occasion and found it effective and the attention professional.Of course, thankfully, life in Spain tends to be healthy. The country has the longest longevity rates for women in Europe and the second longest for men (after Sweden). So, hopefully, you will rarely need healthcare in Spain!