Tuesday 29 September 2009

HEALTH CARE IN SPAIN


Ten days ago I received a request from a media company for an article about health care in Spain to expand upon what I had written in my recent book ‘How to Move Safely to Spain’. By chance, within a couple of hours, I was taken into hospital with a potentially life threatening illness - making my writing commission nothing if not ironic!

In fact, this was not the first time that I had been forced to request treatment from the Spanish health care system. Previously, a major road accident had resulted in my wife and I being taken into the A&E department of our local hospital and my daughter has had emergency attention from the local children’s clinic (apart from the normal array of vaccinations etc.). On each and every occasion we have been stunned by the professionalism of the service that we have received.

Spanish State health care (we do not have private health insurance) has been nothing if not impressive. Indeed, along with ex-patriot friends of ours, we would claim that the service provided has been better than we received in the UK.

Certainly, the Spanish state health care system is extensive. 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.

Importantly, children under the age of fourteen are 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 and provide expert care for children.

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. Any follow-up treatment (such as I needed) is undertaken by the hospital - who arrange nursing visits together with any requirement for transport to and from the hospital.

Of course, Spanish health care is not ‘free’ just because you are an EU citizen despite a common misconception to the contrary. For ‘free’ state health care you need to be tax resident (paying tax or making an annual tax return to the Spanish State) or a pensionista (over 65). Merely having an NIE number or inscribing yourself on the Central Register of Foreigners (Centro Registro de Extranjeros) is not sufficient!

If you are over 65 or tax resident than you will need to obtain a 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.

Naturally, one of the major problems for foreigners with regard to the Spanish health service revolves around language – or the lack of it in the case of many foreigners. Interpreters are not supplied in Spanish state hospitals or clinics and fluency in English can never be guaranteed amongst Spanish medical staff. However, this is not necessarily an impediment to using Spanish State health care as usually interpreters are available within most communities – particularly those with high density foreigners. For a modest fee, you can normally find someone who can attend any appointment with you and translate your problems and the anwers of your Spanish doctor.

Of course, Spain has private health facilities (a minority of Spaniards use them) and most major health insurance companies have policies that cover Spain. In addition, in many large towns there are ‘walk-in’ Spanish private medical clinics that also have beds and sometimes an A&E capacity. So, if you choose not to go the Spanish State health care route then you should easily find adequate medical cover for all your needs.

As for us, we have had no regrets in using the Spanish health system. Any system that was able to provide a check-up from two consultant paeditricians, a full head scan and the results (as was done for my daughter) within four hours is good enough for me! Equally, the treatment that I have received over the past ten days has been beyond criticism and a tribute to a system and staff that that would be hard to better.

From the above you may come to the conclusion that we are an unhealthy family! However, this is far from the truth and our life in Spain has been remarkably free from ill health. Indeed, few houses in Western Europe have fewer pills and potions than ours and trips to the doctor are extremely rare.

In fact, this is consistent with Spain being a healthy place within which to live. It evidently has the greatest longevity rate for women in Europe and the second longest for men. So, hopefully, any use of the Spanish health service should be minimal. However, should you need it - be assured that it works and, at its best, is superb.

Finally, it would be churlish of me not to publicly express my gratitude to the staff of Gandia (Valencia Province) hospital and health service for their excellent treatment of both my family and (most recently!) myself! Well done - and many, many thanks...1

1 comment:

  1. Intentamos desde hace 10 días darte las gracias por el post (y las galletas). No podemos por problemas de internet, que ya hemos solucionado.
    Hemos mandado la dirección de la entrada a nuestros jefes para que vean que somos bien valorados por gente que conoce otros sistemas de salud.

    MUCHAS GRACIAS. Unidad Hospital a Domicilio

    PD: Esperemos vernos "climbing" por la Drova y no como paciente

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