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You are here: Home Health & Fitness Healthcare An expat's take on the Spanish healthcare system

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07/10/2009An expat's take on the Spanish healthcare system

An expat's take on the Spanish healthcare system Nick Snelling shares his experiences with excellent doctors and efficient hospitals in Spain and explains briefly how the healthcare system in his adopted country works.

It is not every day that the commissioning of an article coincides with the writer becoming a part of his subject matter.

However, it happened to me last week when Expatica asked me to write an article on healthcare in Spain and I was carted off to hospital unexpectedly that very day.

So, this article on healthcare may have a little more veracity than many articles written from theoretical knowledge.

Good reputation

In fact, as I mention in my book How to Move Safely to Spain (available on www.movetospain-safely.com), state healthcare in Spain has a generally good reputation with some 800 hospitals and 2,700 medical centres (Centros de Salud) throughout the country. Almost every village will have 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 doctor the same day.

However, note that children under the age of 14 must be treated in specific children’s health centres, which are staffed by specialist paediatricians. These are normally located in the nearest town of any size.


Meanwhile, there is a network of hospitals across Spain with accident and emergency departments (urgencias) 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. On the two occasions that I have been treated personally (in Gandia hospital, Valencia), I have found the system impeccable and the staff excellent.

If follow-up treatment is necessary (as it has been with me) then this is organised by the hospital itself. In my case, I was stunned to receive a daily telephone call from the department handling my care to ask if I was all right, in pain or if my condition has worsened. I was also visited by an extremely efficient district nurse (despite living up in the mountains) and I have a direct telephone number to her department should I need anything.

I should add that this is not the first time that we have experienced this type of efficiency from the Spanish healthcare system.

Last year we visited the local children’s clinic, as we were very concerned about the constant headaches being suffered by my daughter. By midday my daughter had been seen by two paediatricians and we had the results of a full brain scan. This was nothing short of being deeply impressive.

Of course, there will be variations on people’s experiences of Spanish state healthcare. Spain is nothing if not a vast country with significant regional differences with the Spanish often tending to state that their state health system is becoming ever worse.

However, if my family’s experience is anything to go by, in reality, they have much to be pleased about. More importantly, of course, if you are thinking of coming to live in Spain you can be confident that the system functions well.

Not being able to speak Spanish

Obviously, the main downside to using the Spanish state healthcare system is the problem of being understood. The doctors, nurses and staff work in Spanish and translators are not provided within hospitals or medical centres. This can present difficulties unless you are fortunate enough to speak Spanish or encounter staff who speak English. Having said that, most areas with a high density of foreigners tend to have a network of people who will undertake interpreting and who can be called upon when you need to attend a doctor or hospital.

Who is eligible for free healthcare?

Of course, Spanish healthcare is not freely available to everyone who comes into the country – whether from the EU or elsewhere. To obtain free healthcare you must be either over 65 (a pensionista) or tax resident. The latter means that you must be paying Spanish tax or making a Spanish tax return. Merely having a NIE number or inscribing on the Registro Central de Extranjeros is not sufficient.

If you are tax resident or a pensionista and want free healthcare, you must apply for a SIP (Sistema de Informacion Poblacional) card. This is your individual Spanish state health card and is needed whenever you attend a clinic or hospital. It is something that you can apply for yourself or through the services of a gestor.

Of course, Spain has comprehensive private healthcare facilities which many foreigners living in Spain use. This is often the case because they lack confidence in the Spanish state system, speak no Spanish, are under 65 or do not wish to become tax resident. Walk-in private medical centres exist in many towns (particularly along the coast) and all the big, international private medical providers have healthcare insurance cover and associated facilities in Spain.

Finally, if you are coming over to Spain as a visitor then you must obtain an EHC (European Health Card) before you leave your own country - if you want to use the Spanish healthcare system.

However, note that your EHC is not a substitute for medical travel insurance and it will not cover you for medical repatriation, on-going medical care, specific medical treatment or treatment that is not urgent.

7 October 2009

Move-to-Spain-book-coverThe writer, Nick Snelling, is author of three books on Spain including: How to Move Safely to Spain. The book is now available on www.movetospain-safely.com



2 reactions to this article

Celia Villa-Landa posted: 2012-01-11 11:37:03

I would like to endorse Nick's remarks about the Spanish healthcare system. My husband and I have lived (as pensioners) in Spain for 15 years and have found the healthcare system excellent. We get 24 hour care from our friendly local health centre, which we need quite often as my husband is a chronic asthma sufferer, and we have also had excellent hospital care from the provincial hospitals. Everyone fears that with the financial cuts the service will deteriorate, but we have seen no sign of that yet.

Michael posted: 2012-01-11 16:20:36

A dated article - much in need of a 2012 review to ensure accuracy of advice and information for this particularly important subject
Instance: Pension status for women - was 60 now transition to 66/67

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2 reactions to this article

Celia Villa-Landa posted: 2012-01-11 11:37:03

I would like to endorse Nick's remarks about the Spanish healthcare system. My husband and I have lived (as pensioners) in Spain for 15 years and have found the healthcare system excellent. We get 24 hour care from our friendly local health centre, which we need quite often as my husband is a chronic asthma sufferer, and we have also had excellent hospital care from the provincial hospitals. Everyone fears that with the financial cuts the service will deteriorate, but we have seen no sign of that yet.

Michael posted: 2012-01-11 16:20:36

A dated article - much in need of a 2012 review to ensure accuracy of advice and information for this particularly important subject
Instance: Pension status for women - was 60 now transition to 66/67

Add a comment
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