Health Care in Spain

As in most EU countries, there are two health systems in Spain, the private one and the National Health Service. Both are generally excellent.

National Health Service

This service is available to all Spaniards, those in work (and paying taxes), some foreign pensioners (including those from the UK), visitors from other EU countries, and in emergency situations. If you don't come into any of these categories, you will probably get treatment, but you may have to pay for it.

If you are a tourist from a participating EU country, make sure you have a valid E112 form, or a European Health Insurance Card (EHIC), as you may not get free treatment without it. It just proves who you are and that you are entitled to treatment.

All EU persons resident in Spain are entitled to free health care under the Spanish system. You should apply for a Tarjeta Sanitaria (health card) as this will be needed when visiting your doctor, clinics and hospitals. Prescriptions will be stored on this card and read at the pharmacy - overcoming the need for paper prescriptions. Although computers are slowly being introduced into the Spanish health system for maintaining data on patients, you may still be required to look after any paperwork produced by the pre-computer system, for presention to doctors and specialists in the future.

State hospitals in Spain tend to be basic, but spotlessly clean. The purpose of the hospital staff is for medical duties only. The comfort care of patients is the duty of family and friends, and for this, there is usually a reclining chair next the to patient's bed where family or friends of the patient can stay 24 hours a day, usually taking their 'caring' duties in turn. Hospitals are normally open 24 hours a day with no specific 'visiting hours'.

In general, do not expect the nursing staff to speak English, but many hospital doctors, specialists, surgeons, can, as many will have been trained or have worked in the UK. In some of the bigger hospitals, especially those in the coastal regions where there are many tourists or foreign residents, they have voluntary interpreters. These are usually available on request by both staff and patients alike. Always remember, they do their work voluntarily and do not get paid - don't demand too much of them. Don't expect the family doctor at the local Health Centre to speak English. Some do in the coastal regions, but the farther you go inland the less chance.

In some areas of Spain, the Red Cross (Cruz Roja) service is also available.

Private Care

The private system is mostly used by patients who are covered by private health insurance or are prepared to pay for their treatment. When the National Health Service gets over burdened with patients, it uses the services of the private sector to help out. Those using the private care system should always remember that the private hospitals are there to make money. Make sure you are not being kept in hospital longer than necessary and that the treatment is what is really necessary. Be cautious, and always ask for a quote before having treatment.

Private hospitals and clinics are usually modern and more 'comfortable' than the state hospitals.

Private Health Insurance

Private Insurance schemes in Spain are generally good. Most people take out private health insurance because they are either not entitled to treatment on the National Health System, or because they may not want to be placed on a waiting list, or prefer to choose the hospital which is most convenient.

These insurance schemes are especially good for covering small cost situations such as consultations, but read the terms and conditions very, very carefully. Insurance companies may decline treatment, for many reasons, especially the more expensive operations, with the 'you had this complaint before taking out insurance with us' or 'this is a problem of your own making' comments as probably being top of the list. Some situations are not possible to prove or disprove, so protracted negotiations may take place, while all the time your treatment may become ever more necessary.

If possible, take out private health insurance which covers ALL situations, and preferably written in English so you really understand what you are letting yourself in for, Don't just consider your future health cover, but make sure there are no clauses about your past health (or lifestyle - type of work, smoking, drinking, drugs, etc.). With health, you never know what treatment you might need in the future - even in Spain.

Ambulances

Naturally both the National Health Service and the private sector have their own ambulances, but beware of other ambulance operators. They have a habit of appearing as if they have been called for, and will offer a professional service to get you to a hospital or other establishment, but once there, they won't let you leave until you have paid them. No more than a medical taxi service. Beware, especially if you have been in an accident for example, and you are not carrying enough, or have lost your money. In these types of situations, things can get nasty, at a time when it is least wanted.