In this months column, I wanted to discuss healthcare in Spain, which is very different to the National Health Service, back in the UK. To be honest, I haven’t had much experience of either system, accept for the removal of an appendix when I was in my teens, many years ago; as well as an on going prescription for medication, before I left for Spain and that is really about it. Like most people however, I was aware of the huge problems the NHS experienced on a daily basis, especially with reference to funding, the shortage of nurses and doctors and the constant reorganising of this highly regarded public institution. Using the personal reminiscences of those who live in Gran Alacant, a few statistics and my own personal views, I want to explore just how good or not heathcare allocation and delivery is in Spain.
The system in Spain is among the best in the World; like the UK it offers universal care, with no upfront fees. Spain spends around ten percent of its GDP on healthcare and is ranked 6th in Europe for the number of Doctors per person. A recent survey also showed that Spanish women outlive all other nationalities apart from the Japanese, living to the grand old age of 85.5 years old. All of these statistics point towards a healthcare system that is working. As an Expat you are entitled to free provision if you are working and paying into the system, are retired or have an EHIC card, which can be used throughout Europe. The process of registering for your SIP card is fairly straight forward, taking along relevant paperwork to your local Doctors surgery, who will arrange for your card to be issued; this card allows you to access all medical services, free!
I have been fortunate to talk to a number of Expats, who live in Gran Alacant about their experiences navigating Spain’s healthcare system; wanting to find out the truth behind one of Europe’s best national health services. Ges who has lived here for ten years, currently uses the facilities more than she has done in the past; her reaction was positive and praising, both for her local Doctor and Elche Hospital, who have been extremely efficient and expedient in dealing with her medical diagnosis; conditions we could all get in the future, the older we get. Whether treatment programmes, outpatient and inpatient appointments or hospital surgery, Ges can’t fault the standards; waiting times are shorter and the quality of provision is second to none; far better than what is offered by the NHS in the UK. All of us at the GA Advertiser wish her well!
For the purpose of this article, I will call my next interviewee, John. John was taken to Hospital in 2011, after suffering an accident; spending two weeks inside and undergoing two operations; in John’s view the treatment was ‘first class.’ During the year after, complications set in and John had to undergo some very painful treatment, ending in further procedures. Again John can not fault the care given. Finally a decision was taken to sort out the source of the problem once and for all. With all the scans and pre ops done, John awaited surgery, suddenly receiving a call, stating that if he wanted the medical procedure, he would have to pay and claim back the cost from the UK. In 2014, at a time when an economic crisis was taking hold in Spain, the Spanish Health Service, felt unable to offer the resources John needed, so he returned to the UK for the necessary operation. Administrative decisions, based on financial concerns had prevented further treatment being carried, out under the EHIC scheme. However he would like to point out, that at no stage did he receive bad or substandard care; nothing but. Circumstances beyond his and the consultants control had prevented a successful conclusion. Today John is fit and healthy, still enjoying his life in Spain.
Local resident Jane also found the time to tell me a little bit about her encounters. Jane had to attend A&E on several occasions with her partner and was in and out of the hospital within two hours. During that time the centre carried out an xray, blood test, injection and her partner was given medication for the pain. In the UK, on the small number of occasions that I myself had to attend A&E in Southampton, I have had to wait a minimum of three hours before even being assessed. Already you can see a stark contrast in the two countries. Jane’s partner is now scheduled to have an operation on his spine, with a waiting time of only two months. Finally Jane wanted to say how pleased she was with the service she has received, both at the hospital and from her Doctor, here in Gran Alacant, where you can usually get an appointment within a couple of days.
I haven’t had an awful lot of experience with the health service in Spain as yet. I had to accompany someone to the emergency department in Santa Pola, while they had an XRAY done, on the same day as the referral and we progressed though the centre quickly, taking twenty minutes or so. In the UK a similar process would have taken much longer and certainly would not have been undertaken, on the same day. Arranging a consultation with a GP in England at least was always a nightmare. In order to secure an appointment I would have to book at least two weeks in advance, sometimes much longer. The alternative was waiting around the surgery on specific days of the week, where appointments were not necessary. One could be waiting for up to three hours to be seen. We do love our National Health Service in the UK, but there is so much wrong with it and so much more we could realise from Spain. To give you just one example; in Gran Alacant, I can buy certain medicines over the counter, without prescription. In the UK I would either have to see a Doctor first, or wait for a repeat prescription; a time consuming and an unnecessary burden on the NHS!
I spoke to many local residents about their encounters, using the Spanish Health System; the vast majority of those questioned, had no complaints with a service that actually works, far better than even I expected. I also asked about the British equivalent (NHS), here the answers given were very different. Waiting times were longer, standards of care well below what Spain offers and access to medical practitioners was far more limited, with people having to book appointments weeks in advance, rather than a few days to see their GP. The British are regarded as a reserved lot, polite and unwilling to complain; local residents however were scathing about health provision in the UK, less so in the case of Spain; all offering positive views. No National Health Service is perfect; there are issues that Governments have to tackle in every country, but by and large the Spanish seem to have the balance right. It is important to note that one is able to purchase private health insurance also, as many people, especially Expats do. Insurance premiums remain reasonable, unlike equivalent policies offered in the UK and are certainly an option for those who do not qualify for free public health cover, whilst living for a prolonged period in Spain. Whichever system you choose, you will be surprised at the differences. Unlike the United Kingdom, there is no automatic entitlement to free care, that only comes from paying social security contributions. Nothing in this World is for free; Britain has much to learn from Spain, who puts those who work and contribute first, making Spain’s Health Service one of the best in the World.