Chatter

Healthcare

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 havent 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 Spains healthcare system; wanting to find out the truth
behind one of Europes 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 cant 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 Johns 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. Janes 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 havent 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 Spains Health Service one of the best in the
World.