Lorraine Williamson
Spain’s public healthcare crisis is no longer just a talking point on morning radio or a frustration muttered in hospital corridors. A new annual tally from the patient advocacy group El Defensor del Paciente points to a system under sustained strain, with emergency departments taking the brunt as primary care falters and patient flow breaks down.
In 2025
The figures are not an official national audit of confirmed negligence. They are, however, a sharp signal of what many patients and staff describe as the new normal: long waits, crowded corridors, and a growing sense that the safety net is being stretched beyond its limits.
A record year for complaints — and a familiar pattern behind them
El Defensor del Paciente argues that the surge reflects structural problems: delays in accessing family doctors, bottlenecks for tests and specialist appointments, and the knock-on effect when people abandon local health centres and head straight to hospital. In its Memoria 2025, the group describes a “race of obstacles” to access routine care, warning that the pressure simply relocates to Urgencias.
That picture sits alongside the Spanish Health Ministry’s own waiting-list snapshot. As of 30 June 2025, 832,728 patients were waiting for non-urgent elective surgery across the National Health System, with an average wait of 118.6 days.
When routine care slows, everything downstream absorbs the impact.
Why emergency departments are the pressure point
Emergency units appear repeatedly in the complaints described by El Defensor del Paciente: overcrowded waiting rooms, limited space, staffing gaps, and a shortage of beds that turns “waiting” into a prolonged stage of care in itself.
Patients, the organisation says, report not only delayed treatment but also a lack of compassion — what it frames as a creeping “dehumanisation” of care. Staff, meanwhile, are frequently portrayed as exhausted and burnt out, working inside a system that cannot flex when demand spikes.
It is a dynamic seen in many European health systems, but Spain’s case has its own pressure multipliers: high tourist demand in some regions, seasonal flu peaks, and a primary-care gateway that is increasingly hard to access quickly.
The 10 hospitals most cited in complaints
El Defensor del Paciente’s report lists the hospitals it says attracted the most complaints in 2025 — largely focused on emergency care and patient flow.
-
Hospital Universitario de Canarias
-
Hospital Universitario La Paz
(Madrid) -
Hospital Universitario de Toledo
-
Hospital Universitario Miguel Servet
(Zaragoza) -
Complexo Hospitalario Universitario de Santiago
-
Hospital Universitari Vall d’Hebron
(Barcelona) -
Hospital Clínico Universitario de Valencia
-
Hospital Universitario Virgen Macarena
(Sevilla) -
Hospital Universitari Son Espases
(Palma de Mallorca) -
Hospital Universitario de Cruces
(Bilbao)
Infobae, reporting on the same dataset, highlights emergency departments as the recurring fault line — where delays, crowding and communication failures are most visible to patients.
Madrid leads the complaints tally
The report also singles out Madrid as the region with the highest number of complaints: 4,005 cases, including 292 deaths, according to the organisation’s count.
Within the region, La Paz is listed as the most complained-about hospital, followed by other major Madrid centres, including Gregorio Marañón and 12 de Octubre.
What these figures do — and do not — prove
It is important to handle the numbers carefully:
-
They reflect complaints received by one advocacy organisation, not a definitive national registry of proven negligence.
-
They do, however, align with broader indicators of system stress, including persistently large waiting lists and heavy reliance on emergency departments as a substitute for timely primary care.
In other words, the report is best read as a high-volume warning flare: not a courtroom verdict, but an argument that the risk profile of public care is worsening when access, staffing and capacity do not match demand.
Spain´s healthcare is at breaking point every summer
The next test is whether Spain can rebuild the “front door” of care
If there is a single theme running through the complaints, it is this: when primary care fails as a fast, reliable front line, hospitals become the default — and emergency departments become the system’s waiting room.
Spain’s public healthcare remains universal and, in many areas, clinically excellent. The question now is whether policymakers can relieve pressure before the next winter peak, by strengthening primary care access, improving hospital patient flow, and stabilising staffing conditions — or whether patients will increasingly conclude that the only way to guarantee speed is to pay.
Sources: