Madrid hospital wants to send foreigners without health cards to private clinics

by Lorraine Williamson
Foreigners health cards
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MADRID – A hospital in Madrid has ordered foreigners without health cards to be sent to private clinics and to pay for their treatment. However, the regional health authorities claim to know nothing about this. 

If the order is taken literally, it also means that tourists who end up in a public hospital and do not have a health card could be turned away. Foreigners without residence status are unable to provide ‘tarjeta sanitaria’ (health cards). 

Last Friday, doctors at Getafe Hospital in the Spanish capital received an email from the centre’s medical director, Rosa Fernández Lobato. The subject of the message was a “message to patients without a CIPA/health card”. The message stated the explicit instruction to refer patients without ‘tarjeta sanitaria’ to private centres. This was so they pay for ‘the needed care’ there. 

A spokesman for the Ministry of Health assures this order does not come from the regional government. Nor has it been sent to any other public centre in Madrid; it is not part of the region’s current protocols and it is somewhat inconsistent with those regulations. 

When asked about the reason why that email was sent, the hospital replies in writing through a spokesperson. They said, “Emergency health care is guaranteed for every citizen. This is regardless of their administrative situation and whether or not they have a health card”. Something that is done this way in every hospital in almost every place in the world. 

The spokesperson for the Ministry of Health also confirms; “they are always treated in the emergency room, whatever their administrative situation.” 

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What the law says 

According to the response of the regional health service, people without a card can always be helped. Even if their situation is not urgent. “In addition, for applicants who do not yet have their documentation, a preliminary code valid for three months is available. Anyone can just apply for it, even without having provided the documents, that code must be provided,” says the spokesperson in El País.  

Sometimes tourists, but more often foreigners without a residence permit 

Nacho Revuelta, of Yo Sí Sanidad Universal, an anti-health exclusion platform, explains that one of these patients could be a tourist at one point: “But in many cases, they’re people who don’t have any resources.” That is, foreign population that is not registered or authorised to reside in Spain. 

In 2018, this group regained the universal right of access to the national health system. The government of Mariano Rajoy had withdrawn this in 2012. People were only helped in an emergency, serious illness, after accidents or during pregnancy, during and after childbirth. Meanwhile, foreigners without means and without legal residence in Spain can obtain a health assistance document that entitles them to care. 

The problem with the Getafe hospital email is it is addressed to healthcare professionals. Normally, the administrative department of a hospital deals with these issues. The health of the patient is always the primary concern for a doctor. This should not be derived from considerations as to whether a patient can pay the bill. 

“Refusing someone for help as a doctor is unthinkable” 

A dozen doctors from various public hospitals replied to El País that “the health of the patients comes first”; they assure that they would “under no circumstances” think of “not caring” for a patient who arrives for “an emergency or if he needs further assistance”; and several of them refer to their code of ethics, the most basic general principles of which state that the primary duty of the physician is to care for the health of the individual and the community, without discrimination of any kind. One of them, “very surprised”, says: “Refusing someone for help as a doctor is unthinkable, it would be like skipping everything you believe in.” 

Editors note: The image showing the Tarjeta Sanitaria is simply an example and not a real card.

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