Lorraine Williamson
Spain’s much-admired public health service is under growing strain, as frustrations mount over access, waiting times, and underinvestment—especially in mental health. While patients who directly engage with the system generally report high satisfaction levels, nearly half of Spaniards remain critical, voicing concerns shaping a growing call for reform.
According to the latest data from Spain’s Ministry of Health, a striking contrast exists between how the healthcare system is perceived by those who have used it recently and those who haven’t. Over 80% of people who visited their GP or a hospital in the past year rated their experience positively. They cited trust, professionalism, and safety as key strengths. Yet, those without recent interaction were far more sceptical—often citing lengthy waits and poor accessibility.
The ministry attributes this to a “perception gap”: direct contact with medical staff tends to generate a more realistic and favourable opinion, whereas those outside the system feel shut out by bureaucracy and inefficiency.
Struggles to access basic care
Despite positive experiences among users, the data reveals deeper systemic issues. One in four people say they struggled to get a GP appointment. Of those, more than half ended up turning to emergency services instead—clogging up departments already under pressure. Alarmingly, nearly a third simply gave up on seeking care altogether. For some, even following a prescribed treatment isn’t possible: 4.6% admit to stopping their medication due to cost.
Diagnostic tests: a mixed picture
For the first time, the report includes detailed statistics on access to diagnostic imaging for new health issues. Around 23% of respondents underwent ultrasound scans, 16% had CT scans, 15% received MRIs, and 4.8% had colonoscopies. While ultrasounds and CTs were mostly scheduled within a month, MRI appointments averaged a 37-day wait. Colonoscopies took the longest—patients waited an average of 113 days, potentially delaying critical diagnoses.
Demand for mental health support climbs
Mental health emerged as another area of concern. Over 20% of people said they needed psychological or psychiatric care in the past year—up three percentage points on the previous period. While just over half accessed this through the public system, a substantial portion turned to private health insurance or paid out-of-pocket. Yet despite turning to private services, nearly 60% of insured patients still believe the public system is better equipped to handle serious mental health conditions.
This paradox reveals a complex truth: trust in the Spanish public health system remains strong, even as accessibility and service speed decline.
Momentum building for reform
Spain’s universal healthcare system has long been a source of national pride. But behind the scenes, mounting demand, insufficient funding, and an ageing population are putting immense pressure on infrastructure and staff. Mental health services—once marginalised—are now facing unprecedented demand, exposing gaps in availability and response time.
As dissatisfaction grows among those locked out of care, and with the cost of living driving patients to abandon treatments, the calls for deeper structural reform are likely to grow louder. For now, trust remains. But without change, it risks eroding further.
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