Lorraine Williamson
Spain’s soaring sick leave figures have become one of the country’s quieter but more serious economic and social problems. New 2025 data show a fresh record in temporary sick leave cases, adding to pressure on public finances, family doctors, and employers at a time when ministers, unions, and business groups still cannot agree on how to bring the trend under control.
The latest Social Security statistics, cited in reporting published on Monday, put average common-illness sick leave among employees at 53.7 cases per 1,000 salaried workers in 2025, up from 51.1 in 2024. The public cost reached €18.4 billion last year, making it the system’s second-largest spending item after pensions.
Why the issue is now impossible to ignore
What makes this more than a dry labour-market story is the direction of travel. Sick leave in Spain has been climbing steadily since 2012, when the average stood at 19.1 cases per 1,000 salaried workers. Since then, the rise has become almost uninterrupted, with especially sharp increases in the years after the pandemic.
That trend matters because it cuts across several of the issues Spaniards already feel most acutely: overstretched healthcare, long waiting lists, workplace stress and an ageing workforce. It is also becoming harder to dismiss as a temporary blip. The numbers now point to a structural problem rather than a short-lived hangover from Covid-era disruption.
AIReF sees five main causes
Spain’s independent fiscal watchdog, AIReF, set out a broad explanation earlier this year in its study on temporary incapacity. According to El País’ reporting of that review, the watchdog identified five main drivers: weak supervision and follow-up of sick leave cases, a more worker-protective legal framework, better collective agreements that reduce the financial hit of being off work, a stronger labour market that makes people less afraid of losing their jobs, and growing strain on the health system through primary-care demand and waiting lists.
That is one reason the issue has become politically awkward. There is no single villain and no quick fix. Some of the factors reflect positive changes, such as stronger worker protection. Others point to deeper weaknesses, especially in public healthcare, where delays can leave people signed off for longer than medically necessary.
Waiting lists and mental health are now part of the story
One of the clearest pressure points is healthcare access. El País reports that waiting lists remain historically high, with 846,600 people waiting for medical attention in December 2024 and an average wait of 126 days. When tests, treatment or specialist appointments are delayed, sick leave often lasts longer too.
Mental health is also playing a bigger role. The same reporting says AIReF highlighted mental health as the main factor behind the increase among younger workers, while sick leave among people aged 25 to 35 rose 67% between 2017 and 2024, compared with 43% among workers aged 55 to 65.
That shift says something important about modern Spain. This is no longer only about back problems, accidents or physically demanding jobs. Anxiety, burnout and other psychological pressures are becoming part of the labour-market conversation in a much more visible way.
Employers, unions and government still disagree
There is no shared diagnosis, which is why the debate keeps circling without landing. Business groups have warned about the hit to productivity and competitiveness, while unions argue that talk of abuse or fraud risks obscuring the real causes: delayed healthcare, poor prevention and worsening health conditions among workers. El País reports that the Social Security ministry is in talks with unions and employers, but positions remain far apart.
Measures already agreed have not yet changed the picture much. One of the main steps has been to expand the role of mutuas in handling some musculoskeletal cases, but implementation depends on agreements with regional health services and has barely taken hold so far.
Not all workers are affected in the same way
There are also sharp differences within the labour force. The rise is strongest among employees, while self-employed workers have seen a slight fall in common-illness sick leave for a second straight year, according to the same data. The explanation is not hard to grasp: autónomos usually lose more income when they stop working, so they tend to take leave only when health problems are more serious. Their sick leave cases are therefore less frequent but much longer.
Regional differences are just as striking. El País says the highest overall rates were recorded in Galicia (74.7 cases per 1,000 workers), Canary Islands (73.7) and Cantabria (67.5), while the lowest were in Madrid (44.7), La Rioja (46.9) and the Balearic Islands (47.3).
A growing issue with no easy solution
What makes this story worth following is not only the record itself, but the absence of a convincing answer. Spain has a labour market that is performing relatively well, but a healthcare system under strain and a working population dealing with longer lives, heavier pressure and more visible mental health problems. Those realities are now colliding in the sick leave figures.
The political challenge is obvious. If ministers tighten controls too aggressively, they risk being accused of targeting ill workers. If they do too little, the bill keeps rising, and businesses keep complaining. For now, Spain’s sick leave record looks less like a one-year anomaly than a warning sign of wider stress running through the country’s healthcare and labour systems.