When Your Overseas Home writer Sally Veall found herself needing more than a GP visit in Spain, she got a firsthand look at how the country’s public healthcare system really works for expats. From her local CAP to the hospital and late-night pharmacy, she shares what to expect – and why she’s full of praise for it.
Spain’s healthcare system often ranks among Europe’s best, but how does it actually work when you’re the patient? For many expats, the CAP – Centre d’Atenció Primària – is the first port of call for everyday healthcare and emergencies. When long-time resident Sally Veall suffered a serious asthma flare-up, she saw the system in action from start to finish. Her experience, from the calm efficiency of her local CAP to the attentive care at the hospital and even a late-night dash to the pharmacy, reveals just how comprehensive Spain’s public health network really is. If you’re living in Spain or planning to, Sally’s story shows why you can feel confident putting your health in local hands.
A visit to the CAP
Last week I needed to use my local Spanish healthcare service for something more than a GP visit. I am asthmatic and have been coughing badly for a while. I felt the well-known but unpleasant signs of a bad asthma attack, so I drove five minutes to my local health centre, the CAP.
This is a medical centre found in every town which houses GP/gynaecological/pediatric care and most importantly, a 24-hour emergency service. The CAP doesn’t have X-rays or other major technological equipment but it does have everything for the immediate treatment of an emergency patient.
I was seen within five minutes, immediately given Salbutamol through a mask and an injection. Gradually, my breathing improved but the cough continued. The young doctor on duty gave me three rounds of the mask treatment but finally said he wasn’t happy… I was worse than I felt.
Protocol says that in a case like this, I must be sent to the local hospital, 10 km away, by ambulance.
After spending three hours in the CAP emergency department, I was whisked off to A&E at the hospital.
The hospital A&E department
This was not the first time I had been there. I expected a wait but was taken immediately to triage and then to a cubicle with a bed. After a few minutes, a doctor arrived and spoke to me in English. I didn’t expect this and as I speak Spanish, it wouldn’t have been a problem if he spoke in his own language but he had obviously looked up my notes and felt it better to converse in mine.
Many doctors do speak some English but don’t expect it. The hospital will have a translator, often another member of the medical staff and if you are struggling, ask for someone who can interpret for you. Local Red Cross volunteers might be called (I am one) to help. The nurses and auxiliary staff are friendly, though there is always one who is having “a bad day”. They are efficient too and have plenty of patience for the person they treat. I’ve only once had a less-than-pleasant encounter – in a large teaching hospital, just after coming round from anaesthetic. When I asked for something in Spanish, the nurse reminded me rather sharply that I was in Catalonia and should speak Catalan instead!
All the tests
The Spanish public healthcare system is nothing if not thorough. I was put through a long series of tests including X-rays, an ultrasound, a blood test and an ECG. Again, I was given the mask with Salbutamol three times. About two and a half hours later, I was told I had pneumonia on the right side. Again, sadly, not the first time. I was prepared for a hospital stay.
They immediately put me on antibiotics and cortisone and continued to monitor me for another three and a half hours. I had asked the doctor to send me home, if at all possible, as I didn’t relish the thought of another stay upstairs.
Not that Spanish hospitals are bad. There are no wards as such, but rooms for two people with a bathroom. Of course, it’s potluck as to who your room companion might be and here in Spain, it is quite normal for members of the family to stay with the patient, even all night long. This can make things a little noisy and it’s sometimes difficult to genuinely rest. There is also a TV in the room and the service is payable. Elderly people tend to want the volume up high, so if you know in advance you are going to the hospital, take earplugs and a tablet – if you have one – with Bluetooth earphones. Don’t forget your charger! WiFi is available, usually for free.
Support from friends
Expecting to be staying overnight, I asked a friend who has my keys, to kindly bring me my phone charger. She kindly brought it and also thought to bring my earphones, toothbrush and toothpaste.
Two hours after her visit, they told me I could go home! However, with a long prescription for five medicines. It was late now – 10:00pm. They said they might find an ambulance to take me if there was one available. That meant a long wait. I decided to ring another friend to ask her to pick me up. I am not in the habit of asking for favours, but both these people are good friends, so I felt able to.
She arrived at 10:30pm.
Emergency pharmacy
Every town in Spain will have a duty chemist, open all night. They take it in turns. The one open that night was near my home and I was duly given the five medicines and then headed back to my car, which was still parked outside the CAP. My friend followed me home to make sure I was safe.
Almost a week on, I am much better. I am still religiously taking the medication as required. A doctor from the CAP phoned me on Friday to see how I was feeling. My GP is on holiday, so I didn’t know this doctor but she was very kind and understanding.
Hopefully, it’ll be a long while before I need to return for anything similar, but I really can’t fault the care I received. My experiences in the past have been just as positive.
Protocols
The Spanish health service is constantly changing and upgrading its protocols. Often this means you might be required to do something you don’t expect, such as being taken in an ambulance to a hospital. The ambulance staff monitor you during the journey, not only for signs of illness but also mental state and coherence. This gives the hospital an immediate assessment of the patient so that they can start treatment as quickly as possible.
Healthcare apps
In my region, we have a very efficient healthcare app. Once signed up, you have access to all your medical records, blood test results, a full list of your medications and an appointment section to see your GP and arrange vaccinations. These apps save a lot of time, and you will always get confirmation of your appointment and even a reminder by SMS. Other regions have similar technologies. It is worth your time to find out what is available and to use them. Trying to telephone or having to visit a CAP to make an appointment is time-consuming and inefficient.
