An introduction to the Spanish healthcare system

Registration for the Tarjeta Sanitaria (medical card)

Almost the first thing we did when we moved to Spain was to apply for our Tarjetas Sanitarias.  To get these, you need to be employed, self-employed (called autonomo in Spain) or retired, if – as is the case with the UK – there is a reciprocal arrangement between governments.  Or you take out private insurance.

We were very lucky, as in our case Hilary was retired and in receipt of a UK state pension, which meant that he could apply to the NHS for an S1 form, in order to be covered in Spain.  Interestingly enough, and I still don’t quite understand how, I snuck in on his S1 as his dependent.  I’ve always been fiercely independent, so not something I’m totally comfortable with, but it works, and we are now both fully registered on the Spanish healthcare system.

The process of registration

As you’d expect, there are forms to complete and evidence to provide.  This included our marriage certificate, confirmation of Spanish residency, passports, S1 form and a whole lot of other documentation.  We’ve learned that for official applications in Spain, it’s useful to bring all original documents and two photocopies of each.  It saves a lot of time and energy!  And the mountain of paperwork and photocopies also worked well for our medical card applications.

Except that the cards still hadn’t arrived after 8 weeks.  We went back to the office, where the same officer who’d seen us before was working at his desk.  There was nobody else around.  We asked when we might get our health cards, but he simply pointed to a machine in the corner for us to make an appointment.

The machine wasn’t very intuitive, so he got up to help us with it (still no other customers about) and the machine issued an appointment ticket for two hours later.  It was pouring with rain, and we decided to stay around until our appointed time.  There were still no other customers.  When our appointment time finally came, the officer looked up, gestured that we could come over, we asked our question and within 2 minutes had the answer.  Bureaucracy gone mad…

Flu jab

Our medical cards came soon after that, and we decided to make an appointment for a flu jab.  The process was a little different from what I’d got used to in the UK, where before being given the vaccine, you are required to answer a whole bunch of questions on a form, and sign and date this.  The nurse then asks you the questions again to make absolutely sure, and you have a choice – the jab can go in your right or left arm, the arm is cleaned and the jab is given.  Takes about 5 minutes in total.

Contrast this with the Spanish healthcare system approach: I walk into the nurse’s office, she gets the vaccine out, asks me to roll up my sleeve, and done.  One minute tops!

Coronavirus test

A few weeks ago, Hilary wasn’t feeling very well, and we were a little concerned that it could be COVID.  And in our current lock-down scenario, it wasn’t easy to find a thermometer as all local chemists had sold out.  I guess a more relevant item to stockpile than loo rolls…   Finally, I managed to get one, and even though Hilary didn’t have a temperature, we were still concerned.

So after a couple of phone call with the medical centre, they made an appointment for the following day.  Hilary was advised to go in at the side entrance.  Within seconds of him entering the back door, he was greeted by a lady who explained what would happen and a few minutes later was tested by a specialist in full protective gear who did the swabs.  He got the results 15 minutes later.  Negative, thankfully.  A very slick process!

A great app, great service

When we picked up our medical cards, we also got a leaflet about an app called Salud Responde.  So as soon as we got home, we downloaded it, and after some initial security questions we got through to a fantastic technology-enabled platform. This covers doctor and nurse appointments, repeat prescriptions, lab results, flu jab appointments, information about coronavirus, organ donation – even an icon for major surgery (which I haven’t explored yet).

A really impressive piece of technology.  And it works!  Although we can’t book face to face appointments due to coronavirus, we can make a telephone appointment with a doctor, and are provided with a timed window for a call.  Usually on the same day or the following day. What a great service and addition to the Spanish healthcare system!