Spanish doctors protest against law that excludes immigrants from public healthcare

BMJ 2012; 345 doi: (Published 23 August 2012) Cite this as: BMJ 2012;345:e5716
  1. Aser García Rada
  1. 1Madrid

More than 1300 Spanish doctors and nurses have promised to continue to treat immigrants without official papers, after a law was passed on 24 April that denied most of them access to health services.

The law, which was approved by the current conservative government of Mariano Rajoy’s People’s Party (PP), comes into force on 1 September. It is estimated that it could affect between 150 000 and 300 000 immigrants “not registered or authorised as residents.” This group will have access only to emergency, maternity, and paediatric care, says the law.1

Doctors and other health professionals have stated their objection to the law and vowed to keep treating immigrants by signing an online form set up by Spain’s largest primary care physicians’ society, Sociedad Española de Medicina de Familia y Comunitaria.2

The law has attracted wide criticism from medical organisations and immigrants’ associations, which argue that it will lead to humanitarian problems and public health issues. They have also criticised the government’s argument that the country is facing unprecedented pressure from health tourism.3

“It is an ethical duty to serve all citizens,” said Serafín Romero, general secretary of the national association of Spanish medical colleges (Organización Médica Colegial).

The controversy has increased since the ministry of health, social services, and equality said it was offering what appeared to be private health insurance to immigrants who want to continue using the public health system. According to newspaper reports, immigrants under the age of 65 would be able to pay €710.40 (£561; $885) per year to receive health treatment, and those older than 65 would pay €1864.80 per year.

The plan, which is still being finalised, will be released after the next joint meeting of regional and national health authorities at the end of September, a spokeswoman from the ministry confirmed.

Of the country’s 17 autonomous communities, five governed by opposition political parties (Andalusia, Asturias, the Basque country, the Canary Islands, and Catalonia) have announced that they will continue to fund care for immigrants.

Even in some areas governed by the PP, doubts have arisen. Alberto Núñez Feijoo, the conservative president of Galicia, said, “I am not in favour of reducing healthcare to undocumented migrants.”

By contrast, Valencia, also governed by the PP, has warned that public resources cannot be used for attending immigrants.

However, the decision to maintain care may be confounded by administrative issues because the immigrants do not have a healthcare access card and their details will not be included on the healthcare system’s database.

The debate has widened significantly through social networks. The popular health blog “Una palabra tuya bastará para sanarme” (Only say the word and I shall be healed),4 set up by GP Roberto Sánchez, proposes “godfathering” an immigrant—that is, sharing computer record numbers for administrative purposes.

The charity Doctors of the World (Médicos del Mundo) has launched its own campaign—“Right to heal” (Derecho a curar)—to promote conscientious objection, offer public support to objectors, and campaign for the withdrawal of the law.


Cite this as: BMJ 2012;345:e5716


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