Spanish health service


Dear Editor

The World Health Organisation rates the Spanish health service as number 7 in the world, while the UK lags at 18 (even behind poverty-stricken Oman at 8th). There are criticisms of the WHO’s methodology, but no degree of argument is going to reverse those positions. America is a lowly 37 despite spending the most and France is number one!
During my 12 years’ residency here I have often heard the Spanish service lauded, but that is not always the case. Bureaucracy rules even above patients’ interests – after all this is Spain.
When I came here I followed all the rules of residency and taxation and transferred my health care from the UK. For a while, my wife and I visited the local clinic until we realised that we sat there watching the shadows lengthen while Spanish names were called long after our appointment time. Then we found how cheap health insurance is here and ceased to trouble the public health service further.
The years rolled by until a test at a private hospital showed I had a heart condition and I was prescribed medication to contain it. I paid for this for a year until I realised that this medication was a life-time situation that was costing me more than my UK old age pension and that the UK government was paying Spain some €3,500 each year for my health care – it is not provided free! It was obviously time to seek help from the state service that I had not troubled for some 10 years.
I dutifully copied all the Spanish cardiologists’ reports and left them for my health service doctor at the local clinic clearly marked with his name and marked “confidencial”, thinking to avoid the health service unnecessarily duplicating the tests. The days and weeks passed, I regularly visited the clinic to be told to be patient as my GP was considering the matter. After three weeks I made an appointment to see him (that took another week), only to discover that he had never seen my letter. After a two-hour search it was found on a shelf behind the reception along with a prescription for a drug I had not requested but I had been prescribed some 11 years earlier.
My GP told me that I would have to visit a cardiologist at the regional hospital Denia, as he doubted that the specialist cardiologists at the Benidorm hospital may not even be qualified, and certainly could not be of specialist level. Two months later I met the public cardiologist at Denia, and despite showing my SIP card three times, they called up another person’s records with severe heart problems and diabetes in error.
When this confusion was cleared up (and I was told that somehow it had all been my fault), I was prescribed the very drug that had been prescribed at Benidorm and had been paying for privately for over a year, plus another drug that was not mentioned to me. There was no indication as to why I needed it, when to take it or what to avoid with it. The next day I took the prescription to my local pharmacist only to be told the computer system showed it had not been authorised. I returned every day without success until I eventually made another appointment with my GP, who told me that the prescription had been cancelled by an “Inspector”, but that no arrangements had been considered for any alternative.
I had been warned by two cardiologists that after I had started to take the medicine, I would be at a greatly increased risk of a stroke if I stopped the drug, but despite this European-wide warning, the prescription had simply been cancelled. My GP told me he could take the matter no further; Denia was supreme, only the prescribing cardiologist could take the matter up with the Inspector and the Denia doctor had apparently failed to do so. His only suggestion would be for him to refer me to a haematologist in some month’s time and hope that the specialist would take the matter up on my behalf. I could alternatively go to see the Denia cardiologist again and plead there to do what everyone would expected to have done initially, and find a suitable alternative medicine.
So I wrote a polite letter in Spanish asking the specialist to take the matter up with the Inspector. I waited for over two hours at Denia to persuade the nurse to carry the letter three metres to the cardiologist, but received a response within minutes. I was told in no uncertain terms that the doctor would only read the letter if I first made an appointment. Apparently caring for a patient with heart trouble is not high on the hospital’s list of priorities. Nevertheless I went to make an appointment, only to be told that the earliest I could be offered was a full year away. I pleaded the urgency of the case and was offered one seven months away. Seven months more without medication or pay for it myself.
Before readers rush to find ways to defend Denia’s decision, may I remind them that AFPO write that the UK pays Spain some €3,400 each year to cover my health care, that makes a total of €40,800 to date. Surely that is sufficient profit even for Spain? My Benidorm cardiologist reminded me again of the dangers of stopping the medication and that an October cardiologists’ conference in Alicante agreed that this medication should be the first choice for my age and condition, an opinion shared by the NHS on their website. He could also find no good reason for the second medication they had prescribed.
Why then should Spain refuse to prescribe any medicine at all, let alone the one chosen by their own public health cardiologist? Is the prime responsibility of a health service the health of residents and is such an action simply shameful? Why should the British government pay Spain every month when they adamantly refuse to supply any health care?

Best wishes
Ron Williams

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