How to make a complaint about public healthcare (reclamación)

Terms used

• Reclamación — A reclamación is a formal complaint about a service, here filed with the public health service.
• Responsabilidad patrimonial — Responsabilidad patrimonial is a claim for compensation from a public body for harm its service caused you.
• Colegio de médicos — The colegio de médicos is the professional association of doctors in a province, which can review a doctor's conduct.
• Cl@ve — Cl@ve is Spain's digital identification system for online dealings with public bodies.

Key rules

• Where to file: File at the patient-service office of the centre where the problem happened, or through your region's own channel.
• Response time: Each region sets its own deadline, so ask the office for yours and request an acknowledgement of receipt.
• Silence: No reply does not mean your complaint was accepted, but you can escalate.
• Ombudsman: The regional ombudsman or Defensor del Pueblo is free and needs no lawyer, but can only recommend.
• Damages: A claim for harm from medical negligence needs a separate responsabilidad patrimonial claim.

Where a complaint goes

Send your reclamación to the patient-service office of the hospital or health centre where the problem happened. Each region also has its own channel, usually on the regional health service website. The same route works for a complaint, a grievance (queja) or a suggestion (sugerencia).

You can file in any of these ways:

• In person at the patient-service office.
• At any public registro.
• By post.
• Online, through your regional health service's electronic office.

The form

There is no national form. Each regional health service has its own, and you get it at the patient-service office. Most regions also let you download it from the regional health portal.

Online filing often asks for Cl@ve or a digital certificate. Some regions let you file without either. The documents block below lists what to have ready.

Describe what happened, with dates, the place and the people involved. Say what you want: an explanation, a correction or an apology. A letter template is below if you prefer to write your own.

How long the answer takes

The health service must acknowledge your complaint and answer in writing. Each region sets its own deadline. Around 30 days is common, and some regions allow up to 3 months. Many regions require an acknowledgement of receipt within days, so ask for one when you file.

Your region's deadline is in its regional rules on patient complaints. The patient-service office can tell you the exact period.

Silence does not mean you won. A complaint does not give you a right to a particular result, and no reply does not grant what you asked for. It does leave you free to escalate.

If the answer is no, or there is none

You can escalate in two ways, and the steps below show the order.

• Take it to the regional health authority (consejería de sanidad), which has patient-service or inspection units.
• Complain to the regional ombudsman or the Defensor del Pueblo. Many regions have their own ombudsman, and it usually handles health complaints against the regional service.

The ombudsman is free and needs no lawyer. Foreigners can use it. Your complaint must be in writing and signed, with your identification, the facts and the body concerned. You can file online, by post or in person. It is normally accepted only after you first tried to resolve the matter with the health service. It is not accepted if a court case on the same matter is pending. The ombudsman can only recommend or suggest, not impose a decision.

If you are challenging a formal decision, the process below covers the administrative appeals and then the courts.

Other situations

A claim for damages from medical negligence is a different route. You file a responsabilidad patrimonial claim with the health service, and then go to the courts.

Private care follows other routes: consumer bodies, civil courts or the colegio de médicos (the doctors' professional association).

Escalating a health complaint step by step

Escalating a health complaint

• File the complaint with the patient-service office of your centre: First step, as soon as you have your facts and dates ready

• Wait for the centre's answer: Your region sets the period. Typical periods are about 30 days, and some regions allow up to 3 months. If no rule sets a period, 3 months applies

• If the centre rejects the complaint or does not reply, take it to the regional health authority (consejería de sanidad) or its inspection unit: Once the centre has refused or its period has passed. Silence does not grant what you asked, but you are free to escalate

• Complain to the regional ombudsman or the Defensor del Pueblo. It is free, needs no lawyer and must be in writing and signed: Within one year from when you learned of the facts, and only after you first tried to resolve it with the administration. It is not admitted if a court case is pending on the same matter

• If you are challenging a formal decision, file a recurso de alzada (appeal to the higher authority): Within 1 month of an express decision, or within 3 months after silence takes effect

• Go to the contencioso-administrativo court: Within 2 months of an express decision, or within 6 months from when silence takes effect

• For a damages claim over medical negligence, file a responsabilidad patrimonial claim with the health service, then go to court if refused: Within one year from when the harm became stable

Documents you need

• The official complaint, grievance or suggestion form of your regional health service. You get it at the patient-service office of your hospital or health centre, and usually as a download from the regional health portal.

• Cl@ve or a digital certificate, only if you file through the regional online office and it asks for one. Some regions allow online filing without either.

Checklist

• Ask the patient-service office of your hospital or health centre for the official complaint form (hoja de reclamaciones).

• File the complaint at that office, at any public registry, by post, or online through your regional health service's website.

• Find out your region's deadline for a written answer.

• If the centre rejects the complaint or does not reply, take it to the regional health authority (consejería de sanidad) and to the regional ombudsman or the Defensor del Pueblo.

What to watch out for

• Silence does not give you what you asked: If the centre does not reply, that does not mean your complaint was accepted. A complaint does not give you a right to a particular outcome. Treat silence as a reason to escalate to the regional health authority or the regional ombudsman.

• Damages claims need a different route: A complaint will not get you compensation for medical negligence. File a responsabilidad patrimonial claim (a claim for damages against the health service) instead.

• Private care follows other routes: This complaint route covers the public health system. Private care is pursued differently.

Template for a patient complaint letter

Use this wording if your region's official complaint form is not available, or as an attachment to that form. Your region's form comes first, so fill it in too if it asks for more. Replace each blank in square brackets with your own details. Keep the letter to one page.

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To: [Name of the hospital, health centre or patient-service office] Subject: Complaint about [the service or department concerned]

My details

• Full name: [as on your ID]
• ID number: [DNI, NIE or passport number]
• Address for letters: [street, number, postcode, town]
• Phone and email: [how you want to be contacted]

Where it happened

• Centre and service: [for example, Hospital X, orthopaedics department]
• Date or dates: [day, month, year; add the time if it matters]

What happened [Describe the facts in the order they happened. Use short, dated points.]

1. [Date]: [what happened, who attended, what was said or decided]
2. [Date]: [next event, such as a missed appointment, a refusal or a delay]
3. [Date]: [the effect on you, such as pain, lost work or money paid]

What I am asking for [State exactly what you want. For example: an appointment with a specialist by a set date; a written explanation; a refund of [amount] for [cost] that I paid privately; a correction of my medical record.]

Documents attached

• [Copy of the medical report, test results or referral]
• [Appointment letters, messages or refusal letter]
• [Invoices or proof of payment, if you are asking for money back]
• [Copy of your ID]

I ask for a written reply to the address above.

Date: [day, month, year] Signature: [your signature]

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Before you send it

• Send copies and keep the originals.
• File it at the centre's registry or through your region's online office. Ask for a stamped receipt with a reference number, and keep it as proof of the filing date.
• If you cannot file at a registry, send it by registered mail with proof of delivery.
• If something is missing, the office must give you 10 days to fix it. If you do not, the complaint is treated as withdrawn.
• If someone files for you, they must attach proof that you authorised them.

Frequently asked questions

Can I file a health complaint online?

Yes, most regional health services let you file online through their sede electrónica (online office), usually with Cl@ve or a digital certificate, and some allow it without one. Forms differ by region, and there is no single national form.

Can a foreigner complain to the ombudsman about healthcare?

Yes, anyone with a legitimate interest, including foreigners, can file with the ombudsman, free of charge and without a lawyer.

Will the ombudsman force the health service to change its decision?

No, the ombudsman can only recommend or suggest, not impose a decision. It will usually not take your case if you have not first tried to resolve it with the health service, or if a court case on the same matter is pending.

Which ombudsman handles my health complaint?

Your regional ombudsman usually handles complaints against your regional health service, for example the Síndic de Greuges in Catalonia, the Defensor del Pueblo Andaluz, the Ararteko in the Basque Country or the Valedor do Pobo in Galicia. Each has its own filing portal.