Your rights as a patient in Spain

Key rules

• Equal rights: Your rights to information, consent, privacy and complaints apply to you as a patient, whatever your nationality or residence status.
• Right to refuse: You can ask for a clear explanation and refuse a treatment, except in emergencies and a few legal exceptions.
• Who sees your data: Only you and the staff treating you can see your record, unless you consent or the law allows access.
• Regional differences: Choice of doctor, hospital and companions depends on your region and centre, so check your regional charter.

Your rights apply to you as a patient, whatever your nationality

Patients in Spain have legal rights to information, privacy, choice and, in many places, companionship. A national law on patient rights sets the basics, and each region adds its own patient charter. You can use these rights to ask questions and to say no. They belong to you as a patient, not as a citizen or resident, so they apply to foreigners treated in the public system too, including people whose entitlement to ordinary care is limited.

Having these rights is not the same as having full access to public care. Who gets ordinary care free depends on your status. People without that status are covered for emergencies until discharge, for pregnancy, childbirth and the weeks after, and for anyone under 18. Otherwise you may need to pay, use private insurance, or take out a special public scheme (convenio especial). Some regions go further, so ask your regional health service.

Information: you decide what you know

Before any test or treatment, the doctor must tell you its purpose, its nature, its risks and its consequences. This is normally given out loud and noted in your medical record. It must be truthful and in words you can understand, so ask again until it is clear.

• You can say you do not want to be told. This is written down, and you still have to consent to the treatment itself, except in emergencies and a few other legal exceptions.
• Your information belongs to you. Family or friends can be told only as far as you allow, openly or by your silence. If you cannot decide for yourself, the information also goes to the person close to you.
• In rare cases a doctor can hold back information if knowing it would seriously harm your health. This must be recorded and your relatives told.

Saying no

You can refuse a treatment after hearing the explanation. Consent comes from you, so you can ask questions first and take your time where care is not urgent.

Privacy of your health data

Health data gets extra legal protection. Your record can be seen only by you and the health staff involved in your care. Others can see it only with your consent or where the law allows it, for example a court order, an inspection or public-health work. Staff are bound by professional secrecy.

Tell the doctor which relatives may hear your health information and which may not. You can ask for access to your data, correction, or limits on its use. Write to the centre's data protection officer. Clinical records usually cannot be erased, because centres must keep them for at least five years after discharge, and longer in some regions. If you are not satisfied, you can complain to the Agencia Española de Protección de Datos, which is the national data protection authority (Catalonia and the Basque Country have their own). You can also go to court or claim compensation.

Choosing your doctor and hospital

In primary care you can usually choose a GP, paediatrician and nurse within your health area, and often within your region. This depends on availability and on registering at a health centre. Some regions let you change on request, sometimes only once a year. A doctor whose list is full can refuse you.

Choice of specialist or hospital is set region by region. Many regions let you choose for specialist consultations and non-urgent procedures. Emergencies go to the nearest or designated centre. Complex cases may go to a reference hospital. Treatment in another region needs prior authorisation. Ask your regional health service what applies to you.

Bringing a companion

No national law gives you a general right to bring someone to a consultation. In practice companions are normally allowed in primary care and outpatient visits if you wish, especially for children, people with disabilities, or when you need help with language. Regional charters and hospital rules often cover hospital stays, childbirth and patients who need support. A doctor may ask the companion to leave for an examination, for privacy, or for infection control or space. Check the rules of your region or centre beforehand. Your privacy rights still apply, so the companion hears your health information only if you agree.

Where to find your region's patient charter

Every regional health service publishes a charter of patients' rights and duties. Search the health service's name with "derechos y deberes", or look under "Ciudadanía", "Pacientes" or "Atención al paciente". Hospitals and health centres usually display it and give copies at the patient information desk (Atención al Usuario).

The checklist, the choice guide and the warnings below turn this into steps, and the quick answers cover common questions.

Choosing between options

How do you use your right to choose your doctor and have company?

• Choose a GP within your health area: You are registering at a health centre or want a different GP, paediatrician or nurse, and the doctor's list has space.

• Choose a hospital or specialist in your region: Your region allows it for specialist consultations or non-urgent procedures, for example to cut waiting time.

• Go to the assigned or nearest centre: It is an emergency, you need complex care at a reference hospital, or choice is not offered in your area.

• Bring a companion: You want support in a routine consultation, you need language help, or you are a minor or dependent, who is accompanied by a parent or guardian.

Choice depends on your region and on availability. A companion is normally welcome in primary care and outpatient visits if you wish, and your consent still decides who hears your health information.

Companion and choice rules vary by region and centre, so check with your regional health service or the centre.

Checklist

Using your patient rights

• Ask the doctor to explain the purpose, risks and consequences of any test or treatment before you agree to it.

• Ask for the explanation in words you understand, and ask again if anything is unclear.

• Use your rights in the public system even if you are a foreigner without full entitlement to ordinary care: information, consent, privacy and complaints apply to every patient.

• Ask your health centre to register you with a GP, paediatrician and nurse of your choice within your health area.

• Ask your regional health service whether you can choose your hospital or specialist for non-urgent care.

• Tell the doctor if you want your companion to hear the consultation, or ask for privacy if you prefer to be seen alone.

What to watch out for

What to watch out for

• Information can be withheld in rare cases: A doctor may hold back information if knowing it would seriously harm your health. This must be written in your record and your relatives or linked persons told. Ask what has been recorded and why, and ask for the full information to be given to someone you trust.

• Others may hear your information without your say: Relatives are informed only to the extent you allow. If you say nothing, staff may assume you agree. Say clearly who may and may not be told, and ask for it to be noted.

• Your choice of doctor may be refused: A doctor's list may be full, and complex care goes to a reference hospital. You also have no right to be treated in another region except with prior authorisation. Ask for another doctor in your area, and get authorisation before seeking care in another region.

• Choice rules differ by region: Some regions allow free choice of hospital or specialist only in some areas, and limit how often you can change GP, for example once a year.

Quick answers on patient rights in Spain

Can I refuse a treatment my doctor recommends?

Yes, you can refuse a recommended treatment, except in cases set by law such as public-health risks and emergencies. Your refusal goes in writing and in your clinical record, and the centre must offer an alternative treatment if one exists. If you refuse, you may be asked to sign a voluntary discharge (alta voluntaria), and you can change your mind later.

Can I see what my doctor wrote in my clinical history?

Yes, you have the right to see your clinical history and get copies of what is in it, in public and private care. Two limits apply: you cannot see other people's confidential data, and doctors may keep their personal impressions and judgments (subjective notes) out of your access. A relative of someone who has died can ask only if the person did not forbid it.

Can I bring a companion to my consultation?

Usually yes, in primary care and outpatient visits, but no national law gives you a general right to a companion. Rules for hospital stays, childbirth and minors come from regional charters and hospital rules. The doctor may ask your companion to step out for an examination or to protect your privacy.

Will the public system give me an interpreter if I do not speak Spanish?

Not always, because no national law guarantees an interpreter, but some regions and centres offer telephone or video interpreting or cultural mediators. Ask at reception or the patient service desk (atención al usuario) when you book. If you bring a friend, choose an adult, never a child, as an independent interpreter is better for consent and privacy.

Can I refuse to have students observe my consultation?

Yes, you can refuse students or trainees at a consultation or examination, and this must not affect your care. Teaching hospitals often have students present, and staff should tell you who is in the room and ask your agreement. Residents (MIR) who treat you are supervised doctors in training, not observers.