How good is Spanish public healthcare, and what is under strain?

Key rules

• Hospitals: Hospital and emergency care is a clear strength of the public system.
• Family doctors: Getting a routine GP appointment is the main pressure point, and it varies a lot by region.
• Strikes: Strikes can cancel non-urgent consultations and surgery, but emergencies stay covered.
• Expectations: Expect good treatment once you are in the system and some waiting to get in.

Figures on doctors, waits, satisfaction, strikes and spending change often, so check the latest with the Ministry of Health and your regional health service.

The short answer

Spanish public healthcare is good where it matters most: hospitals, emergencies and complex care. The weak spot is getting a quick appointment with a family doctor. Expect high-quality treatment once you are inside the system, and some waiting to get in.

What works well

• Long, healthy lives. Spain has one of the highest life expectancies in the EU and the world, at around 83 years at birth.
• Transplants. Spain has led the world in organ donation per million inhabitants for more than three decades.
• Good results. European and OECD health indicators show good outcomes for treatable deaths, cancer survival and avoidable hospital admissions.
• Hospital capacity. Public hospitals have strong capacity for emergencies and complex care.

International rankings of health systems also place Spain high.

What is under strain

Family doctors. There are roughly 0.7 to 0.8 family doctors per 1,000 people. The gap between regions is large, and many rural posts sit vacant. Waits for a non-urgent GP appointment have lengthened since the pandemic. They are typically several days, and in some regions and health centres they run past a week. Check the current figures with the Ministry of Health.

Strikes and disputes. Doctors' unions have struck over the draft framework statute (the Estatuto Marco) in 2025 and 2026. There have also been regional primary-care strikes, for example in Madrid and Catalonia, and disputes involving resident doctors (MIR). During a strike, non-urgent consultations and surgeries can be cancelled. Health authorities set minimum services so emergencies and urgent care keep running. Check dates and the current status with your regional health service.

Money. Public health spending is below that of Germany, France and the Nordic countries, both per person and as a share of GDP. Total health spending is about 9 to 10 percent of GDP. Public spending is around 6.5 to 7 percent, near or below the EU average. Spain has been working to raise spending on primary care.

What people think

Most residents say the public system works well or fairly well. The average rating is around 6.5 out of 10 in recent editions of the Barómetro Sanitario. People are more satisfied with hospital and GP care once they are being treated than with waiting times.

How to set your expectations

• Expect good care for serious illness, but plan for a wait for routine appointments.
• Your experience depends on your region and even your health centre.
• Urgent care continues during strikes, but a planned appointment or operation may be moved.
• Ask your regional health service how long routine waits are in your area.

The questions below cover family doctors, satisfaction, strikes and spending.

Frequently asked questions

How many family doctors does Spain have for each 1,000 people?

Spain has roughly 0.7 to 0.8 family doctors per 1,000 people, with large differences between regions. Many rural areas have vacancies, so ask your local health centre how soon you can get an appointment.

How satisfied are people in Spain with the public health system?

Most residents rate the public system as working well or fairly well, with an average of around 6.5 out of 10 in recent surveys. People are happier with the hospital and GP care they receive than with waiting times.

Will a doctors' strike cancel my appointment or surgery?

A strike can cancel non-urgent consultations and surgeries, but emergencies and urgent care keep running under minimum services. Doctors' unions have called strikes in 2025 and 2026, and some regions have had primary-care strikes. Ask your regional health service whether your appointment is affected.

Does Spain spend less on public healthcare than other European countries?

Yes, Spain's public health spending is below Germany, France and the Nordic countries, at around 6.5 to 7 percent of GDP. Even so, outcomes such as life expectancy, at around 83 years, are among the best in the world.