In 2018, the first Government of Pedro Sánchez approved a royal decree on universal access to the National Health System with which it intended that all people could access public health, regardless of their administrative situation. However, a little more than 6 years later, “the confusing, if not directly contradictory, wording” of this rule, according to Médicos del Mundo, “has given rise to foreigners – particularly those in an irregular administrative situation – being requires a series of requirements that are difficult to meet to access the health system.
Thus, the Third Report on access barriers to the National Health System (SNS), prepared by Médicos del Mundo, confirms that, since 2022, 28,744 people have suffered some barrier that has made it difficult or prevented them from accessing the health system. In that 32-month period, the organization has documented a total of 69,650 cases in which barriers to being treated in public healthcare have been found, an average of 2.42 cases per person. Almost all of them occur in immigrants.
The ineffectiveness of this royal decree is also evident in the bill for the universality of the National Health System, recently approved by the Council of Ministers and which is being processed in Congress, which mentions in its explanatory statement that different groups , movements and organizations have highlighted through reports “situations that show a lack of homogeneity in the application of this royal decree-law and that visualize fissures in universal access to the National Health System (SNS).”
According to the data now presented by Médicos del Mundo, the barriers that people face when requesting health care are discriminatory, physical, economic, informational and cultural. The first are defined as those legal or administrative requirements that make access to the public health system difficult and that only affect certain people or groups, especially those most vulnerable, and are the ones that are most documented, with a total of 19,748 cases, 40 .84 percent.
Demonstrate registration
The report places special emphasis on the problems of proving registration, as well as that residence in Spain is longer than three months, to be treated by public health. “For many migrants, especially those in a situation of greater social vulnerability, it may be impossible to register, either because they do not have a valid identification document, because they live in informal rentals, substandard housing areas or because they are directly homeless,” highlights the text. The barriers due to not being able to prove residence time mostly affect minors and pregnant women, he points out.
The organization also denounces that, although the legislation establishes that people who do not comply with this residence time will be able to access health care with a favorable report from social services, this is often impossible to obtain. “In practice this is a route that has certainly proven inoperative,” he alludes, pointing out the collapse of social services and the impossibility in some communities of getting an appointment with social work.
No centers nearby
Regarding physical barriers, the report mentions 6,534 cases in which people cannot be treated by health services because they do not have a health center within a reasonable distance from their home, due to restricted opening hours or due to accessibility difficulties for people. with reduced mobility.
But the cost of treatments also influences these difficulties in accessing healthcare, the organization insists. It thus refers to the inability of some people to afford the medications they need or to emergency billing for foreign people who do not reside in Spain.
The document assures in its conclusions that the barriers to access to healthcare increase as people’s vulnerability increases and focuses on immigrants who are in an irregular situation. In addition, it points out several specific cases that have encountered these barriers: 130 cases of cancer, 138 of cardiovascular diseases, 265 cases of diabetes, 279 of hypertension, 162 of HIV, 224 of serious mental health, 82 of respiratory diseases, 97 of degenerative diseases or 43 cases in which abortion has been denied.
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