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LIFE IN SPAIN

Spain to scrap hated ‘cita previa’ appointment system for official matters

Spain's government has vowed to scrap the gatekeeping system used by civil servants to stop people from going to public administration buildings to complete official processes or to enquire without first having a compulsory ‘prior appointment’. 

cita previa spain
The cita previa system was used in Spain before Covid-19, often haphazardly depending on the preferences of the civil servants at a specific branch. (Photo by CESAR MANSO / AFP)

Nothing exemplifies Spanish bureaucracy quite as much as being turned away by a security guard at an empty public administration building because you don’t have a cita previa (prior appointment).

Fortunately, it appears that the mandatory cita previa, which became the norm during the pandemic, has its days numbered. 

Spanish Minister of Digital Transformation and Public Function José Luis Escrivá announced on Wednesday that his ministry intends to eliminate the requirement of booking an appointment beforehand to enter the offices of the Social Security, the Hacienda tax agency or the DGT traffic authority, to name a few.

“It requires a regulatory change that we will see how to raise in Parliament as soon as possible,” Escrivá said. 

The cita previa system was used in Spain before Covid-19, often haphazardly depending on the preferences of the civil servants at a specific branch, but it was during the pandemic that it became compulsory across all public administrations. 

READ ALSO: Why so many people in Spain ‘dream’ of becoming civil servants

It has been kept in place long after the coronavirus ceased to dominate public life, and rather than ensure that Spanish citizens and foreign residents were helped in an orderly and timely fashion, it’s often led to month-long waits to get an appointment.

READ ALSO: ‘Four months to get an appointment’: Huge delays at Spain’s Social Security

Numerous law firms have previously pointed out that it is illegal for Spain’s public bodies to make appointments compulsory.

Escrivá’s ministry has since admitted that under no circumstances should the cita previa be compulsory, and that what’s known as atención presencial (face-to-face customer service) has to be offered without an appointment. 

The cita previa system has also been exploited by criminal groups who book up all appointments to then sell them at a premium to desperate citizens. 

“In-person customer service at public administrations has no substitute,” the minister stressed during a press conference.

“When someone wants to retire, what they want is to have a conversation with an official.”

The ministry is currently testing AI-powered systems which will help to guarantee this appointment-free customer service helps vulnerable groups in particular.

That’s not to say that the prior appointment system will completely disappear in Spain, as for example it is likely that for matters relating to the foreigners’ office (extranjería) it will still be necessary to get an appointment for residency and visa processes.

Prior appointments may also still be offered as a way of avoiding having to wait a long time to be seen during busy times, only that it will optional rather than mandatory as it has been for the past three years in most public buildings.

Other goals set by the former Social Security Minister include lowering the legal jargon used in official communications with the public so it can be more easily understood and hiring more and generally younger civil servants for an ageing and depleted workforce.

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HEALTH

EXPLAINED: Spain’s plan to stop the privatisation of public healthcare

Spain’s Health Ministry has announced a new plan aimed at protecting the country's much-loved public healthcare system from its increasing privatisation.

EXPLAINED: Spain's plan to stop the privatisation of public healthcare

In 1997, at the time when former Popular Party leader José María Aznar was Prime Minister of Spain, a law was introduced allowing public health – la sanidad pública in Spanish – to be managed privately.

According to the Health Ministry, this opened the door to a model that has caused “undesirable” consequences in the healthcare system for the past 25 years.

Critics of the privatisation of Spain’s public healthcare argue that it leads to worse quality care for patients, more avoidable deaths, diminished rights for health staff and an overall attitude of putting profits before people, negative consequences that have occurred in the UK since the increased privatisation of the NHS, a 2022 study found

Companies such as Grupo Quirón, Hospiten, HM Hospitales, Ribera Salud and Vithas Sanidad have made millions if not billions by winning government tenders that outsourced healthcare to them.

On May 13th 2024, Spanish Health Minister Mónica García took the first steps to try and rectify this by approving a new law on public management and integrity of the National Health System, which was published for public consultation.

The document sets out the ministry’s intentions to limit “the management of public health services by private for-profit entities” and facilitate “the reversal” of the privatisations that are underway.

It also aims to improve the “transparency, auditing and accountability” in the system that already exists.

The Ministry believes that this model “has not led to an improvement in the health of the population, but rather to the obscene profits of some companies”. 

For this reason, the left-wing Sumar politician wants to “shelve the 1997 law” and “put a stop to the incessant profit” private companies are making from the public health system. 

The Federation of Associations in Defence of Public Health welcomed the news, although they remained sceptical about the way in which the measures would be carried out and how successful they would be.

According to its president, Marciano Sánchez-Bayle, they had already been disappointed with the health law from the previous Ministry under Carolina Darias.

President of the Health Economics Association Anna García-Altés explained: “It is complex to make certain changes to a law. The situation differs quite a bit depending on the region.” She warned, however, that the law change could get quite “messy”.

The Institute for the Development and Integration of Health (IDIS), which brings together private sector companies, had several reservations about the new plan arguing that it would cause “problems for accessibility and care for users of the National Health System who already endure obscene waiting times”.

READ MORE: Waiting lists in Spanish healthcare system hit record levels

“Limiting public-private collaboration in healthcare for ideological reasons, would only generate an increase in health problems for patients,” they concluded.

The way the current model works is that the government pays private healthcare for the referral of surgeries, tests and consultations with specialists. Of the 438 private hospitals operating in Spain, there are more who negotiate with the public system than those that do not (172 compared with 162).

On average, one out of every ten euros of public health spending goes to the private sector, according to the latest data available for 2022. This amount has grown by 17 percent since 2018.

However, the situation is different in different regions across Spain. In Catalonia for example, this figure now exceeds 22 percent, while in Madrid, it’s just 12 percent, according to the Private Health Sector Observatory 2024 published by IDIS.

Between 2021 and 2022, Madrid was the region that increased spending on private healthcare the most (0.7 percent), coinciding with the governance of right-wing leader Isabel Díaz Ayuso, followed by Andalusia (0.6 percent).  

READ MORE: Mass protest demands better healthcare in Madrid

Two years ago, Andalusia signed a new agreement with a chain of private clinics that would help out the public system over the next five years.

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