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The Catalan Government guarantees primary healthcare to all immigrants registered for at least three months

The decision by Spanish Government to restrict access to the public healthcare system could leave 600,000 people in Catalonia (8% of the population) without primary and specialised medical attention. 180,000 of these people would be foreigners. The Catalan Minister for Health, Boi Ruiz, explained that the measure aims to guarantee the universal access to healthcare to all the population, independent of their legal status, but at the same time avoid healthcare tourism.


30 August 2012 11:20 PM



Barcelona (ACN).- The Catalan Public Healthcare System (CatSalut) will provide primary medical attention to all people living in Catalonia for at least three months and duly registered to the municipal population lists, including immigrants without their legal residence status. The Catalan Minister for Health, Boi Ruiz, explained this Thursday that the measure aims to guarantee the universal access to healthcare to all the population, independent of their legal status, but at the same time avoid healthcare tourism. Furthermore, the Catalan Healthcare System will attend all genuine emergencies, with no exceptions. The Spanish Government, run by the People\u2019s Party (PP), approved a decree restricting immigrants without legal residence access to primary and specialised healthcare if they do not pay substantial fees. The Catalan Government, run by the Centre-Right Catalan Nationalist Coalition (CiU), already announced it would guarantee universal access to healthcare, but had not announced the details until today. With the Spanish Government\u2019s decision, 600,000 people in Catalonia risk being left out of the public healthcare system, 180,000 being foreign nationals. The new regulation enters into force this Saturday September 1st. The Catalan Government, which exclusively manages healthcare in Catalonia, has guaranteed that for the first six months, everybody who already has a Catalan health card (7.6 million people in 2010) will still have access to the entire system, no matter their legal status.

Ruiz explained this Thursday how the new system will work from this Saturday for people without a health card and for everybody in six months time. Medical attention at the community health centres in Catalonia will only be for people registered at their town halls for at least three months, both nationals and foreigners, regardless whether they have legal residence or not. Furthermore, specialised attention will be for people living at least one year in Catalonia, although particular attention to AIDS/HIV and other infectious diseases will be provided. In addition, other exceptions may be included if authorised by doctor committees that will study each particular case. However, services will always be provided for children as well as in the case of emergencies and pregnancies, with no exceptions. For tourists, attention in emergencies will always be guaranteed and specialised treatments will be provided but the CatSalut will then pass the bill on to the public healthcare system of the person\u2019s country or to his or her private insurance, in the same way the European health card system currently works for the entire EU.

All the people having a Catalan health card will have access to the entire public system, including specialised treatment. This card will be given to the employed, independent workers, pensioners, registered unemployed, minors and people with revenues below 100,000 euros per year who have their legal residence in Spain and are Spanish, EU, European Economic Space or Swiss nationals. For immigrants from other countries, if they have legal residence status, they will have the card and therefore full access to the Catalan Healthcare System. In addition, the legal partners of the direct beneficiaries of the card will also have universal access, as well as former partners with compensatory pension, their sons or daughters below 26 years old, and their children above 26 years old and with a disability level above 65%. All pregnant women will have universal access, including birth and the post-birth period. In addition, some groups of people with a particular agreement with CatSalut, such as religious congregations or certain liberal professions, will also have universal access.

Therefore, those who could have been excluded from the system according to the Spanish Government\u2019s decision were people earning more than 100,000 euros per year and not contributing to the Social Security, those without a specific agreement with the CatSalut, and immigrants without their legal residence status, whether they are registered on town hall lists or not. The Catalan Government has foreseen exceptions to the Spanish Government decree to guarantee that irregular immigrants living in Catalonia are not left out of the system but to avoid healthcare tourism.

Therefore, all the immigrants living in Catalonia and registered on the town hall lists for more than a year will receive the Catalan Health Card and thus access to the entire universal system. Those being registered for a shorter period but for at least three months will be given a provisional document valid for one year giving them access to medical attention in primary healthcare centres as well as to the subsidies for prescribed drugs, emergency ambulances, and specific programmes for infectious diseases, such as AIDS/HIV, and vaccines. However, a doctors committee will allow exceptions based on particular cases to grant access to specialised treatments. After one year, they will have unrestricted access to the entire health care system. The measure will only be valid in Catalonia.

Asked about a potential \u201Cmagnetic effect\u201D concerning immigrants from other parts of Spain, Ruiz said they will deal with it. However, he doubted about the levels of such an effect, as \u201Creality is stubborn\u201D and the issue doesn\u2019t simply disappear by approving a decree. Therefore other Autonomous Communities will have to deal with the irregular immigrant situation as well, since \u201Caccess to healthcare is an individual right\u201D but it has a collective element to preserve the entire population\u2019s health. In fact, besides moral and ethical components, doctor associations have criticised the Spanish Government\u2019s decision as it puts at risk the entire population since infectious diseases do not care about people\u2019s legal status. In addition, they warned that not treating some pathologies in their early stages and waiting for them to turn into emergencies, besides being a medical problem and putting people\u2019s lives at risk, might turn into being more expensive for the public system, as treating emergencies is much more expensive than regular treatments.


  • A waiting room in the Catalan Healthcare System (by B. Cazorla)

  • A waiting room in the Catalan Healthcare System (by B. Cazorla)