GP's are not common in Spain and the GP (médico de familia, médico de cabecera) doesn't play such an important role as in the UK.

GP surgeries are known in Spain as CAP (Centro Ambulatorio Público) or Centro Médico. A CAP is intended for patients with national health insurance (Seguridad Social). A Centro Médico serves the privately insured. Some Centro Médico's also offer services to patients with Seguridad Social. It is mostly general doctors that work there.

Larger CAP’s en Centros Médicos exist with more facilities. They're often actually well equipped small clinics with a laboratory, x-ray machine etc. Medical specialists may be available by appointment. Depending on the centre, 12 or 24 hour medical assistance may be offered. However for emergency assistance in the evenings or at night it's advisable to go to the accident and emergency department of a hospital as these are open 24 hours per day.

English doctors work in a number of places in Spain, for example in the Costa Brava.

The chemist supplies all sorts of medicine. When paying yourself, many medicines are available without a prescription.

In general terms, Spanish doctors readily prescribe medicines, notably antibiotics and symptom repressing medicines (Ibuprofen, Voltaren, Naproxen), though this tendency is slowly changing. If you want to know if it's really necessary you can usually discuss this with the doctor. If you're still unsure you can always make contact with us.

In life threatening emergency situations it's best to go to a public hospital. In Barcelona they are: Hospital Vall d’Hebron, Hospital Clínic, Hospital Bellvitge en Hospital del Mar and for children the Sant Joan de Deus. The level of intensive care in public hospitals is good.

However, for less urgent conditions there are long waiting lists and little time for personal attention. The care for chronic diseases is generally only moderate.

Many medical specialists work until about 3 o'clock in the a public hospital. In the late afternoon from 4 until 8 they work elsewhere in a private clinic.

For regular medical care* you can also go to a private clinic. Most private clinics aren't only for patients who pay themselves, but also for those with insurance (both Spanish (mutua) and foreigners with private insurance).

The level of medical care in private clinics varies somewhat but attention and care are more personal and there are no waiting lists. Clinics are often specialised in certain kinds of treatment.

*meaning all medical care with the exception of cosmetic treatment and treatments for which special dispensation would be required before reimbursement is made (for example laser operations on the eyes, stomach reduction etc.).

• Are you only in the National Health Service?

Every resident in Spain has the right to receive medical treatment offered by the National Health Service (Seguridad Social), mostly in public hospitals. Some private clinics also serve the National Health Service. EU nationals should bring Form E111 with them to Spain, as it covers them for emergency medical treatment during the first 3 months of their stay. For further details on the European Health Insurance Card (EHIC) see http://www.dh.gov.uk/.



• Do you have additional private medical insurance in your own country?

Normally medical costs are covered by foreign private insurance companies. Theoretically you could go to any private hospital as long as the medical help needed is not aesthetical. For high costs it's always sensible to consult your insurance company beforehand. If you're on holiday please read your policy carefully before leaving. In private hospitals you usually have to pay the costs yourself and the money is reimbursed from your insurance company. If you need an operation or treatment which is not an emergency, consult your company beforehand. They can sometimes arrange payment directly to the hospital.



• You have a Spanish private medical insurance (mutua)?

Spanish private medical insurance companies do have contracts with doctors and or hospitals. This means generally that you can only get treatment as a patient when your insurance company has a contract with your doctor or hospital. Some polices will reimburse money when you go to another doctor.

In principle that's not necessary. The technical level of medical care in Spain is good and in case of emergency you have no choice. If you're in Spain on vacation and become ill, make contact with your travel or health insurance company as soon as possible. If you live in Spain and speak good Spanish then you can probably achieve good communication with a doctor. If in doubt over the treatment, request more information from your doctor in England or ask us for a second opinion.

If a course of antibiotcs isn't really necessary, you shouldn't do it. But how do you know if they're needed? You can obviously ask your doctor. Probably they will be more quickly recommended in Spain than would be the case in England. Though doctors are becoming more cautious in prescribing antibiotics

If you do take antibiotics make sure you finish the whole course, even if you feel better before then. If not, there is a chance that the bacteria won't be completely killed. The bacteria then arms itself against that specific antibiotic and an antibiotic resistant bacteria is born. Possibly not dangerous for you, more so for someone with lower resistance.

Never use different antibiotics simultaneously, unless that is specifically prescribed by the doctor. Not only because the antibiotics can react with each other, but also because of the risks mentioned above.

Long term use of antibiotics has the disadvantage that also bacteria which properly belong in our bodies are also eliminated. This can lead to the growth of other bacteria and fungi. A fungal infection of the vagina (candidiasis) is a complaint that is often associated with long term antibiotic use.

Today that's still very difficult. There are some foreign health workers that are involved in this area. But because these are rarely supported by the Spanish gynaecologists the trend hasn't really got off the ground. Also maternity care at home is difficult to arrange.

Checks of mother and child are conducted by the gynaecologist themselves in Spain. The birth takes place in a hospital often still with a ruggeprik. Mother and child typically spend a week in hospital after the birth.

Vaccination and checks of the child are conducted by a paediatrician. You have to buy some vaccinations yourself from the chemist.

It's important to remember that paediatricians are used to dealing with sick children and thus in general are quicker to contemplate the existence of serious complaints. The most important consequence is that your child is likely to be hospitalised sooner.

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