# A word of warning to all the "I want to move to Spain" ers



## owdoggy

This is a story of a gay couple but if that upsets you then don’t worry it’s not a gay story, it’s a story about the idiosyncrasies of the Spanish health system in regard to people here with no family ……. and I think that probably will upset you.

Ron & Richard were friends of ours. They were a gay couple and had been together for 39 years. Now, whatever you think about the gay thing you must admire the longevity of the relationship. We used to meet them at the local bar and had many happy summer afternoons having a few drinks & a good chinwag.

Then Ron died. He had been diagnosed with a cancerous growth in his stomach. The operation was a complete success and the doctors were going to let him go home in a couple of days when he had a massive heart attack .

Richard was heartbroken and just caved in. Although he was quite a heavy drinker before all this happened he hit the booze big time. A combination of the drinking, malnutrition and severe depression had reduced him to a mentally shot skeleton of a man. 

Sue & I tried to look after him for the next few days but after finding him on the floor of his living room one morning in a very distressed state it became clear that he would need to go to hospital. An ambulance was called and that’s when it all started.

The staff at the local urgencias (A&E) just wanted to whack his fluid levels back up & send him home. Sue, a nurse of some 38 years, was close to killing two doctors and I was very close to stuffing the security guard’s firearm up where the sun don’t shine.

They brought him back home a day & half later but this was only after trying to dump him back home at quarter past midnight that same morning. They tried to ring us (we were the key holders) and seemed surprised that they didn’t get an answer!

Richard now has very expensive 24 hour private nursing care because there is nothing in place in the Spanish system that happens fast enough to cater for this situation & the reason is that the Spanish health service here is only geared up, however well, for the medical side of things. The typical extended Spanish family is expected to tend to anything else that the patient may need….. and there’s the rub. Most of us come over here to Spain wanting the good life but when things go wrong we have no family backup which, although is now a bit of an old fashioned view because our Spanish friends have told us that this is an increasing problem in modern day Spain for the indigenous people as well as immigrants, is presumed by the health service.

We are now wading through meetings with doctors, social services, liaison nurses (who apparently arrange transport, appointments etc.) and abogados to see what can be done for Richard ….. before the money runs out.

So when you think that coming over to Spain from the UK will be all roses…… just keep in mind that the health & social system is totally different …… and don’t upset your neighbours because when the brown sticky stuff hits the silver twirly thing they might be all you have.

Doggy


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## VFR

{and don’t upset your neighbours because when the brown sticky stuff hits the silver twirly thing they might be all you have.}



Ain't that a fact !


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## Chopera

Yup it's definitely worth pointing out that the Spanish health system provides a bed and medication but has no duty of personal attention. The upside is that everyone knows where they stand - so you don't get so many cases of patients suffering because families expect care that never arrives. And there is less of a sense of entitlement - people don't expect miracles from hospital staff, but rather members of the public are expected to take on extra responsibilities to look after their close friends and family. And if you find yourself on your own in later life then you should make your own arrangements. A line has to be drawn somewhere and to be frank that's where I'd draw it.


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## Lolito

Me being Spanish, I understand where you are coming from, however, here in Spain it has always been this way, you go to hospital and they look after you until you are well enough, then the family take over, we don't know other ways. 

Grandparents lived alone until they could not longer live on their own, and the children cared for them until they passed away. 

If someone does not have any family, then I believe it is up to that person to make arrangements for the future, although I have not come across people in this situation, (I know there are a few!). 

I think it gets much worse when you are in another country with no family, and it might be really horrid to be in that situation, but if it was me, I would have made arrangements beforehand, i.e. moving back to my country to be with family/friends. 

In the other hand, having lived in the UK for many years, I've come across lots of friends that were happy to put their 'parents/grandparents' in a home with the excuse they were busy and couldn't take care of them and visiting them once in a blue moon. I am generalising of course, but I do have come across this many times, I have worked for around 20 years in Old People's Homes and Day Care Centres in central London and have seen really bad things. 

I also think that in other countries, people do expect their elders to be cared by other people like Social Services, Supporting People Help, Sheltered Housing, etc, when in my view, it should be their families (if any) looking after them in the first place, unless of course, the situation is bad enough that they need professional care, respite, home help, etc.


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## Pesky Wesky

Lolito said:


> Me being Spanish, I understand where you are coming from, however, here in Spain it has always been this way, you go to hospital and they look after you until you are well enough, then the family take over, we don't know other ways.
> 
> Grandparents lived alone until they could not longer live on their own, and the children cared for them until they passed away.
> 
> If someone does not have any family, then I believe it is up to that person to make arrangements for the future, although I have not come across people in this situation, (I know there are a few!).
> 
> I think it gets much worse when you are in another country with no family, and it might be really horrid to be in that situation, but if it was me, I would have made arrangements beforehand, i.e. moving back to my country to be with family/friends.
> 
> In the other hand, having lived in the UK for many years, I've come across lots of friends that were happy to put their 'parents/grandparents' in a home with the excuse they were busy and couldn't take care of them and visiting them once in a blue moon. I am generalising of course, but I do have come across this many times, I have worked for around 20 years in Old People's Homes and Day Care Centres in central London and have seen really bad things.
> 
> I also think that in other countries, people do expect their elders to be cared by other people like Social Services, Supporting People Help, Sheltered Housing, etc, when in my view, it should be their families (if any) looking after them in the first place, unless of course, the situation is bad enough that they need professional care, respite, home help, etc.


You're right, people should make provision for their future - where possible. By the same token, I think a rich, developed country like Spain should also have a solid system in base for those that fall through the cracks, of which there are many, not a few. Maybe some just expect the state to look after them. Spanish people know that that's not going to happen, yet there are plenty of old people living in poor conditions. Poor salaries mean poor savings and poor pensions. Families with disabled members can also have tremendous financial problems. And, how many million people is it that now live in households where no one has a job, no one has unemployment benefit, where they are living off family, neighbours and charity????


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## Pesky Wesky

owdoggy said:


> This is a story of a gay couple but if that upsets you then don’t worry it’s not a gay story, it’s a story about the idiosyncrasies of the Spanish health system in regard to people here with no family ……. and I think that probably will upset you.


An eyeopener and one which people need to be aware of.
Thanks for posting.


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## Calas felices

It would appear that the situation amomgst Spanish families is getting worse as a number of them have had to move away from family or even abroad for work. Times change but Spain sometimes takes a bit of time to catch up.


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## mrypg9

It's something that we should indeed all be aware of. I can't see why anyone should be upset by the 'gay thing' these days, in my experience Spaniards are either amazing tolerant or amazing indifferent.
Civil Partners are covered as married couples under the health system although Sandra has her own seg.soc. number applied for as a separate individual - she's still waiting for her card after two and a half years and two applications but that's another issue.

My one short stay in urgencias was a good example of the sutuation described in the OP. Thankfully I could get on my feet and walk from the wheelchair ...but if I hadn't...well, I'm sure some kind person would have given me a push as most Spanish people are like that, kind, thoughtful and compassionate, as are others as exemplified by the actions of Owdoggy which go some way to restore your faith in the rest of humanity.
.


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## g4jnw

Very interesting thread, I worked in Montreal as a staff nurse in my early career and it was similar there but a good mix, family would come in to help the nurses feed etc but when the help wasn't there the state picked up the tab - best of both worlds but you did pay medicare, which is similar to the UK stamp. What has gone wrong is the publics expectation - I now work as a staff nurse in the NHS and relatives won't lift a finger, won't even give there loved ones a drink thats right in front of them - Here is the UK we should go back to basics - Yes i agree in the above statement that old people are quite often just pushed into care, as its the easiest thing to do, also as the younger generation gets older they think its the NORMAL thing to do - UK needs a cultural change - Spain needs to update but not take it as far as the UK - just my opinion.

Please note my flags show expat in Spain but just a potential expat!!


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## Madliz

I agree with all the above comments and it's a very educational and necessary thread for some. Unfortunately, I know the system here all too well having cared for my husband through 14 hospital admissions during his (unsuccessful) battle with cancer. As an example, food is brought in and put before the patient, full stop. If there is nobody accompanying the patient, if said patient is unable to feed himself, he does not eat. Also, there's more to life and personal care than eating, of course, if you get my drift.

I looked after my husband as I would have wanted to be looked after myself. The question then becomes, what happens to those left behind, if they do not have a fair number of very close friends and family? This is the side of Spain that people should consider very carefully while being seduced by 'A Place in the Sun'. If your significant other was no longer by your side, if you had to be hospitalised, who would stay in the room with you and be your bedpan monitor? Sorry to be blunt, but this is how it is.

The state health provision in Spain is widely praised, maybe because nurses are free to take good care of medical matters. Incidentally, hubby's care was in a private hospital, in case others think that makes a difference.


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## g4jnw

Madliz said:


> I agree with all the above comments and it's a very educational and necessary thread for some. Unfortunately, I know the system here all too well having cared for my husband through 14 hospital admissions during his (unsuccessful) battle with cancer. As an example, food is brought in and put before the patient, full stop. If there is nobody accompanying the patient, if said patient is unable to feed himself, he does not eat. Also, there's more to life and personal care than eating, of course, if you get my drift.
> 
> I looked after my husband as I would have wanted to be looked after myself. The question then becomes, what happens to those left behind, if they do not have a fair number of very close friends and family? This is the side of Spain that people should consider very carefully while being seduced by 'A Place in the Sun'. If your significant other was no longer by your side, if you had to be hospitalised, who would stay in the room with you and be your bedpan monitor? Sorry to be blunt, but this is how it is.
> 
> The state health provision in Spain is widely praised, maybe because nurses are free to take good care of medical matters. Incidentally, hubby's care was in a private hospital, in case others think that makes a difference.


Really sorry to hear about your husbands care, this does not happen everywhere and certainly wouldn't happen where i work, its down to individual managers to make sure it doesn't happen - I trained in the 60's so nearing retirement so perhaps am old school but if that were to happen in my hospital a i can assure you the dole cue would be increasing!!

I agree that the system is getting silly, with increased lifelong learning schemes and nurses are taken away from the duties they are supposed to do for paperwork - thats another argument and i hate that side of the job, i could go on, BUT its no excuse for neglect.

However there is nothing wrong with what i call a partnership between relatives and staff, as was stated earlier in the thread spanish families expect to help perhaps thats why spanish nurses have more time to do there job.

I watch with interest the reaction at the moment as spanish nurses are recruited to UK hospitals due to the training of nurses being eroded over the last decades - maybe we will get a good mix - time will tell (might improve my spanish at least!)


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## Madliz

g4jnw said:


> Really sorry to hear about your husbands care, this does not happen everywhere and certainly wouldn't happen where i work, its down to individual managers to make sure it doesn't happen - I trained in the 60's so nearing retirement so perhaps am old school but if that were to happen in my hospital a i can assure you the dole cue would be increasing!!
> 
> I agree that the system is getting silly, with increased lifelong learning schemes and nurses are taken away from the duties they are supposed to do for paperwork - thats another argument and i hate that side of the job, i could go on, BUT its no excuse for neglect.
> 
> However there is nothing wrong with what i call a partnership between relatives and staff, as was stated earlier in the thread spanish families expect to help perhaps thats why spanish nurses have more time to do there job.
> 
> I watch with interest the reaction at the moment as spanish nurses are recruited to UK hospitals due to the training of nurses being eroded over the last decades - maybe we will get a good mix - time will tell (might improve my spanish at least!)


Please don't misunderstand, I have no complaints about my husband's care whatsoever. The system here is the system here and the medical care was superb. I was merely reiterating the fact that nurses here are not expected to care for the patient's personal needs. Potential patients, that is, all of us, had better be prepared!


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## extranjero

Although Spanish families look after their own I wonder how they cope with double incontinence, dementia, especially at the aggressive stage?
Now that people move away to find work, there are less of the extended family around to care. Are things like incontinence pads etc available on prescription-the cost would be horrendous, how do people cope in the current economic climate.
I bet elderly care will be the big growth sector, residential, nursing homes sheltered housing etc.Looking at some of the horror stories of mis- management and maltreatment in the UK, there will have to be very strict legislation, rules and inspections when setting up this sort of facilty in Spain. I imagine that many ex pats will return to the UK not being able to afford this care.
There are various organisations near us which provide Help in the home and nursing care, but it is expensive, and I have heard of people being found in a state, unable to cope with toilet needs etc. If people wait until they are too frail or worn down to cope with packing up and moving back, who will help them?
It's time to think about it now! If you are very wealthy, no problem, but if you are of modest means , like most, will your budget cope with your needs in a few years time?


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## Chopera

Agree with Madliz - I've had various family be taken in to hospital for various reasons, and I've never seen hospital staff feed a patient. They might with a child though, but I wouldn't put it to the test. I also have private medical cover but in my experience they offer no more care than the public hospitals. I use the public hospitals whenever I can. The other thing to be aware of is thieves - with so many strangers wandering around hospitals, it's easy for people to just walk in and steal anything unattended.


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## el pescador

*I imagine that many ex pats will return to the UK not being able to afford this care.*

the council have to provide care in the UK...if you cant afford it they will put you in a home .

If you can then they will wait for your funds to hit below the 23k mark and then if you get financial help they will look to reduce their liability by taking into account any property you own and forcing you to sell up to pay for nursing home care.

not nice but once that runs out they will put you in a nursing home which is cost effective if you aren't already in one.

Presume if you are living in spain and you are alone you might be better off finding out what you can and cant do.

AT the end of the day if you are elderly they aren't going to leave you on the streets if you do come back.


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## g4jnw

Looks like care is changing then in Spain, never thought of families not looking after their elderly or that they may have to move away for work, guess its a sign of the times - there maybe an opening for myself and my wife to work over there pre retirement then, can't believe that care companies haven't started opening care homes in Spain allied with Elderly Health Care insurance?

I've always thought basic nursing care is a human right whether it be provided by family or care companies - something to think about


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## g4jnw

el pescador said:


> *I imagine that many ex pats will return to the UK not being able to afford this care.*
> 
> the council have to provide care in the UK...if you cant afford it they will put you in a home .
> 
> If you can then they will wait for your funds to hit below the 23k mark and then if you get financial help they will look to reduce their liability by taking into account any property you own and forcing you to sell up to pay for nursing home care.
> 
> not nice but once that runs out they will put you in a nursing home which is cost effective if you aren't already in one.
> 
> Presume if you are living in spain and you are alone you might be better off finding out what you can and cant do.
> 
> AT the end of the day if you are elderly they aren't going to leave you on the streets if you do come back.


Planning is the key then, the 23k you talk about doesn't always happen, people have the sense these days to sign over property to there relatives and provided they do this through a solicitor and its 7 years before care is required then they are exempt from care costs, guess if spain were to take this up they would lose this loophole, of course you could always sell your property to a member of your family and this would make you exempt - I do wonder what would happen though if UK were to come out of the EEA what effect that would be on expats - thats the one that frightens me - ie; would my pension still rise with the cost of living?


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## baldilocks

In this village, there is a _Residencia_ (Old folks' home) for the older persons who are unable to look after themselves and have nobody to do it for them. It also provides a drop-in centre for the elderly where they can have a cup of coffee, sandwich etc. there are communal games,, cards, etc. They also do lunches to which non-elderly can go for a meal. The kitchen also prepares "meals on wheels" that go out to the elderly still living in their own homes but can't manage to do the cooking and we have a lot of those (the average age of decease is about 87).

Now quite who pays for all of this, IDK, it might be the Ayuntamiento, the Provincial government or the AC.


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## g4jnw

baldilocks said:


> In this village, there is a _Residencia_ (Old folks' home) for the older persons who are unable to look after themselves and have nobody to do it for them. It also provides a drop-in centre for the elderly where they can have a cup of coffee, sandwich etc. there are communal games,, cards, etc. They also do lunches to which non-elderly can go for a meal. The kitchen also prepares "meals on wheels" that go out to the elderly still living in their own homes but can't manage to do the cooking and we have a lot of those (the average age of decease is about 87).
> 
> Now quite who pays for all of this, IDK, it might be the Ayuntamiento, the Provincial government or the AC.


Sounds like you are in a great area


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## mrypg9

baldilocks said:


> In this village, there is a _Residencia_ (Old folks' home) for the older persons who are unable to look after themselves and have nobody to do it for them. It also provides a drop-in centre for the elderly where they can have a cup of coffee, sandwich etc. there are communal games,, cards, etc. They also do lunches to which non-elderly can go for a meal. The kitchen also prepares "meals on wheels" that go out to the elderly still living in their own homes but can't manage to do the cooking and we have a lot of those (the average age of decease is about 87).
> 
> Now quite who pays for all of this, IDK, it might be the Ayuntamiento, the Provincial government or the AC.


We have something similar. The Ayto funds ours, as well as the church and voluntary associations.


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## jojo

el pescador said:


> *
> 
> the council have to provide care in the UK...if you cant afford it they will put you in a home .
> 
> If you can then they will wait for your funds to hit below the 23k mark and then if you get financial help they will look to reduce their liability by taking into account any property you own and forcing you to sell up to pay for nursing home care.
> 
> not nice but once that runs out they will put you in a nursing home which is cost effective if you aren't already in one.
> 
> .*


*

I'm not sure thats quite how it happens in the UK???????????. That said, I fully support and expect to sell my house to pay for any care in might need when I'm old - I'm sure I'll need care, more than a house lol!!!!

Jo xxx*


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## mrypg9

jojo said:


> I'm not sure thats quite how it happens in the UK???????????. That said, I fully support and expect to sell my house to pay for any care in might need when I'm old - I'm sure I'll need care, more than a house lol!!!!
> 
> Jo xxx


I doubt whether local authorities are obliged to provide residential care for the elderly. The Housing Association of which I was Director had care homes for the elderly..but more applicants than places.

Tbh, I'm more worried about care for Azor and Xena if we both get mown down by a donkey or herd of goats or whatever..


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## gus-lopez

g4jnw said:


> Planning is the key then, the 23k you talk about doesn't always happen, people have the sense these days to sign over property to there relatives and provided they do this through a solicitor and its 7 years before care is required then they are exempt from care costs, guess if spain were to take this up they would lose this loophole, of course you could always sell your property to a member of your family and this would make you exempt - I do wonder what would happen though if UK were to come out of the EEA what effect that would be on expats - thats the one that frightens me - ie; would my pension still rise with the cost of living?


In the Uk you can't sign over the house to a family member as if they consider that you have done it to avoid paying care costs they can legally rescind the sale.


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## g4jnw

gus-lopez said:


> In the Uk you can't sign over the house to a family member as if they consider that you have done it to avoid paying care costs they can legally rescind the sale.


Sorry thats wrong a relative of mine did it, there is a proviso, you have to do it 7 years before you need care. Unfortunately she didn't survive and never went into care but it was all done legally and checked out with a solicitor. Anytime after that period and with knowledge that you are going into care can be seen as avoidance.


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## Lolito

Lots of homes for old people everywhere, I have relatives in OPH now and in the past, usually because they developed Dementia or Alzheimers (late stages) and the family members couldn't help anymore as they needed special 24 hours care. Usually Town Hall and their SS departments cover this. 

Unless you want to go private, of course. This can costs anything from 1400 to 2400 monhtly, it might be cheaper if the residencia is not in a big city, i.e. small villages, etc. Usually it is the person or their family who pays for it, i.e savings, selling their house, etc. But if they cannot cover the costs, then the public administration covers it mostly by sending you to a 'residencia concertada' (public). 

If the person does not have enough money, then though a few assessments, they decide whether they need 24 hours care in a home (residencia), or Day care centres or home help. It does not mean the person won't pay anything, they will pay whatever the administration decide they should pay, it might be 40 euros a month, or more, or even less. 

A few years ago, la ley de dependencia, said that people could go to a public/concertada residence even if they had enough money to pay for a private one, the queues are so long that some people might actually stay in private for a few months/years until a place becomes available in public/concertadas. 

My mum cared for my grandmother when she couldn't live on her own anymore, but later on, they opened a Residencia Concertada in her own village (a very small one), and she wanted to go there herself as most people in the residence were childhood friends, old neighbours, etc. and we really didn't want her to go, but she was very happy there with all her friends, going out for walks and visiting family members living in the same village, so she was like at home really. Mind you, she only enjoyed it for a couple of years. 

So, yes, you have all this in Spain too, but only as a last resort, family come first.


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## gus-lopez

Just as an aside .When my father went into a residencial home in the UK he was self funding. His state & private pensions weren't actually enough to pay the monthly bill & the shortfall was made up initially by savings.
As the person who had 'Enduring Power of Attorney ' for him it fell to me to balance the books.
He regularly used to ask me "how's the money going" , & I'd reply " all ok Dad, don't worry about it ". You can't tell someone in that position that there's a shortfall & you're throwing in the rest . No one told me until some years had passed that I could get the council to fund him , albeit we'd still have to pay due to the pensions, & then you find that for the same home, the same care , the council actually pay less ! Then it gets worse when you find out that as a council funded person they can't include all the pensions but must legally leave you with 'pocket money ' ?? Hows that work then ? The private payer is being shafted left right & centre! Not only paying for themselves but not even getting allowed any pocket money , & having to make up any shortfall ! 
I ended up reducing the bill to around 1k, but then had to sign to state that I , personally, was fully liable to pay the care fees in the event of his pensions disappearing ! 
The whole Private/council funding system is scandalous. In fact just writing this down makes me consider whether it is even legal to differentiate in such a way.
I feel an investigation coming on when these olives are picked !! :lol:


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## gus-lopez

g4jnw said:


> Sorry thats wrong a relative of mine did it, there is a proviso, you have to do it 7 years before you need care. Unfortunately she didn't survive and never went into care but it was all done legally and checked out with a solicitor. Anytime after that period and with knowledge that you are going into care can be seen as avoidance.


Yes if you do it long enough before although it must vary from area to area, as when we filled in the forms for my father ,in Devon in the late 90's, it actually said 
" have you owned a property in the last 6 months " ??? 
Even I couldn't believe the question was so lax.


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## g4jnw

gus-lopez said:


> Just as an aside .When my father went into a residencial home in the UK he was self funding. His state & private pensions weren't actually enough to pay the monthly bill & the shortfall was made up initially by savings.
> As the person who had 'Enduring Power of Attorney ' for him it fell to me to balance the books.
> He regularly used to ask me "how's the money going" , & I'd reply " all ok Dad, don't worry about it ". You can't tell someone in that position that there's a shortfall & you're throwing in the rest . No one told me until some years had passed that I could get the council to fund him , albeit we'd still have to pay due to the pensions, & then you find that for the same home, the same care , the council actually pay less ! Then it gets worse when you find out that as a council funded person they can't include all the pensions but must legally leave you with 'pocket money ' ?? Hows that work then ? The private payer is being shafted left right & centre! Not only paying for themselves but not even getting allowed any pocket money , & having to make up any shortfall !
> I ended up reducing the bill to around 1k, but then had to sign to state that I , personally, was fully liable to pay the care fees in the event of his pensions disappearing !
> The whole Private/council funding system is scandalous. In fact just writing this down makes me consider whether it is even legal to differentiate in such a way.
> I feel an investigation coming on when these olives are picked !! :lol:


Looks like since my relatives used the 7 year rule the rules may be changing now, there are new proposals there are some new fact sheets on this on age concern Care home fees | Paying for permanent residential care | Age UK They also talk about discretionary - so it depends which side of the bed the councillor gets out of - its a mine field in the uk now so it must be just the same in Spain

I find it really unfair for the elderly that have struggled to buy a house all there life and payed there taxes for the government to wave the wand and take away what they have - mind you its not the only changes happening is it?


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## jojo

g4jnw said:


> Sorry thats wrong a relative of mine did it, there is a proviso, you have to do it 7 years before you need care. Unfortunately she didn't survive and never went into care but it was all done legally and checked out with a solicitor. Anytime after that period and with knowledge that you are going into care can be seen as avoidance.


Quite right too IMO. My view may not be a popular one, but I dont see why family or anyone else (apart from a spouse/co-owner of the property) should receive any "inheritance" while their loved one is financially looked after by the NHS/government. 

Jo xxx


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## g4jnw

jojo said:


> Quite right too IMO. My view may not be a popular one, but I dont see why family or anyone else (apart from a spouse/co-owner of the property) should receive any "inheritance" while their loved one is financially looked after by the NHS/government.
> 
> Jo xxx


Thats why my wife and i propose to look after her Dad ourselves (we are both well qualified to do so and nothing would phase us, plus we could give him better care, rather than place him in a money grabbing institution)
Jo its not the NHS im talking about as care is free, its the wealthy care homes - our local one has an owner that drives a farrari and pays his eastern block workers less than minimum wage - now is that fair? (I realise that not all care home owners are rich but there are a few and that takes advantage of our system - I do hope that care review will change that too)


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## g4jnw

Just to go back to the original thread
*quote; So when you think that coming over to Spain from the UK will be all roses*

It aint a bed of roses in the uk either!!


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## baldilocks

g4jnw said:


> Just to go back to the original thread
> *quote; So when you think that coming over to Spain from the UK will be all roses*
> 
> It aint a bed of roses in the uk either!!


and with idiots like IDs in charge of DWP there are plenty of thorns to catch you as well.


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## gus-lopez

I agree as well but what I find galling is that due to incorrect info from the social security from the outset with my father , we ended up paying far more than was necessary over the years & a staggering amount for me personally that even my wife doesn't know the true sum. 
back to topic . we also have council funded residencial homes. the main one in town though always strikes me as peculiar for elderly people in that it is 10 storeys tall ! I hope there's a lift.
we also have similar to UK district nurses making home visits as I am occasionally accosted ,when out the front, by these ladies with there patient lists asking where the addresses are !


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## el pescador

jojo said:


> I'm not sure thats quite how it happens in the UK???????????. That said, I fully support and expect to sell my house to pay for any care in might need when I'm old - I'm sure I'll need care, more than a house lol!!!!
> 
> Jo xxx


I think every council is different and maybe its just mine that explained this to me.


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## GUAPACHICA

jojo said:


> Quite right too IMO. My view may not be a popular one, but I dont see why family or anyone else (apart from a spouse/co-owner of the property) should receive any "inheritance" while their loved one is financially looked after by the NHS/government.
> 
> Jo xxx


Hi - I disagree, totally! The answer to your '_Why._.?' is that, presumably, just like members of my own family in the UK, those 'loved ones' have worked incredibly hard all their lives,in real jobs - thus rendering themselves liable for taxes, also paid throughout their working lives! Then, of course, they've paid into the Social Security system throughout their lives! Until recently, house ownership in the UK was known to be one of the very few ways in which a family, without independent means, could hope to acquire an asset of significant financial value, which could be bequeathed to the subsequent generation. Now, even house ownership is an impossible dream for many - even working professionals! The current 'Help to Buy' scheme is supposed to last just three years...

Of course, I wouldn't expect any of the current Govt.'s crop of Public school educated, Trust -fund recipient Ministers to be sympathetic to my viewpoint - but, as former Tory Prime Minister John Major has just made abundantly and publicly clear, the UK is absolutely not a country in which fairness, equality of opportunity or justice might be expected! I doubt, very much, whether that is _'News_' to most of us Brits - wherever we live...!

Saludos,
GC.


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## jojo

GUAPACHICA said:


> Hi - I disagree, totally! The answer to your '_Why._.?' is that, presumably, just like members of my own family in the UK, those 'loved ones' have worked incredibly hard all their lives,in real jobs - thus rendering themselves liable for taxes, also paid throughout their working lives! Then, of course, they've paid into the Social Security system throughout their lives! Until recently, house ownership in the UK was known to be one of the very few ways in which a family, without independent means, could hope to acquire an asset of significant financial value, which could be bequeathed to the subsequent generation. Now, even house ownership is an impossible dream for many - even working professionals! The current 'Help to Buy' scheme is supposed to last just three years...
> 
> Of course, I wouldn't expect any of the current Govt.'s crop of Public school educated, Trust -fund recipient Ministers to be sympathetic to my viewpoint - but, as former Tory Prime Minister John Major has just made abundantly and publicly clear, the UK is absolutely not a country in which fairness, equality of opportunity or justice might be expected! I doubt, very much, whether that is _'News_' to most of us Brits - wherever we live...!
> 
> Saludos,
> GC.


I hope when my/our time comes to have to go into care (personally I hope I dont live long enough for that to happen), that because we worked hard and accrued a nice house, that it can be sold to ensure we get accommodation of our choice and arent in a situation whereby we're drawing finances from an already struggling system. You cant take it with you and my children, just like the children of those who dont have properties to inherit should, by then have made their own way in the world and arent sitting there waiting for us to die! 

I'm also a bit of a believer in looking after your own - I know its not easy, although I managed to do it for my parents and my father in law, while I had five young children and a full time job, we managed. Altho, cos pa-in-law suffered with dementia, we had to put him into a private nursing home in the end - and that took care of any inheritance, but so be it. He was able to go into one that was close by so we could visit him

Jo xxx!


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## gus-lopez

The problem is though that the people who worked, saved , did everything right are basically going to end up with nothing , when all they worked & strived for was to ensure a better life & future for their families so that they don't have to struggle as much as their parents did. 
My Father lost his Father to the effects of poison gas shortly after the 1st WW. My Grandmother & the 3 children were basically thrown out on the street & for a while relied on 'Parish relief'.
My Grandmother worked multiple jobs to get them back on there feet & it wasn't until my Father was approaching retirement that I fully appreciated how much it had affected him , probably being the eldest & only 8 when his father died.

I always used to think that money was 'tight' when I was young . We weren't poor but it didn't appear to me that we were far off ! :lol: I'm the youngest , by 10 years ( must have been an 'accident' ) & my late brother & my sister had left home by the time I was about 10 & I remember many times as a child the constant discussions/rows about money.
As I say it had affected him badly, although he never said, & he obviously had a deep fear & utter dread of it ever happening again, to the extent that he could not spend anything on anything that wasn't an absolute necessity. Yeras later his younger sister , my Aunt, actually confirmed it to me that it had affected him extremely badly to the extent that she considered it had made his life & existence extremely sad.
He changed when he reached retirement, as though he realised he had 'made it' ; the prospect of being thrown out on the street again was lifted. 
I doubt that he would understood the situation we have today.


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## jojo

I remember when my father in law finally had to go into a home. He kept saying he didn't want to use his savings - the GPs words stuck in my head "you saved for a rainy day didnt you. Well mr, ********, it's raining!!" and that kinda sums it up for me. It was his money, he saved and actually he was able to spend his last fee weeks in a beautiful place

Jo xxx


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## baldilocks

jojo said:


> I remember when my father in law finally had to go into a home. He kept saying he didn't want to use his savings - the GPs words stuck in my head "you saved for a rainy day didnt you. Well mr, ********, it's raining!!" and that kinda sums it up for me. It was his money, he saved and actually he was able to spend his last fee weeks in a beautiful place
> 
> Jo xxx


That GP needs to work on his bedside manner!


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## jojo

................. what also needs to be considered is what if people who own their own houses etc DONT have to contribute to their care?? Everyones NI payments would increase massively, which would/could cause an outcry from those who are destined to inherit nothing??? In their eyes, simply to allow others to become "rich"???????

So, it all needs careful thought. I know it seems unfair to a point, especially to the previous generation who were brought up to save, but like I say, we cant take it with us!

Jo xxx


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## jojo

baldilocks said:


> That GP needs to work on his bedside manner!


lol!! Actually he was lovely. Sadly, the GP (he'd been the familys GP forever) died soon after this, so we then got a new "modern thinking" chap - (but thats another story!). He did have a point tho

Jo xxx


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## mrypg9

GUAPACHICA said:


> Hi - I disagree, totally! The answer to your '_Why._.?' is that, presumably, just like members of my own family in the UK, those 'loved ones' have worked incredibly hard all their lives,in real jobs - thus rendering themselves liable for taxes, also paid throughout their working lives! Then, of course, they've paid into the Social Security system throughout their lives! Until recently, house ownership in the UK was known to be one of the very few ways in which a family, without independent means, could hope to acquire an asset of significant financial value, which could be bequeathed to the subsequent generation. Now, even house ownership is an impossible dream for many - even working professionals! The current 'Help to Buy' scheme is supposed to last just three years...
> 
> Of course, I wouldn't expect any of the current Govt.'s crop of Public school educated, Trust -fund recipient Ministers to be sympathetic to my viewpoint - but, as former Tory Prime Minister John Major has just made abundantly and publicly clear, the UK is absolutely not a country in which fairness, equality of opportunity or justice might be expected! I doubt, very much, whether that is _'News_' to most of us Brits - wherever we live...!
> 
> Saludos,
> GC.


I've got mixed feelings on this. Yes,I can see your point and it's true, when you add up the taxes and NI contributions you've paid throughout your working life, you could reasonably expect to be well cared for in your old age, especially if you have never drawn on those contributions for sick pay, dole or significant NHS usage.

But..the concept of a welfare state encompassing life from cradle to grave has become unaffordable. Our population is ageing and the number of people working to pay taxes to pay for welfare services is shrinking. The whole question of maintaining an elderly population with sufficient means to be able to lead dignified, comfortable lives, is an urgent one beyond and above party politics.

The state currently takes well over 50% of our income in taxes. We have little if any control over how our money is spent. Personally, I'm against having my hard- earned money being spent on pointless wars, renewing Trident, mis-directed overseas aid and similar things. If we kept more of our money perhaps many of us could make some provision for care in our old age.

I think the fact that for most people a house is the sole means available to make any future savings is one of the root causes of our social and economic problems. If people had other means of saving, such as being stakeholders in their workplaces, then huge amounts of capital could be released for other more productive purposes.

Lolito's post is instructive. The OPH he describes has strong local roots in a known community. I'm beginning to think that localism is also an important key to many problems. I think I'm turning into a social market Trotskyite!!


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## NickZ

jojo said:


> ................. what also needs to be considered is what if people who own their own houses etc DONT have to contribute to their care?? Everyones NI payments would increase massively, which would/could cause an outcry from those who are destined to inherit nothing??? In their eyes, simply to allow others to become "rich"???????
> 
> So, it all needs careful thought. I know it seems unfair to a point, especially to the previous generation who were brought up to save, but like I say, we cant take it with us!
> 
> Jo xxx


Didn't we discuss this last year?

All you're proposing is that the group in the middle pays for everybody.

The poor are poor and have nothing to sell.

The rich aren't going to spend a moment in public care. 

The only people who end up paying would be those that aren't quite rich enough for a posh private centre.


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## jojo

NickZ said:


> Didn't we discuss this last year?
> 
> All you're proposing is that the group in the middle pays for everybody.
> 
> The poor are poor and have nothing to sell.
> 
> The rich aren't going to spend a moment in public care.
> 
> The only people who end up paying would be those that aren't quite rich enough for a posh private centre.


That'll be me then!!

Jo xxx


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## baldilocks

jojo said:


> That'll be me then!!
> 
> Jo xxx


"The rich aren't going to spend a moment in public care." see as your other half is living off them.


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## jojo

baldilocks said:


> "The rich aren't going to spend a moment in public care." see as your other half is living off them.


 Everyone is doing that one way or another

Jo xxx


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## Leper

Chopera said:


> Yup it's definitely worth pointing out that the Spanish health system provides a bed and medication but has no duty of personal attention. The upside is that everyone knows where they stand - so you don't get so many cases of patients suffering because families expect care that never arrives. And there is less of a sense of entitlement - people don't expect miracles from hospital staff, but rather members of the public are expected to take on extra responsibilities to look after their close friends and family. And if you find yourself on your own in later life then you should make your own arrangements. A line has to be drawn somewhere and to be frank that's where I'd draw it.


I was looking at Spain to where I could retire and live longer but Chopera has stopped me bigtime. I have never seen the inside of a Spanish hospital. But, let's say I am in hospital in Spain carrying a fairly serious illness . . .

Can you expand on the personal attention that is not given?

I, for one, could not tell you what entitlements I would receive outside of medical care if in a Spanish hospital bed now.

I have heard stories of expats in Spanish hospitals being treated charitably by Spaniards and I dismissed them as hearsay and I am now having second thoughts of moving to Spain for long periods. I have seen the inside of Irish hospitals where excellent treatment is received and I have seen Spanish nationals in the same hospitals given the same treatment medical and otherwise. 

If what Chopera is saying (and I have no reason to doubt) Spain is only one step above being a 3rd World Country.


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## jojo

Leper said:


> I was looking at Spain to where I could retire and live longer but Chopera has stopped me bigtime. I have never seen the inside of a Spanish hospital. But, let's say I am in hospital in Spain carrying a fairly serious illness . . .
> 
> Can you expand on the personal attention that is not given?
> 
> I, for one, could not tell you what entitlements I would receive outside of medical care if in a Spanish hospital bed now.
> 
> I have heard stories of expats in Spanish hospitals being treated charitably by Spaniards and I dismissed them as hearsay and I am now having second thoughts of moving to Spain for long periods. I have seen the inside of Irish hospitals where excellent treatment is received and I have seen Spanish nationals in the same hospitals given the same treatment medical and otherwise.
> 
> If what Chopera is saying (and I have no reason to doubt) Spain is only one step above being a 3rd World Country.



A few years ago, I used to work for an agency who put "carers" into hospitals to care for expats who had no relatives (the expats had to pay the agency, it wasnt a free service). I found that the nursing staff did most things - washing, changing sheets, dressing etc. But they didnt do things like shaving, feeding (altho they did provide the food), plumping up pillows, putting false teeth in/out, helping to the toilet, unless it needed more than one person (they certainly didnt help with the..... er... "wiping after!!), emptying catheter bags, changing conti sheets (altho they did do bed pans)!

But, as I say, that was a few years ago and I got the impression that it very much depended on the staff - some would help out of the kindness of their hearts, others felt it wasnt their job!

Jo xxx


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## xabiaxica

jojo said:


> A few years ago, I used to work for an agency who put "carers" into hospitals to care for expats who had no relatives (the expats had to pay the agency, it wasnt a free service). I found that the nursing staff did most things - washing, changing sheets, dressing etc. But they didnt do things like shaving, feeding (altho they did provide the food), plumping up pillows, putting false teeth in/out, helping to the toilet, emptying catheter bags (altho they did do bed pans)!
> 
> But, as I say, that was a few years ago and I got the impression that it very much depended on the staff - some would help out of the kindness of their hearts, others felt it wasnt their job!
> 
> Jo xxx


the nursing staff are definitely there to look after the _medical _side of nursing care

however - years ago when my husband had a short stay in hospital they understood that I had two small children & no other family here to help, so they did everything for him because they knew I couldn't be there all the time - I did do the washing/feeding stuff when I was there though


a couple of years ago my dad was in hospital here - our situation had changed - obviously my children are much older & my husband was also at home to be with them - so I was expected to be there all the time & do everything for him (food/water/meds/oxygen) - HE however didn't want me giving him a bed bath & changing his sheets & the staff respected that & did it for us

this summer my older daughter was in overnight & I stayed the entire time - my younger daughter stayed at friends - & I did everything for her - because I could & we were both comfortable with it


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## Alcalaina

Leper said:


> I was looking at Spain to where I could retire and live longer but Chopera has stopped me bigtime. I have never seen the inside of a Spanish hospital. But, let's say I am in hospital in Spain carrying a fairly serious illness . . .
> 
> Can you expand on the personal attention that is not given?
> 
> I, for one, could not tell you what entitlements I would receive outside of medical care if in a Spanish hospital bed now.
> 
> I have heard stories of expats in Spanish hospitals being treated charitably by Spaniards and I dismissed them as hearsay and I am now having second thoughts of moving to Spain for long periods. I have seen the inside of Irish hospitals where excellent treatment is received and I have seen Spanish nationals in the same hospitals given the same treatment medical and otherwise.
> 
> If what Chopera is saying (and I have no reason to doubt) Spain is only one step above being a 3rd World Country.



I don't think anyone is questioning the quality of the medical treatment. Spain is as good if not better than many countries in this respect and certainly not "Third World". 

But there are differences in who is responsible for personal care, as described by Jo. It isn't the nurse's job to shave or feed you, or wipe your *rse for that matter. It's important that anyone planning to move to Spain is aware of this.

Are there any insurance agencies who offer cover for personal care costs?


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## jojo

Alcalaina said:


> Are there any insurance agencies who offer cover for personal care costs?


A good question. The agency I worked for. as far as I know, werent paid by insurance companies?????? They were a rip off tho! They charged the patients €25 an hour!!!!! They paid staff like me €7 an hour - 9€ an hour for over night! and we had to sign to say that we wouldnt leave the agency and work for the patients privately!

Jo xxx


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## Madliz

It's three years since my last hospital stay, as a carer, but previous posters have described it how it is. As far as personal care went, staff would change the bed and wash the patient daily, as well as attend to all medical requirements. Everything else - tooth brushing, feeding, a***-wiping/nappy changing (yes, adults too), nose blowing, etc., had to be performed or assisted by the 'carer'. 

If you can imagine being confined to bed and, for instance, wanting your phone charger plugging in, or need to top up the TV card in reception, or fancy a snack, or cold drink, all these 'luxuries' are impossible without help, which does not come from the hospital staff.

When you think about it, why should medically trained staff, or other health service employees, have to do these things?

I do, however, think there should be some system for those without support, apart from agencies with their steep fees. I gather that some areas with plenty of expats have volunteer help, though I don't know how far this goes.

All this being said, I still think Spanish hospitals are superior to the NHS I last had experience of in 2000. My father had a stroke and before returning to Spain I asked to speak to a doctor to discuss his care. I was told that the doctor came on Wednesdays and I could see him then only. This was, of course, a Thursday.


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## Lolito

Here in Spain, whenever I go inside a Hospital, sometimes I feel like I am in a five stars hotel, all the shiny bits and the marble and the smell of 'real' coffee coming from the cafeteria.... 

While in the UK, I worked for a year as 'domestic assistant' and I visited quite a few hospitals and to be honest... they were erm... 'third country' hospitals, dirty mostly and not very nice. 

If I have to choose, having spent half my life there and half my life here, I would not hesitate choosing the hospitals in Spain. I think the doctor care here is much better and they are very professionals.


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## Lolito

...mind you... I have to add that mostly, the hospital I go frequently is the Clinica Universitaria de Pamplona, which is probably the best of one of the best in Spain, used by the Royal Family often enough. (Mainly because I am Pamplonica myself!).


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## jojo

Lolito said:


> Here in Spain, whenever I go inside a Hospital, sometimes I feel like I am in a five stars hotel, all the shiny bits and the marble and the smell of 'real' coffee coming from the cafeteria....
> 
> While in the UK, I worked for a year as 'domestic assistant' and I visited quite a few hospitals and to be honest... they were erm... 'third country' hospitals, dirty mostly and not very nice.
> 
> If I have to choose, having spent half my life there and half my life here, I would not hesitate choosing the hospitals in Spain. I think the doctor care here is much better and they are very professionals.



I totally agree!!!

Jo xxx


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## Calas felices

Of course, everyone has their own either horror or congratulatory story about Spanish Hospitals . Here is mine. My wife and I have recently spent some time in Gran Canaria. Due to the appalling condition of the pavements and roads there, she managed to trip and in the process dislocated her shoulder. There was a clinic nearby and since she was in great pain I took her there. The hotel had checked that I had the E111. As it happened it was private but I wasn't prepared to move her somewhere else given the pain she was in. We wasted about 30 minutes whilst it was sorted out how they were going to get their money. Eventually they accepted the Insurance Company and took her for X Ray - they resisted me going with her even though she speaks little Spanish and I could translate. The X Ray showed a dislocation and so an orthopaedic surgeon and an anaesthetist was found from somewhere (the surgeon had been running somewhere) and the shoulder was put back. Not with a block as is normal but with a GA. She was discharged after she had recovered from the anaesthetic. Not a word of Englsih was spoken to her by the nurse but she did spend a lot of time discussing her family with the radiologist. If I hadn't been there , there would have been little explanation of what was going on - the surgeon did speak good English though. She was sent home, her other injuries - scraped elbow , badly grazed knee were not detected or treated. No medication offered or prescribed. But heigh ho I did sign over a dozen forms on her behalf. Priorities???


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## xabiaxica

Calas felices said:


> Of course, everyone has their own either horror or congratulatory story about Spanish Hospitals . Here is mine. My wife and I have recently spent some time in Gran Canaria. Due to the appalling condition of the pavements and roads there, she managed to trip and in the process dislocated her shoulder. There was a clinic nearby and since she was in great pain I took her there. The hotel had checked that I had the E111. As it happened it was private but I wasn't prepared to move her somewhere else given the pain she was in. We wasted about 30 minutes whilst it was sorted out how they were going to get their money. Eventually they accepted the Insurance Company and took her for X Ray - they resisted me going with her even though she speaks little Spanish and I could translate. The X Ray showed a dislocation and so an orthopaedic surgeon and an anaesthetist was found from somewhere (the surgeon had been running somewhere) and the shoulder was put back. Not with a block as is normal but with a GA. She was discharged after she had recovered from the anaesthetic. Not a word of Englsih was spoken to her by the nurse but she did spend a lot of time discussing her family with the radiologist. If I hadn't been there , there would have been little explanation of what was going on - the surgeon did speak good English though. She was sent home, her other injuries - scraped elbow , badly grazed knee were not detected or treated. No medication offered or prescribed. But heigh ho I did sign over a dozen forms on her behalf. Priorities???



not pleasant to say the least & I hope your wife is recovering

but it was a _private _hospital - so can't be held to be an example of state healthcare in Spain

as for the lack of English being spoken - I know people here who have taken health insurance with 'english-speaking' companies - thinking that it means they'll 'english-speaking' doctors etc., only to discover that it just doesn't work that way - and often the 'service' isn't as good as state care

cancer patients in my area are frequently told by the private doctors that, if they can access state healthcare, then they should do so because they'll get swifter & better care


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## jojo

When I broke my leg in Mercadona, I had an ambulance take me to urgencia in malaga, they then X-rayed and plastered my leg and sent me home by taxi - all within two hours. They didnt even ask for proof of residencia, EHIC.... My only complaint was that the plaster was too tight and it was in the heat of the summer, so I couldnt use the pool!

A long story short - I was also seen in the UK a few weeks later (for the all clear on my leg) and was seen by a doctor who was foreign and spoke little english - fortunately the nurse in the room was the same nationality as him (Indian?? Pakistan??... not sure), but could speak english and translated for him/me!!!!! That whole visit took over 3 hours - mainly waiting, I was with the doctor for less than 10 minutes!

I have no moral to my story, other than the UK is painfully slow and language barriers exist everywhere!!!

Jo xxx


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## Lolito

The sooner people stop thinking that in Spain everybody should speak English, the better. 

I never expected anyone in the UK to speak Spanish to me, not doctors, not nurses, not anyone, why should they? 

pah!


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## mrypg9

Lolito said:


> The sooner people stop thinking that in Spain everybody should speak English, the better.
> 
> I never expected anyone in the UK to speak Spanish to me, not doctors, not nurses, not anyone, why should they?
> 
> pah!


Yet of course the most common complaint about immigrants to the UK is that they don't speak English!!

Very few British people can speak a foreign language- imo languages are not well taught in UK schools- and many can't speak or write their native language correctly.
Yet I remember a market trader in Morocco, a young man, speaking fluently to customers in French, German, English..and education for all is a goal still to be attained in parts of that country.

Our Moroccan gardener speaks Berber, Classical Arabic, French and Spanish all fluently and can make himself understood in English- I'm helping him learn. Yet I know of educated Brits, residents here for years, who speak no Spanish.

My Aunt has lived in an almost totally French town in Quebec since 1946 and cannot speak or understand a word of French. She seems to regard being addressed in French as some kind of personal affront.
The few Anglophones in the town are fast dying out - she is almost ninety- so she is becoming more and more isolated and more and more in need of support as her immediate family live in other parts of Canada..a very big country.
There is a lesson here for ageing non- Spanish-speaking Brits..see thread about care in old age.


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## baldilocks

As having personally experienced Spanish hospitals I feel qualified to add to this conversation.

As in UK much depends on the person you deal with be it nurse, doctor, ambulance crew, etc.

In UK I had been taken by ambulance a couple of times to hospital with chest pains, ECG, meds - discharge. Most hospital staff were quite pleasant except there is always one - a tyrannical petty Hitler who goes out of her way to make life unpleasant. I was dictating from a document and SWMBO was writing down - nothing stressful and quite relaxing (in fact the BP monitor kept flashing up "bradycardia" which is low pulse rate - so no stress). OK, the document was a police report in Spanish for an insurance claim for a client and I was translating it to English but as I said not stressful. La Führer went ballistic. Eventually had a bypass - no more rushes to hospital.

In Spain. Chest pains at 4 a.m. on Tuesday morning. At that time we did not have an ambulance on standby at our health centre and realising that it would take time to get one and for the driver to find our house in our narrow street, SWMBO took me to the hospital in Alcaudete 15 minutes away. I was whisked in on a trolley and they had me on a n ECG within minutes and was given an injection that stabilised me and left me pain-free within 10 minutes. Once they were certain that I was in no danger, they put me in an ambulance (on standby outside the door) with nurse and doctor to Jaén Provincial hospital. Entrance to the hospital is through X-Ray and they put you on the table and take piccies as a matter of course (none of that business of taking you to the ward then carting you to X-Ray. First into Observation where they keep you for about 12 hours while they assess you. In Observation there are three or four doctors all the time plus others who drift in and out as needed or they choose. There is also a team of nurses (I counted eight) one of which plays the "Hitler" role.

Bear in mind that apart from a very small drink when I took my night-time pills (10pm) on Monday I'd had nothing to eat or drink since 7pm. I was quite dry so when I was offered a sip of water to take some tablets, I wanted a drop more. La Führer was having nothing of that! OK, I know it was because I might have been operated on. SWMBO couldn't be there the whole time (and, as she found out visiting was for just 15 minutes at 1pm) because she was working.

Wednesday I was moved to the Cardiac ward - nice individual glass boxes and that afternoon, I was taken to theatre and had two stents inserted in the previous bypass. I wasn't allowed to move for fear of pulling the stitches in my groin. 

Thursday morning, moved to general ward (3 to a room), bed offered no support to middle of back, absolute agony but I did get lunch (awful!). By this time I was trying to mobilise and the day staff had no problem with this, as long as I took it easy. We had been told that there was no problem with visiting - the other two beds had family there 24hrs. When SWMBO came up at 10pm (she got a friend to come with her since driving at night is not her favourite) the night shift were on. Out of consideration for the other two old-boys who were settling to sleep, we moved out into the corridor where I could continue to mobilise (got me off that uncomfortable bed) and the night-shift Führer went spare and sent SWMBO out and me back to bed.

Fortunately 3pm on Friday I was discharged having survived my first hospital in-patient experience in Spain and a mild heart attack!


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## baldilocks

mrypg9 said:


> Yet of course the most common complaint about immigrants to the UK is that they don't speak English!!
> 
> Very few British people can speak a foreign language- imo languages are not well taught in UK schools- and many can't speak or write their native language correctly.
> Yet I remember a market trader in Morocco, a young man, speaking fluently to customers in French, German, English..and education for all is a goal still to be attained in parts of that country.
> 
> Our Moroccan gardener speaks Berber, Classical Arabic, French and Spanish all fluently and can make himself understood in English- I'm helping him learn. Yet I know of educated Brits, residents here for years, who speak no Spanish.
> 
> My Aunt has lived in an almost totally French town in Quebec since 1946 and cannot speak or understand a word of French. She seems to regard being addressed in French as some kind of personal affront.
> The few Anglophones in the town are fast dying out - she is almost ninety- so she is becoming more and more isolated and more and more in need of support as her immediate family live in other parts of Canada..a very big country.
> There is a lesson here for ageing non- Spanish-speaking Brits..see thread about care in old age.


We had a period in UK when we were importing Colombian arts and crafts and one of the places we sold them was in Portobello Road market. If I heard a foreign accent, I would ask where the person was from and would try to greet that person in their own language. I also used to take foreign currency, both of which helped sales.


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## Leper

Alcalaina said:


> I don't think anyone is questioning the quality of the medical treatment. Spain is as good if not better than many countries in this respect and certainly not "Third World".
> 
> But there are differences in who is responsible for personal care, as described by Jo. It isn't the nurse's job to shave or feed you, or wipe your *rse for that matter. It's important that anyone planning to move to Spain is aware of this.
> 
> Are there any insurance agencies who offer cover for personal care costs?


I never said that Spain was offering a Third World Hospital service. Furthermore, I dont expect a nurse to shave, feed, wipe etc. I recognize that they are medical people.

Please read my post. The original poster here pointed out some lackings in the Spanish hospital system. I am just trying to find out the reality of a hospital stay outside of the medical treatment whether it be for a few days or long term.


----------



## Chopera

Leper said:


> I was looking at Spain to where I could retire and live longer but Chopera has stopped me bigtime. I have never seen the inside of a Spanish hospital. But, let's say I am in hospital in Spain carrying a fairly serious illness . . .
> 
> Can you expand on the personal attention that is not given?
> 
> I, for one, could not tell you what entitlements I would receive outside of medical care if in a Spanish hospital bed now.
> 
> I have heard stories of expats in Spanish hospitals being treated charitably by Spaniards and I dismissed them as hearsay and I am now having second thoughts of moving to Spain for long periods. I have seen the inside of Irish hospitals where excellent treatment is received and I have seen Spanish nationals in the same hospitals given the same treatment medical and otherwise.
> 
> If what Chopera is saying (and I have no reason to doubt) Spain is only one step above being a 3rd World Country.


It's hard for me to say what personal attention is not given because whenever a member of my family has been in hospital, there has always been someone with them 24/7. In my 10 years living in Spain I have had plenty of experience with family members and in-laws spending time in hospital and there is always someone with them. If you are working and an immediate family member goes into hospital then by law you are allowed 2 or 3 days off work to attend to them. It becomes a real problem if someone is in hospital for longer than a week - people then have to take holidays or unpaid leave. My 3 year old son has respiratory problems and might spend a week in hospital each year, connected to an oxygen supply, and I make sure I keep a week's holiday back each year just in case this happens.


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## extranjero

Hospitals in Spain have the equivalent of nursing auxiliaries/care assistants.
They make beds, collect specimens, deliver meals etc.I see no reason why they can't help more with personal care, feeding, toileting, especially for those who don't have anyone who can stay with them all the time. Time spent chatting at the nurses' station could be put to better use- checking on fluid balances, pressure area care(of which there is none!) , mobilising, or even just talking to patients. Spanish nursing care is very limited, it seems they don't take the needs into consideration. I bet not all Spanish patients have a loving, extended family spending 24/7 with them;what do they do? Some hospitals are a long journey away, and can be a daunting journey for a partner, frail, maybe can't drive, taxis very expensive etc. Food and fluids are a vital part of care and recovery, but there was no chart to record this when my husband was in hospital.
I wonder how Spanish nurses will get on in an British Hospital, having only dealt with the medical side of nursing;It seems odd that they will have to learn to care. Nursing is supposed to be centred on TOTAL patient care, not just medication and procedures.
Speaking as a former Nurse!


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## Chopera

To be fair the auxiliary nurses did help bathe my son when he was last in hospital, and they changed the sheets and performed those duties well. Also my son was connected to a monitor so the nurses could see if there was a problem with is breathing. But staff only came round to check up on him maybe every two or three hours. He had a double room to himself so if I wasn't there then there was nobody there during those periods. This seems to be part of the problem - I imagine in the UK he would have been on a childrens ward with a nurse being on duty at all times. But in the Spanish hospitals I have seem, long term patients have their own rooms, or at least share one, so even if they were obliged to, it would be quite hard for hospital staff to go round checking up on every patient.


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## Solwriter

I ended up spending over a week in a Spanish hospital after major surgery on my leg and hip following a serious accident.
The medical care I received was very good, but the actual patient care less so.

I was told in no uncertain terms that I should have had someone with me as a carer (I couldn't get out of bed for the first 3 days).
But my husband was the only one I could call on and he could only visit for a couple of hours a day, owing to the long drive and because we had several dogs (two of whom were new arrivals) that had to be fed, walked and cared for.

The hospital staff reaction to this depended (as Baldy has pointed out) on the staff on duty.
A small number of care assistants were happy enough to fetch my dinner tray or washing gear and call a nurse for me if required.
But others were not so happy. A lot of the time they ignored me. Others called me rude names in Spanish. Either the care assistants thought I would not understand them or they didn't care.

And it wasn't as if I asked for much - in fact I asked for as little as possible, knowing what the reaction might be.

In comparison, the care given by the doctors was very good, as was that given by the majority of the nursing staff.
I received regular pain meds and had regular obs done.

It was more the care assistants I had a problem with.

I was in a fair amount of pain and quite worried and depressed. Their attitude didn't help.

I now need a follow up operation to review and possibly replace the work done by the Spanish surgeons. Ideally it should be done again in Spain by the same orthopedic team.
But there is no way I want to spend any more time in a Spanish hospital.
Hence I'm in the UK permanently.


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## g4jnw

Solwriter said:


> I ended up spending over a week in a Spanish hospital after major surgery on my leg and hip following a serious accident.
> The medical care I received was very good, but the actual patient care less so.
> 
> I was told in no uncertain terms that I should have had someone with me as a carer (I couldn't get out of bed for the first 3 days).
> But my husband was the only one I could call on and he could only visit for a couple of hours a day, owing to the long drive and because we had several dogs (two of whom were new arrivals) that had to be fed, walked and cared for.
> 
> The hospital staff reaction to this depended (as Baldy has pointed out) on the staff on duty.
> A small number of care assistants were happy enough to fetch my dinner tray or washing gear and call a nurse for me if required.
> But others were not so happy. A lot of the time they ignored me. Others called me rude names in Spanish. Either the care assistants thought I would not understand them or they didn't care.
> 
> 
> And it wasn't as if I asked for much - in fact I asked for as little as possible, knowing what the reaction might be.
> 
> In comparison, the care given by the doctors was very good, as was that given by the majority of the nursing staff.
> I received regular pain meds and had regular obs done.
> 
> It was more the care assistants I had a problem with.
> 
> I was in a fair amount of pain and quite worried and depressed. Their attitude didn't help.
> 
> I now need a follow up operation to review and possibly replace the work done by the Spanish surgeons. Ideally it should be done again in Spain by the same orthopedic team.
> But there is no way I want to spend any more time in a Spanish hospital.
> Hence I'm in the UK permanently.


Sorry to hear about you needing a revision to the work that you had done in Spain, I work in Orthopaedics but it happens in the UK too, sometimes for no reason or blame to the original surgeon, it just happens.

Im starting to think that care in Spain is no better or worse than the UK, different hospitals different standards - blame is usually aimed at the management and so it should be as its they who set and maintain the standard of care - this applies to Spain as much as the UK.
Have heard from my son who works in Spain part of the year that some British people hop over to Gibraltar for care, even ones who have never been treated in Spanish hospitals! so it must be in their case perception rather than actual. Unfortunately i guess this would apply to Spanish hospitals too - we only hear the bad things, good things never make news. I said to one nurse who was going to quit - why are you leaving after one complaint - yes she did wrong and accepted it BUT she had dozens of letters of praise, everyone has a bad day - However some should never be in nursing - their the ones who don't care about complains and the ones who need to be weeded out.

As to the language barrier, it will always be there, whether it's here in the UK with Polish, Bulgarian, Pakistani, Indian etc or in Spain with English etc - it's no excuse for bad care and bad manners, many get by without being able to speak the language - Just think, I have a most wonderful nurse who is dumb, excellent at her job and the patients love her as do we all..


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## g4jnw

Leper said:


> I never said that Spain was offering a Third World Hospital service. Furthermore, I dont expect a nurse to shave, feed, wipe etc. I recognize that they are medical people.
> 
> Please read my post. The original poster here pointed out some lackings in the Spanish hospital system. I am just trying to find out the reality of a hospital stay outside of the medical treatment whether it be for a few days or long term.


I accepted that Nurses didn't feed or bathe patients and did some searching and it looks like its the norm, even Allianz have a paragraph in their healthcare in spain document "The biggest difference between the two is the role of the nurse. Spanish nurses are efficient and well-trained but they do not perform the way British nurses do; feeding and personal care in Spain are normally taken care of by the family of the patient."

Healthcare in Spain

As i have said in a previous posting, this is not unique to Spain, there are other countries that adopt this too.


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## baldilocks

and why should expensively trained nursing staff be used as maids and patient feeders, jobs which can easily be done by family members or non-nursing specialists? It could be that there is a case for a business opportunity for somebody on the forum to, instead of moaning about the perceived shortcomings of the Spanish system, start a patient caring company that will provide the feeding and *rse-wiping on behalf of family who are unable or unwilling to attend to the patient themselves.


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## g4jnw

baldilocks said:


> and why should expensively trained nursing staff be used as maids and patient feeders jobs which can easily be done by family members or non-nursing specialists? It could be that there is a case for a business opportunity for somebody on the forum to, instead of moaning about the perceived shortcomings of the Spanish system, start a patient caring company that will provide the feeding and *rse-wiping on behalf of family who are unable or unwilling to attend to the patient themselves.


Totally agree, good business plan.


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## extranjero

baldilocks said:


> and why should expensively trained nursing staff be used as maids and patient feeders, jobs which can easily be done by family members or non-nursing specialists? It could be that there is a case for a business opportunity for somebody on the forum to, instead of moaning about the perceived shortcomings of the Spanish system, start a patient caring company that will provide the feeding and *rse-wiping on behalf of family who are unable or unwilling to attend to the patient themselves.


A nurse is supposed to provide TOTAL nursing care-care of bodily functions, feeding etc is part of it as much as procedures, medication etc. Having a nursing degree doesn't mean that all the bum wiping is below them and should be left to the assistants! Seeing how well patients feed, observing pressure areas-it's part of the whole picture.
As for being difficult to keep an eye on patients because they are in rooms , it is not difficult.I worked in a private hospital, where every patient was in a single room, and I did my rounds when I was in charge. Nurses usually have a specific number of patients to care for.It's no more difficult than a ward.
The Spanish nurses are not trained in total patient care, more's the pity, and they have a very narrowed view-how can they attend to needs if they do not have the full picture? As nurses will not participate in full care, the assistants should do just that-assist!


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## g4jnw

extranjero said:


> A nurse is supposed to provide TOTAL nursing care-care of bodily functions, feeding etc is part of it as much as procedures, medication etc. Having a nursing degree doesn't mean that all the bum wiping is below them and should be left to the assistants! Seeing how well patients feed, observing pressure areas-it's part of the whole picture.
> As for being difficult to keep an eye on patients because they are in rooms , it is not difficult.I worked in a private hospital, where every patient was in a single room, and I did my rounds when I was in charge. Nurses usually have a specific number of patients to care for.It's no more difficult than a ward.
> The Spanish nurses are not trained in total patient care, more's the pity, and they have a very narrowed view-how can they attend to needs if they do not have the full picture? As nurses will not participate in full care, the assistants should do just that-assist!


The Nurses must have a similar training to the UK as our hospital trust is recruiting Spanish and Portuguese Registered Nurses, they must meet NMC (Nursing and Midwifery Council) standards or we wouldn't be allowed to use them - they will have to go through induction and part of that will show them what is expected (in the UK this includes what you call total care) they will sign a contract which will list their duties - if they don't they won't be employed. - Nursing assistants are not included in recruitment its only qualified staff, there is a shortfall of qualified nurses at the moment - this happens from time to time. Last time they were recruited from other countries, some stayed, some didn't.
Having said that i wouldn't mind seeing a contract from Spain just to compare - Personally i think its a cultural thing ie; relatives have always helped - this also happens in Italy and to some degree in Canada (On personal experience having worked there) not sure of other countries,


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## baldilocks

g4jnw said:


> The Nurses must have a similar training to the UK as our hospital trust is recruiting Spanish and Portuguese Registered Nurses, they must meet NMC (Nursing and Midwifery Council) standards or we wouldn't be allowed to use them - they will have to go through induction and part of that will show them what is expected (in the UK this includes what you call total care) they will sign a contract which will list their duties - if they don't they won't be employed. - Nursing assistants are not included in recruitment its only qualified staff, there is a shortfall of qualified nurses at the moment - this happens from time to time. Last time they were recruited from other countries, some stayed, some didn't.
> Having said that i wouldn't mind seeing a contract from Spain just to compare - Personally i think its a cultural thing ie; relatives have always helped - this also happens in Italy and to some degree in Canada (On personal experience having worked there) not sure of other countries,


The family things is generally much stronger in Southern European cultures anyway. Whenever there's work to be done, the whole family mucks in, some even coming from several hundred kilometres away to help, e.g. for matanza, olive picking, fruit picking, etc.


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## g4jnw

baldilocks said:


> The family things is generally much stronger in Southern European cultures anyway. Whenever there's work to be done, the whole family mucks in, some even coming from several hundred kilometres away to help, e.g. for matanza, olive picking, fruit picking, etc.


I respect the family ties in European culture, when i worked at Montreal General in the 70's I was looking after a man in his 70's who had had a stroke, was taken off a cargo ship and the whole family flew over from Italy to look after him, they literally moved in. It was lovely to see - quite different these days in the UK when relatives won't travel 30 miles - shame really - although having said that if my wife was ill i would do everything i could, not because i distrust in anyway her care but just because im old school.
I did this for my mother in law when she was dying in hospital, its to me a family duty.


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## gus-lopez

baldilocks said:


> The family things is generally much stronger in Southern European cultures anyway. Whenever there's work to be done, the whole family mucks in, some even coming from several hundred kilometres away to help, e.g. for matanza, olive picking, fruit picking, etc.


I could do with some family olive pickers at the moment.


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## baldilocks

g4jnw said:


> I respect the family ties in European culture, when i worked at Montreal General in the 70's I was looking after a man in his 70's who had had a stroke, was taken off a cargo ship and the whole family flew over from Italy to look after him, they literally moved in. It was lovely to see - quite different these days in the UK when relatives won't travel 30 miles - shame really - although having said that if my wife was ill i would do everything i could, not because i distrust in anyway her care but just because im old school.
> I did this for my mother in law when she was dying in hospital, its to me a family duty.


Yep, I took over general care of my previous wife right through to the end even when she had to go into hospital because she needed I/V meds - it's what you do when you love someone.


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## Chopera

baldilocks said:


> and why should expensively trained nursing staff be used as maids and patient feeders, jobs which can easily be done by family members or non-nursing specialists? It could be that there is a case for a business opportunity for somebody on the forum to, instead of moaning about the perceived shortcomings of the Spanish system, start a patient caring company that will provide the feeding and *rse-wiping on behalf of family who are unable or unwilling to attend to the patient themselves.


I agree completely. This is the type of thing I hinted at when I posted earlier that the line had to be drawn somewhere, and this is where I'd draw it. Nurses are specialists in administering medication, and monitoring patients' health, and it is not an efficient use of their skills for them to also be doing tasks that can be performed by family or less skilled people. You don't want to risk a patient's health because a nurse is busy feeding someone else.


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## Chopera

extranjero said:


> A nurse is supposed to provide TOTAL nursing care-care of bodily functions, feeding etc is part of it as much as procedures, medication etc. Having a nursing degree doesn't mean that all the bum wiping is below them and should be left to the assistants! Seeing how well patients feed, observing pressure areas-it's part of the whole picture.


Got a reference for that? Or are you just saying that because that's how nursing is perceived in the UK?



extranjero said:


> As for being difficult to keep an eye on patients because they are in rooms , it is not difficult.I worked in a private hospital, where every patient was in a single room, and I did my rounds when I was in charge. Nurses usually have a specific number of patients to care for.It's no more difficult than a ward.


Except that you can't be in every room at the same time



extranjero said:


> The Spanish nurses are not trained in total patient care, more's the pity, and they have a very narrowed view-how can they attend to needs if they do not have the full picture? As nurses will not participate in full care, the assistants should do just that-assist!


Sorry but you still haven't convinced me why all the tasks should be lumped onto one person rather than split between several people, leaving the nurses to concentrate on the specialist tasks. When it comes to patient safety I'd like the person who administers medication to be very good at that, and not have to worry about a load of things that could easily be done by other people.


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## extranjero

Chopera said:


> Got a reference for that? Or are you just saying that because that's how nursing is perceived in the UK?
> 
> 
> 
> Except that you can't be in every room at the same time
> 
> 
> 
> Sorry but you still haven't convinced me why all the tasks should be lumped onto one person rather than split between several people, leaving the nurses to concentrate on the specialist tasks. When it comes to patient safety I'd like the person who administers medication to be very good at that, and not have to worry about a load of things that could easily be done by other people.


My point of reference is myself and my nursing career. Every patient should have a care plan which takes into account every aspect of their care, physical and mental.I never said anywhere that all the tasks should be lumped onto one person-of course it should be a team effort but no patient care should be beneath even the highest trained staff, and there are times like staff shortages when the person in charge has to help out, as well as doing specialist tasks-I know-I've done it!
Nursing care is about seeing the patient as a whole, not a list of tasks.Nutrition, pressure area care etc, so called menial tasks are part of it.The person doing the medication will concentrate on that, and will not be mixing the job with anything else.
As for not being in every room at the same time, if you are on a large ward, you can't see or know everything that is going on either.That's why patients have the means to call a nurse.
Of course its good if the family can provide all the personal care, but not every family, even Spanish, can do it;Indeed while my husband was in hospital, a family employed a girl to sit with the father for 30 euros per night.
I was surprised when my neighbour had his hip replacement, and was given no instruction on mobilising, no physio, which is essential after this operation.Indeed, well meaning relatives can unintentionally cause dislocation when "helping"
Family help is one thing-leaving you to your own devices is another.


----------



## Chopera

extranjero said:


> My point of reference is myself and my nursing career. Every patient should have a care plan which takes into account every aspect of their care, physical and mental.I never said anywhere that all the tasks should be lumped onto one person-of course it should be a team effort but no patient care should be beneath even the highest trained staff, and there are times like staff shortages when the person in charge has to help out, as well as doing specialist tasks-I know-I've done it!
> Nursing care is about seeing the patient as a whole, not a list of tasks.Nutrition, pressure area care etc, so called menial tasks are part of it.The person doing the medication will concentrate on that, and will not be mixing the job with anything else.
> As for not being in every room at the same time, if you are on a large ward, you can't see or know everything that is going on either.That's why patients have the means to call a nurse.
> Of course its good if the family can provide all the personal care, but not every family, even Spanish, can do it;Indeed while my husband was in hospital, a family employed a girl to sit with the father for 30 euros per night.
> I was surprised when my neighbour had his hip replacement, and was given no instruction on mobilising, no physio, which is essential after this operation.Indeed, well meaning relatives can unintentionally cause dislocation when "helping"
> Family help is one thing-leaving you to your own devices is another.


It's a tricky one. I understand that a nurse should be prepared to go beyond the norm in order to care for their patients, but it really should be in exceptional circumstances. As soon as that is made explicit nurses are responsible for the "complete care" of patients there will be cases where they will be dragged away from their primary duties, if not overloaded, and perhaps even exploited. 

It sounds like your neighbour simply had bad (or non existent) medical advice. The family wouldn't be expected to help in that sense, unless they were trained. My father in law had pretty much everything wrong with him, including diabetes, which led to him having his toes amputated. To begin with a nurse attended to him, both in the hospital and when he was initially released, but eventually his wife was trained to treat what was left of his feet. I'm not sure what would have happened if she wasn't around though.


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## tobyo

an eye-opening thread and something I have thought about. I got to page 8 so forgive me if this was discussed after that but I wonder, if you'd be so kind, for those of you that live there, what arrangements have you made for care that you might need? I saw one question posed as to whether insurance covers personal care in the hospital but I didn't see if that was answered.

thank you.


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## tobyo

mrypg9 said:


> There is a lesson here for ageing non- Spanish-speaking Brits..see thread about care in old age.


is there a thread about care in old age? if so, can someone provide a link?

thanks much.


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## AllHeart

This thread is a real eye opener for me. Wow! Prior to joining this forum, I had read on many sites that healthcare is family oriented. But I had no idea this is what was meant. I have lived in Ontario since my family immigrated to Canada when I was a year old, so I can't speak for all of Canada here - mostly just Ontario. Family is often present in hospitals, but it's just for moral and emotional support. The care here seems to be more like in the UK, where it's a whole-body-mind approach. Here the medical necessities include that of feeding, toileting, bathing, routine monitoring of vital signs and IVs, administration of medications and so many other things that fall on the family in Spain. 

In fact, when I heard that medical care was family oriented in Spain, what I thought (until reading this thread) was that the family was kept closely informed of what the hospital staff was doing. 

The problem with this system in Ontario is that the financial cost to the public is absolutely massive, which you often talk about here in this thread. I do know that all of Canada is suffering because of this - not just Ontario. We simply can't afford this high-end care. We have a multi-tiered staff carrying out all these duties, all the way from doctors, to nurse practitioners, to registered nurses, to registered nurse assistants, to personal support workers, to volunteers. 

Because of the enormous costs, waiting lists for medical treatment are through the roof, and often people aren't treated. The wait times in Emergency Rooms are ghastly. So many people have to go to the States for treatment. Sometimes the government will pay for this treatment, or sometimes private insurance companies pay, or people will pay out of their own pocket. 

So there is a push for private healthcare in Canada, with the province of Quebec finally taking the lead. Some private healthcare groups have recently established in Ontario. So we are moving towards a two-tiered system of public healthcare and private healthcare. The biggest resistance comes from the idea that only the rich will get good healthcare and we will lose good healthcare workers to the private healthcare system. But the fact is, already we're losing lots of healthcare workers to the States and other countries because they get paid better and typically have better working conditions than here. 

I looked at the World Health Organization website for a comparison of Spain and Canada, and it shows in 2011 Canada spent 11.2% of their GDP on healthcare per capita, whereas Spain spent 9.4%. In case you want to see these and other stats, they're here:
Spain: WHO | Spain
Canada: WHO | Canada

So inasmuch as it is indeed shocking and saddening to hear your horrible stories about the healthcare in Spain, perhaps it is just as shocking and saddening as it is here, but for different reasons. Maybe the solution lies somewhere in the middle, meaning more government help in Spain and more family help in Ontario? 

One thing is for sure - I'm now even more eager to find my family in Spain before moving there.


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## g4jnw

AllHeart said:


> This thread is a real eye opener for me. Wow! Prior to joining this forum, I had read on many sites that healthcare is family oriented. But I had no idea this is what was meant. I have lived in Ontario since my family immigrated to Canada when I was a year old, so I can't speak for all of Canada here - mostly just Ontario. Family is often present in hospitals, but it's just for moral and emotional support. The care here seems to be more like in the UK, where it's a whole-body-mind approach. Here the medical necessities include that of feeding, toileting, bathing, routine monitoring of vital signs and IVs, administration of medications and so many other things that fall on the family in Spain.
> 
> In fact, when I heard that medical care was family oriented in Spain, what I thought (until reading this thread) was that the family was kept closely informed of what the hospital staff was doing.
> 
> The problem with this system in Ontario is that the financial cost to the public is absolutely massive, which you often talk about here in this thread. I do know that all of Canada is suffering because of this - not just Ontario. We simply can't afford this high-end care. We have a multi-tiered staff carrying out all these duties, all the way from doctors, to nurse practitioners, to registered nurses, to registered nurse assistants, to personal support workers, to volunteers.
> 
> Because of the enormous costs, waiting lists for medical treatment are through the roof, and often people aren't treated. The wait times in Emergency Rooms are ghastly. So many people have to go to the States for treatment. Sometimes the government will pay for this treatment, or sometimes private insurance companies pay, or people will pay out of their own pocket.
> 
> So there is a push for private healthcare in Canada, with the province of Quebec finally taking the lead. Some private healthcare groups have recently established in Ontario. So we are moving towards a two-tiered system of public healthcare and private healthcare. The biggest resistance comes from the idea that only the rich will get good healthcare and we will lose good healthcare workers to the private healthcare system. But the fact is, already we're losing lots of healthcare workers to the States and other countries because they get paid better and typically have better working conditions than here.
> 
> I looked at the World Health Organization website for a comparison of Spain and Canada, and it shows in 2011 Canada spent 11.2% of their GDP on healthcare per capita, whereas Spain spent 9.4%. In case you want to see these and other stats, they're here:
> Spain: WHO | Spain
> Canada: WHO | Canada
> 
> So inasmuch as it is indeed shocking and saddening to hear your horrible stories about the healthcare in Spain, perhaps it is just as shocking and saddening as it is here, but for different reasons. Maybe the solution lies somewhere in the middle, meaning more government help in Spain and more family help in Ontario?
> 
> One thing is for sure - I'm now even more eager to find my family in Spain before moving there.


Things seemed to have moved along since I lived in Montreal although it was just after I qualified as a Registered Nurse. At that time i thought it was a nice mix, family coming in to give intimate care (if they wished) There was a mix of communities in Montreal and quite a big Italian community, particularly the Italians liked to handle hands on care, which we respected. Medicare was in and working, particularly well I would say and not a big burden on peoples pay at that time. We as nurses did all care but at that time there was no registered Health Care Assistants, I think the UK will eventually go down the route of having registered health care assistants, at the moment they aren't registered. Personally I miss the Enrolled Nurses as they were the hands on nurses who were between the Registered Nurses and the nursing auxilliaries, so in effect we have lost a tier here in the UK. I believe some counties still have Enrolled Nurses. There is a heavy burden on health care worldwide due to the cost of technology and drugs, you would not believe the price of some of the drugs!!
I do wonder where health care will be in 20 years as i don't think the public can continue to support the growing cost, personally i think it will end up partly privatised.
As for Spain hmmm not sure whats likely to happen, quite possibly it will remain the same.


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## baldilocks

g4jnw said:


> Things seemed to have moved along since I lived in Montreal although it was just after I qualified as a Registered Nurse. At that time i thought it was a nice mix, family coming in to give intimate care (if they wished) There was a mix of communities in Montreal and quite a big Italian community, particularly the Italians liked to handle hands on care, which we respected. Medicare was in and working, particularly well I would say and not a big burden on peoples pay at that time. We as nurses did all care but at that time there was no registered Health Care Assistants, I think the UK will eventually go down the route of having registered health care assistants, at the moment they aren't registered. Personally I miss the Enrolled Nurses as they were the hands on nurses who were between the Registered Nurses and the nursing auxilliaries, so in effect we have lost a tier here in the UK. I believe some counties still have Enrolled Nurses. There is a heavy burden on health care worldwide due to the cost of technology and drugs, you would not believe the price of some of the drugs!!
> I do wonder where health care will be in 20 years as i don't think the public can continue to support the growing cost, personally i think it will end up partly privatised.
> As for Spain hmmm not sure whats likely to happen, quite possibly it will remain the same.


The problem in UK was the move towards elitism and the idea that everyone should have a degree and that it was wrong to expect people to go into employment with only a basic education. That attitude means that you end up with road-sweepers with a degree, often as not because there is no work for them with the useless degrees that they have. 

To my mind, assisted education (grants and other subsidies) should only be provided in those fields where the end result might be of assistance to the country (e.g. Mathematics, Engineering, Medicine, etc.) and other subjects (e.g. media studies, art, literature, etc.) should be self-funding. 

There is a girl in our village (daughter of the previous owners of this house) who has been subsidised by the state to get her degrees and now is living off her pensioner parents with qualifications in - archaeology with a specialism in Egyptology. Complete and utter waste of money. Since finishing her education (she is now 34) she has worked for one month (JUST one month) stacking shelves in Mercadona. She is no use domestically so does nothing to help her mother around the house, her parents have olives so there is a fair bit of work tending and picking them but she doesn't like doing that so always manages to find some reason to be absent at those times. Yes, she could get married and has been "engaged" for over 6 years and, until recently, her parents had never met him (he is in the GC) so there could be more to it than that.


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## NickZ

g4jnw said:


> I do wonder where health care will be in 20 years as i don't think the public can continue to support the growing cost, personally i think it will end up partly privatised.


What's the difference? The state is merely the sum of all the privates.

The US has the most privatised system and spends the most.

Then you have the actual long term economic issues. If the indivual person needs to pay then you're more likely to see people ignore small issues. Things that could be fixed with ease (and little cost) at an early stage end up costing much more later. Instead of saving money you end up with higher total costs.


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## baldilocks

AllHeart said:


> I looked at the World Health Organization website for a comparison of Spain and Canada, and it shows in 2011 Canada spent 11.2% of their GDP on healthcare per capita, whereas Spain spent 9.4%. In case you want to see these and other stats, they're here:
> Spain: WHO | Spain
> Canada: WHO | Canada
> 
> So inasmuch as it is indeed shocking and saddening to hear your horrible stories about the healthcare in Spain, perhaps it is just as shocking and saddening as it is here, but for different reasons. Maybe the solution lies somewhere in the middle, meaning more government help in Spain and more family help in Ontario?
> 
> One thing is for sure - I'm now even more eager to find my family in Spain before moving there.


I'm not sure that the % of GDP is a fair indication or comparison. UK for example spends 9.3% of GDP which is less than Spain but when you look at Doctors pay/remuneration, in the UK it is very high whereas in Spain the doctors are salaried and can be moved from location to location. In UK Dr's appointment times are often 10 minutes and if a Dr has to see 15 patients in a surgery session, he/she considers him/herself hard done by whereas in Spain the appointments ar 2-3 minutes and a Dr will often see 40 or more patients in a surgery session. In UK they are beset with achieving targets so during your 10 minute appointment, the Dr will waste time taking your BP and going through all sorts of other checks to meet a target whereas in Spain, the Dr will only start checking your BP if there is any cause for concern and get on with treating you or dealing with what your medical needs are within your allotted time of only two or three minutes. In UK your records are on cards and the health centre staff spend a lot of time keeping those records up to date, whereas in Spain the records are computerised and the Dr while you are there will update your records. The Spanish system is more efficient and less money wasted. Hence a lower demand on GDP.


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## xabiaxica

baldilocks said:


> I'm not sure that the % of GDP is a fair indication or comparison. UK for example spends 9.3% of GDP which is less than Spain but when you look at Doctors pay/remuneration, in the UK it is very high whereas in Spain the doctors are salaried and can be moved from location to location. In UK Dr's appointment times are often 10 minutes and if a Dr has to see 15 patients in a surgery session, he/she considers him/herself hard done by whereas in Spain the appointments ar* 2-3 minutes a*nd a Dr will often see 40 or more patients in a surgery session. In UK they are beset with achieving targets so during your 10 minute appointment, the Dr will waste time taking your BP and going through all sorts of other checks to meet a target whereas in Spain, the Dr will only start checking your BP if there is any cause for concern and get on with treating you or dealing with what your medical needs are within your allotted time of only two or three minutes. In UK your records are on cards and the health centre staff spend a lot of time keeping those records up to date, whereas in Spain the records are computerised and the Dr while you are there will update your records. The Spanish system is more efficient and less money wasted. Hence a lower demand on GDP.



really??

appointments at our surgery are 'timetabled' for 10 minutes with the family doctors, and 15 with the paediatrician 

of course sometimes they take more, and sometimes less

agree about the computerised system though - some of our GPs will even make your hospital/consultant appointment while you are sitting there - other less IT aware will send you to the receptionist - but it's all done while you're in the building - no waiting for the GP to write a letter to ask for you to go on a waiting list...


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## baldilocks

That WHO website throws up some interesting stats

Comparing Spain with Canada, UK, and USA - apart from Canada (only slightly better) you are far better off living in Spain with far better life expectancies which must say something about the healthiness of the country and the quality of the medical services and Spain has the lowest per capita expenditure on health


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## tobyo

tobyo said:


> for those of you that live there, what arrangements have you made for care that you might need? I saw one question posed as to whether insurance covers personal care in the hospital but I didn't see if that was answered.
> 
> thank you.


I'm going to repost as I'd really like to know what those of you already living in Spain are doing. perhaps my tiny comment was not seen..............thanks.


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## g4jnw

tobyo said:


> I'm going to repost as I'd really like to know what those of you already living in Spain are doing. perhaps my tiny comment was not seen..............thanks.


If I were you i would post a new thread as it will get lost in a large thread and its important to you.


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## tobyo

g4jnw said:


> If I were you i would post a new thread as it will get lost in a large thread and its important to you.


yea, I wondered about that. thanks


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## baldilocks

tobyo said:


> I'm going to repost as I'd really like to know what those of you already living in Spain are doing. perhaps my tiny comment was not seen..............thanks.


Re: insurance - haven't a clue. We don't have a problems with what's on offer in the health service. I've been an in-patient and the care was OK - not the Ritz but then I wouldn't expect it to be so. It's easier if you are fluent in Spanish but the norm is that family look after your domestic needs which is fine by 40+ million people who live in Spain. You can get insurance (for a price) for just about everything in this world so I guess you could get it for personal care in hospital although at what cost?

If you are in UK then family can contribute greatly to a patient's domestic needs (such as bringing in palatable foodstuffs, washing, frequent changes of clothing, etc.)


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## Chopera

baldilocks said:


> I'm not sure that the % of GDP is a fair indication or comparison. UK for example spends 9.3% of GDP which is less than Spain but when you look at Doctors pay/remuneration, in the UK it is very high whereas in Spain the doctors are salaried and can be moved from location to location. In UK Dr's appointment times are often 10 minutes and if a Dr has to see 15 patients in a surgery session, he/she considers him/herself hard done by whereas in Spain the appointments ar 2-3 minutes and a Dr will often see 40 or more patients in a surgery session. In UK they are beset with achieving targets so during your 10 minute appointment, the Dr will waste time taking your BP and going through all sorts of other checks to meet a target whereas in Spain, the Dr will only start checking your BP if there is any cause for concern and get on with treating you or dealing with what your medical needs are within your allotted time of only two or three minutes. In UK your records are on cards and the health centre staff spend a lot of time keeping those records up to date, whereas in Spain the records are computerised and the Dr while you are there will update your records. The Spanish system is more efficient and less money wasted. Hence a lower demand on GDP.


Yes that's pretty much our experience.


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## Chopera

tobyo said:


> an eye-opening thread and something I have thought about. I got to page 8 so forgive me if this was discussed after that but I wonder, if you'd be so kind, for those of you that live there, what arrangements have you made for care that you might need? I saw one question posed as to whether insurance covers personal care in the hospital but I didn't see if that was answered.
> 
> thank you.


I don't think private insurance will get you any extra care, unless it covers you for private hospitals that have the staff to provide that extra care. I assume they exist but whenever we've gone to private hospitals the care has been about the same as state hospitals. Private insurance may give you more care at home, although the Spanish state service will in certain cases send a nurse round regularly as well. However I wouldn't depend on them alone. In Madrid I have seen many older people being acompanied by what look like carers they have found themselves and employed directly. Possibly unqualified, but better than nothing.


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## AllHeart

Baldilocks, I agree that GDP spent on healthcare may not be a good indication of healthcare, especially as it relates to quality of healthcare. 

Docs and other healthcare providers here also have quotas. Healthcare has become like a processing factory. A typical doc will have to see 100 patients in a day! 

NickZ, it's so true when you say, "If the individual person needs to pay then you're more likely to see people ignore small issues." That's the old adage, "An ounce of prevention is worth a pound of cure." Lifestyle has so much to do with this equation, where a healthy lifestyle prevents the bulk of many diseases, yet a healthy lifestyle cannot be enforced on individuals. 



g4jnw said:


> There is a heavy burden on health care worldwide due to the cost of technology and drugs, you would not believe the price of some of the drugs!!


Rising prices of the high-quality technology and drugs is exactly the problem with healthcare. The debate of euthanasia is rising here in Canada, again with the province of Quebec in the lead. We've reached a critical moral point in the provision of healthcare. Quality of life: Should people be kept alive through severe suffering merely because it is medically possible? Cost to society: Should the exorbitant costs of healthcare be paid to keep people alive through severe suffering merely because it is medically possible? Of course the answers are typically not black and white, which is why there is debate.


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## baldilocks

Chopera said:


> I don't think private insurance will get you any extra care, unless it covers you for private hospitals that have the staff to provide that extra care. I assume they exist but whenever we've gone to private hospitals the care has been about the same as state hospitals. Private insurance may give you more care at home, although the Spanish state service will in certain cases send a nurse round regularly as well. However I wouldn't depend on them alone. In Madrid I have seen many older people being acompanied by what look like carers they have found themselves and employed directly. Possibly unqualified, but better than nothing.


There are a number of very caring 'carers' in the village many from South America - Venezuela, Colombia, Ecuador... They may be unofficial, unqualified and possibly working 'on the black' but there is no other employment for them and as far as we know they do a very good job and enable their charges to continue to live happily in their own homes. They ensure that their charges are well cared for, clean, well fed and get decent outdoor exercise at least twice a day (weather permitting). At least two of those that we know are taking private English lessons to try to improve their lot.

For those who get to the point that they are no longer able to live at home, there is also the Residencia where they also get good care.

I have no doubt that if one of the carers was free she would be content to go to take care of somebody in the hospital, next time I see one, I will ask her.


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## tobyo

thanks for the info baldilocks and Chopera. that helps a lot. appreciate it greatly.


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## kalohi

xabiachica said:


> really??
> 
> appointments at our surgery are 'timetabled' for 10 minutes with the family doctors, and 15 with the paediatrician
> 
> of course sometimes they take more, and sometimes less
> 
> agree about the computerised system though - some of our GPs will even make your hospital/consultant appointment while you are sitting there - other less IT aware will send you to the receptionist - but it's all done while you're in the building - no waiting for the GP to write a letter to ask for you to go on a waiting list...


At our health center all appointments are timetabled for 5 minutes - GP's and pediatricians alike. And considering they have 5-6 hours straight of back to back appointments they stick pretty much to those 5 minutes. Believe me they get right to the point: no chit-chat, no extra questions, no checking out the overall health of the patient, etc. And part of those 5 minutes is spent doing those IT chores you've mentioned, such as filling in the electronic prescription, adding to the patient's history or booking specialists' appointments - which leaves only 2 or 3 minutes for the patient, as somebody previously mentioned. I know the doctors do the best they can but the system isn't good.


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## gus-lopez

Yes it is quite common here that if family can't have someone at the bedside at all times then they'll employ someone to care fo them. 
As Baldilocks said, here is the same with it always being south Americans . They can also be seen frequently accompanying widow/widowers during the day around town giving help & support for those who would be unable to venture out on their own.
It is extremely common around here & it was also very noticeable in Murcia City, when I was there recently.
My neighbour used a South American lady for some 14 months to ensure his mother was cared for at night in the local hospital.
There are many advertisements in bars, shops, & on lamposts offering carers services.


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## kalohi

Chopera said:


> I don't think private insurance will get you any extra care, unless it covers you for private hospitals that have the staff to provide that extra care. I assume they exist but whenever we've gone to private hospitals the care has been about the same as state hospitals. Private insurance may give you more care at home, although the Spanish state service will in certain cases send a nurse round regularly as well. However I wouldn't depend on them alone. In Madrid I have seen many older people being acompanied by what look like carers they have found themselves and employed directly. Possibly unqualified, but better than nothing.


We have full private insurance through Adeslas (and previously with Caser, and before that with Sanitas), and none of them cover any extra personal care. Also, private hospitals don't have any more extra staff to look after patients than a state hospital has. In fact, since you always have your own private room when hospitalized in a private hospital, you are _really _on your own if you don't have any family there to help out. At least in a state hospital there are other patients and their families in the room with you, and my experience has been that they keep an eye on patients who are unaccompanied. 

Here in Seville many people also hire carers to provide care for older people or for family members who are hospitalized. They are usually from Latin America and most likely are unqualified and paid in black - but as you said it is better than nothing.


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## gus-lopez

kalohi said:


> At our health center all appointments are timetabled for 5 minutes - GP's and pediatricians alike. And considering they have 5-6 hours straight of back to back appointments they stick pretty much to those 5 minutes. Believe me they get right to the point: no chit-chat, no extra questions, no checking out the overall health of the patient, etc. And part of those 5 minutes is spent doing those IT chores you've mentioned, such as filling in the electronic prescription, adding to the patient's history or booking specialists' appointments - which leaves only 2 or 3 minutes for the patient, as somebody previously mentioned. I know the doctors do the best they can but the system isn't good.


Still 10 mins here & chit-chat. Especially if he wants info from you. lol
Everything is now able to be done on line . One thing though here , which I never noticed until recently ( not very observant ! lol) is that there are no children in the local consultorios, they all go to ones with childrens Doctors until teenagers. Where it is I've no idea but it's just adults in the local one.


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## Pesky Wesky

Here it used to be 3 mins for each patient which obviously left the system in chaos. It was to do with the number of doctors allotted to the fast growing population. Since I've been in this town the number of doctors has gone from approx five to approx twenty with the corresponding nurses and paediatricians. Now we have a new health centre (2 years old), much nicer receptionists , a lot more time for each appointment, and very little waiting time. In the past I had waited 45 mins, even an hour on one occasion with the doctor staying on after the cleaners had been round for the night.
The government tried to privatise the health centre, but all privatisation of hospitals etc has been put on hold (at least in Madrid) as doctors and other health workers have taken it to court.


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## kalohi

gus-lopez said:


> One thing though here , which I never noticed until recently ( not very observant ! lol) is that there are no children in the local consultorios, they all go to ones with childrens Doctors until teenagers. Where it is I've no idea but it's just adults in the local one.


Children are seen by pediatricians (and pediatric specialists) until they turn 14. In our health center the pediatricians are in a separate wing of the building so they are nowhere near the adults. In the health center in the town where we lived previously there were no pediatricians at all. We had to take our kids to the health center in a nearby town. It could be that your health center is like that.


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## baldilocks

Our village health centre is often crowded but not always with patients. It often serves as a chat room - it's warm and dry (a/c in the summer) so it's a good meeting place. 

The kids are seen in a separate section off the main area. Nurses and muestras, etc. are in a separate wing together with admin and Drs' restroom and this is where the out of hours staff (Dr, Nurse, ambulance driver) are also located.

On the upper floor is a social centre together with a theatre to accommodate about 250+


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## Pesky Wesky

Pesky Wesky said:


> Here it used to be 3 mins for each patient which obviously left the system in chaos. It was to do with the number of doctors allotted to the fast growing population. Since I've been in this town the number of doctors has gone from approx five to approx twenty with the corresponding nurses and paediatricians. Now we have a new health centre (2 years old), much nicer receptionists , a lot more time for each appointment, and very little waiting time. In the past I had waited 45 mins, even an hour on one occasion with the doctor staying on after the cleaners had been round for the night.
> The government tried to privatise the health centre, but all privatisation of hospitals etc has been put on hold (at least in Madrid) as doctors and other health workers have taken it to court.


Sorry, 19 years, not twenty


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## mrypg9

baldilocks said:


> Our village health centre is often crowded but not always with patients. It often serves as a chat room - it's warm and dry (a/c in the summer) so it's a good meeting place.
> 
> The kids are seen in a separate section off the main area. Nurses and muestras, etc. are in a separate wing together with admin and Drs' restroom and this is where the out of hours staff (Dr, Nurse, ambulance driver) are also located.
> 
> On the upper floor is a social centre together with a theatre to accommodate about 250+


I have made two Spanish friends through chatting whilst waiting in our village Consultorio.


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## baldilocks

mrypg9 said:


> I have made two Spanish friends through chatting whilst waiting in our village Consultorio.


Only two? - You are slipping!


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## campocoin

I think there are good and bad in all area's and in the UK as well as Spain, I broke my arm badly and had a stay in the hospital in Malaga and all I can say is they did a great job, I admit that I wasn't use to the system of the family looking after patient's but I got used to the system and think on the whole it is an excellent health care. My word of warning is be careful in all area’s be it health or buying a property, don't leave your brain in the UK


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