# Hospital care standards



## ChrisMcNab (Apr 29, 2012)

Hi All. My wife & I had originally considered moving to Spain (we're both late 60's & retired) but I'm now doubtful. We've looked at various places in Spain and in April we were staying in Guardamar to scout the area when I had an accident, fell down some stairs (sober!) and broke my arm. The ambulance medics wanted my EHIC which I produced & they took me to a local hospital. Believe it or not, I have never broken a bone previously so had no idea what to expect. When the hospital staff reset the bones in my arm they did so by clamping the upper arm and hauling on the hand without giving me any anaesthetic, which was, to say the least, painful. On my return to the UK I attended the fracture clinic at the local hospital and the staff there couldn't believe my story.

The point is, I'd watched a documentary a few months ago about the state of the pharmacies in Spain as they weren't being paid by central government so couldn't restock the drugs dispensed on prescription. Is it possible that Spanish hospitals have some anaesthetics but not enough and so reserve them for major procedures only? The thought of going through that process again is less than appealing.


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## VFR (Dec 23, 2009)

ChrisMcNab said:


> Hi All. My wife & I had originally considered moving to Spain (we're both late 60's & retired) but I'm now doubtful. We've looked at various places in Spain and in April we were staying in Guardamar to scout the area when I had an accident, fell down some stairs (sober!) and broke my arm. The ambulance medics wanted my EHIC which I produced & they took me to a local hospital. Believe it or not, I have never broken a bone previously so had no idea what to expect. When the hospital staff reset the bones in my arm they did so by clamping the upper arm and hauling on the hand without giving me any anaesthetic, which was, to say the least, painful. On my return to the UK I attended the fracture clinic at the local hospital and the staff there couldn't believe my story.
> 
> The point is, I'd watched a documentary a few months ago about the state of the pharmacies in Spain as they weren't being paid by central government so couldn't restock the drugs dispensed on prescription. Is it possible that Spanish hospitals have some anaesthetics but not enough and so reserve them for major procedures only? The thought of going through that process again is less than appealing.


Well Chris (spotted the last name) when I was in the SAS we never used any form of pain killer, still pull my teeth out with a pair of mole-grips to this day rather than visit the dentist.  (btw your books are crap)

BTW I have never had an issue at the Chemist, or know of anyone who has & the same applies to Hospitals / Medical center where we live.


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## ChrisMcNab (Apr 29, 2012)

playamonte said:


> Well Chris (spotted the last name) when I was in the SAS we never used any form of pain killer, still pull my teeth out with a pair of mole-grips to this day rather than visit the dentist.  (btw your books are crap)
> 
> BTW I have never had an issue at the Chemist, or know of anyone who has & the same applies to Hospitals / Medical center where we live.


Thanks for your comments - I'll let my cousin Andy have a copy & no doubt he'll call to see you for a chat 

The article was BBC News - Valencia: A Spanish city without medicine and in all seriousness it's worrying. At age 67 I'm generally healthy but have the fear of God in me should anything happen while I'm in Spain. I have no doubt that the nurses & doctors are just as professional as those in the UK but they can't work miracles.


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## jojo (Sep 20, 2007)

ChrisMcNab said:


> Thanks for your comments - I'll let my cousin Andy have a copy & no doubt he'll call to see you for a chat
> 
> The article was BBC News - Valencia: A Spanish city without medicine and in all seriousness it's worrying. At age 67 I'm generally healthy but have the fear of God in me should anything happen while I'm in Spain. I have no doubt that the nurses & doctors are just as professional as those in the UK but they can't work miracles.



I broke my leg in Spain and my treatment was second to none. In Spain the treatment is very much a "no nonsense" approach - which I prefer! None of the PC, sympathetic softly softly approach you get in the UK !. There was no wait (unlike a friend of mine who broke her leg in the UK a couple of months ago - she was left waiting in A&E for 6 hours and without pain killers), I went straight in and was xrayed immediately. I didnt have pain killers while they put it back into position because they said it would delay the treatment and to be honest, it was such a relief to be treated, a few more minutes of pain didnt matter. That said, they put the plaster caste on too tightly, so I ended up cutting it off myself and going to a private hospital and getting a removable splint a few days later. 

So for me I'd sooner be in spain - of course the recession is taking its toll - but then it is in the UK too. The NHS is a complete shambles from top to bottom right now.

Jo xxx


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## mrypg9 (Apr 26, 2008)

ChrisMcNab said:


> Thanks for your comments - I'll let my cousin Andy have a copy & no doubt he'll call to see you for a chat
> 
> The article was BBC News - Valencia: A Spanish city without medicine and in all seriousness it's worrying. At age 67 I'm generally healthy but have the fear of God in me should anything happen while I'm in Spain. I have no doubt that the nurses & doctors are just as professional as those in the UK but they can't work miracles.


Thanks to a free check-up I was diagnosed with a serious heart condition of which I was totally unaware. I have never been ill in my life....
The treatment I have received at the hospital, GP surgery and pharmacy has been excellent.

Two years ago I had a tiny nasty thing on my left index finger. I thought it was unimportant and even asked the vet at our dog refuge to deal with it. But the GP sent me to the hospital for an XRay, a biopsy and finally for an op!

So healthcare here in Andalucia is very good indeed...but that is my limited experience.


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## kalohi (May 6, 2012)

A couple of years ago I had 2 lithotripsies done here in Spain (kidney stones blasted with sound waves) - once at a private hospital and once at a public one. At the private hospital I was completely sedated (unconscious basically), which is common procedure from what I've read online. But at the public hospital I was given no sedation at all. Needless to say it was quite painful. Because I told the technician once they started that they had forgotten the sedation and I needed it they wrote in my record that I was an "uncooperative patient". Hmmph. No, I was not uncooperative, I was just not expecting the pain, especially considering I had asked the social security urologist if I would be sedated and he said yes.

Now I have a colonoscopy coming up and I'm wondering if they'll give me sedation for that (I was told I'd get it) or if they'll expect me to grin and bear it. I'm not looking forward to finding out. 

I don't think it is a lack of anesthesia causing these situations. I think it's how they keep costs down. No anesthesia means no anesthesiologist and no post-procedure recovery/nursing care. After my private hospital lithotripsy I spent several hours being monitored in post-op. After my social security lithotripsy I literally stood up from the table and walked out the door.


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## JoCatalunya (Mar 16, 2011)

The simplest answer is private medical insurance, I have had pretty bad to mediocre treatment from the public doctors/hospitals, private has been better.

I am not sure if your wife and your age will affect the purchase of medical insurance but you could perhaps have a look online to see what is being offered and by whom.


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## Pesky Wesky (May 10, 2009)

ChrisMcNab said:


> Thanks for your comments - I'll let my cousin Andy have a copy & no doubt he'll call to see you for a chat
> 
> The article was BBC News - Valencia: A Spanish city without medicine and in all seriousness it's worrying. At age 67 I'm generally healthy but have the fear of God in me should anything happen while I'm in Spain. I have no doubt that the nurses & doctors are just as professional as those in the UK but they can't work miracles.


What you have read in the article is correct because the article is talking about Valencia. Valencia has a debt the size of some countries national debt and it's disgusting.
Read this from an article published a year ago

_This is the first time that the state has helped out a region - which in this case, happens to be the most indebted one out of Spain's 17 semi-autonomous communities. Valencia's debt-to-GDP ratio is 19.9 percent, and last September its deficit stood at 2.3 percent, a whole percentage point above what the state had authorized for the entire year.Last year, the Valencian government owed providers 2.4 billion euros in unpaid bills, and pharmacies across the region recently went on a two-day strike to protest the situation_

http://elpais.com/elpais/2012/01/04/inenglish/1325658049_850210.html

Most regions have a debt, but this shows just how much Valencia spun out of control, so in this region at least there have been big problems in the pharmacies. There have been cut backs in many regions in the health service in general with some health centres being closed, emergency room attention at night cut, doctors and nurses contracts being ended, but much will depend on the region.
My daughter had meningitis (one week in hospital) and an emergency appendectomy (2 weeks in hospital - it was serious!!) and was given very professional, but as Jojo says no nonsense, care. She was seen to quickly and made a full recovery. This was all a few years ago. 
Compare to this.
A friend of mine has a pain regulator machine implanted in her back and has been given a very high standard care most of the time. When she was having it replaced last month the doctor who operated was made redundant the day after he did the operation and was not permitted to see his patients.She never saw him again after such a delicate and important operation...


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## JoCatalunya (Mar 16, 2011)

If you are at all concerned and can afford it I would take a look at private medical insurance. 

Like most places Spain is struggling with cutbacks and to be honest even before the crisis the doctors and nurses bedside manner sucked.


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## xabiaxica (Jun 23, 2009)

I posted the following on a similar thread .... 



> I know someone with private health insurance here who started having similar symptoms to one of my daughters at about the same time she did - sometime in February
> 
> I took her to her state paediatrician - he went to his private GP - I made the appointment online the day before - he had to wait a week
> 
> ...


also, my other daughter has a couple of conditions which need regular monitoring, so we're back & forth to the doctors & hospital every few months for check-ups

at an appt with her endocrinologist, we mentioned a recent return of almost constant tonsillitis - there can be a link with her condition

an ENT appt was made there & then for a couple of weeks later, a follow up 3 months later to see if the treatment was helping............ she'll have her tonsils out this summer


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## bob_bob (Jan 5, 2011)

jojo said:


> I broke my leg in Spain and my treatment was second to none. In Spain the treatment is very much a "no nonsense" approach - which I prefer! None of the PC, sympathetic softly softly approach you get in the UK !. There was no wait (unlike a friend of mine who broke her leg in the UK a couple of months ago - she was left waiting in A&E for 6 hours and without pain killers), I went straight in and was xrayed immediately. I didnt have pain killers while they put it back into position because they said it would delay the treatment and to be honest, it was such a relief to be treated, a few more minutes of pain didnt matter. That said, they put the plaster caste on too tightly, so I ended up cutting it off myself and going to a private hospital and getting a removable splint a few days later.
> 
> So for me I'd sooner be in spain - of course the recession is taking its toll - but then it is in the UK too. The NHS is a complete shambles from top to bottom right now.
> 
> Jo xxx


You should go back into nursing jojo, you'll earn far more than you do now and you'll get to see things for real. Returning to nursing - NHS Careers is a good starting point so get off you bum and get back nursing.

You say the NHS is a shambles but you don't know that do you, all you know are the 'horror' stories thrown about on the Daily Mail or forums like this where people can spout off all sorts of nonsense as though their diatribes were written in stone rather than based on fact. IF your friend went six hours with a broken leg without a reason for no pain relief being given then they should pursue a course of legal action.

My mother in law went under the knife in the UK to sort out the utter shambles of a job the Spanish hospital did on her leg fractures when she had an accident on holiday. The staff here were stunned at the mess they'd (the Spanish) made of her leg.


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## ChrisMcNab (Apr 29, 2012)

Reading these interesting replies has helped to clarify the matter - it seems that a minor procedure without anaesthetic is normal in Spain. If I'd had some warning then I could have coped better, but I'm blaming that on my inadequate knowledge of Spanish - perhaps the staff said "grit your teeth & get on with it" but I have a long way to go before that would get through to my confused brain.

Many thanks to everybody for their comments.


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## Calas felices (Nov 29, 2007)

You are unlikely to get a consensus on here because everyone's experience is individual to them. You also have to wonder to what they are comparing - if for example you broke your arm have you received treatment for a broken arm in the UK to make a comparison? probably not. I think it was Jo said "_my treatment was second to none._ She then went on to say "_ That said, they put the plaster caste on too tightly, so I ended up cutting it off myself "_ - both can't be true!!


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## baldilocks (Mar 7, 2010)

This stupid thing just lost my post which ran to a couple of paragraphs 

Here in Andalucía we get excellent care and there are no problems with getting medications in the pharmacies.


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## JoCatalunya (Mar 16, 2011)

The Pharmacy in our village hasn't been paid for over 3 months so he is now getting pretty low on stock. Sometimes he has to borrow medication from other pharmacy's but I guess there may come a time if they aren't paid and paid in full soon that they can't let him have anything further.


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## kalohi (May 6, 2012)

baldilocks said:


> Here in Andalucía we get excellent care and there are no problems with getting medications in the pharmacies.


Well my experience with the lithotripsy happened in Andalucia, and I wouldn't say it was excellent. And just at the beginning of the month I had to go to three different pharmacies to find some medication I had been prescribed.

As someone else said, everyone's experience is individual to them. No system is perfect and there will always be different opinions about it.


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## jojo (Sep 20, 2007)

bob_bob said:


> You should go back into nursing jojo, you'll earn far more than you do now and you'll get to see things for real. Returning to nursing - NHS Careers is a good starting point so get off you bum and get back nursing.
> 
> You say the NHS is a shambles but you don't know that do you, all you know are the 'horror' stories thrown about on the Daily Mail or forums like this where people can spout off all sorts of nonsense as though their diatribes were written in stone rather than based on fact. IF your friend went six hours with a broken leg without a reason for no pain relief being given then they should pursue a course of legal action.


Interestingly Bob, I AM doing some work for the NHS right now. Its a consultancy position and I'm beyond horrified at the ridiculous waste of money, resources and time that is in every corner, high and low in the NHS - the truth goes way passed the stories in the tabloids!! That said, I wouldnt ever knock the staff on the front line, altho in many cases (in particular the ones I'm looking at), they are badly managed and simply unable to perform as they'd like or as they should!!! But the parts I'm looking at in the main are the admin and management. One things for sure, there are too many management layers and too many back handers!

...Oh and my friend was unfortunate enough to break her lag on a Friday night 11pmish and there were far too many rowdy cases that got in the way and the radiographer wasnt available for some reason??!! 


Jo xxx


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## bob_bob (Jan 5, 2011)

What sort of work are you doing Jo, is it better than nursing itself? I presume it pays better than your band when a practise nurse? The 'suits' are closing down a local A&E unit by us to save money and improve service although I don't see how a potential journey of ten miles will improve things. A small mental health unit was closed to save £3m a year, the new costs for integration and amalgamation of services are running at around £7m a year extra. My wife is a band nine so involved to a degree with financial planning and having been in the job for well over thirty years has a great depth of clinical knowledge and thankfully common sense; she tends to 'win her corner' more than loose it but we do feel sorry for the younger inexperienced charge nurses/ward mangers who often get trampled by bureaucracy. Thankfully 'we' are still delivering the goods down here.


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## StevejR1 (May 21, 2013)

As a newbie just starting on the journey of moving to Spain this thread has been of great interest...

I've got a vested interest in the standard of care in andalucian hospitals....2 years ago I smashed my hip socket to pieces in a cycling accident...the NHS has done all it can, but now it's just a case of getting on with it. In Spain however, because of the climate/humidity(??) I find the after effects of the accident minimal, and my daily life so much better.

However, as a result I may need to rely on medical backup in Spain more than most in later life, so the standard of the service, and its availability to me is important to me in my decision making.

My question is...should I go down the private medical insurance route who are the best companies in Spain to contact and consider? Also what is the approx cost of it per month? I realise my premiums may be higher anyway, and my existing condition might complicate my cover in the future...but I just wondered if someone could point me in the right direction to make some enquiries.

Thank you


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## xabiaxica (Jun 23, 2009)

Steve.R said:


> As a newbie just starting on the journey of moving to Spain this thread has been of great interest...
> 
> I've got a vested interest in the standard of care in andalucian hospitals....2 years ago I smashed my hip socket to pieces in a cycling accident...the NHS has done all it can, but now it's just a case of getting on with it. In Spain however, because of the climate/humidity(??) I find the after effects of the accident minimal, and my daily life so much better.
> 
> ...


hi

the availabilty of the Spanish state health service to you is dependent on your personal circumstances - are you/will you be a UK state pensioner when you move here or will you be early retired or working?

as to the standard - as you will see from this & other similar threads, we all have different experiences - some great, some good, some indifferent & some bad - & I'm sure that would be the same in the UK

private health insurance is generally much cheaper here than in the UK though - if you look on our *FAQs & useful info *thread you'll find some links to comparison sites which will give you some idea


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## StevejR1 (May 21, 2013)

Thanks for the reply.

I'll be moving to Spain, but 'commuting' back to the UK to work for 3-4 years, then I will retire full time, but at the age of 51. So I'd be retiring early. That is mainly due to my injury, and to give myself a chance of some 'quality of life' before a possible hip replacement in later years...though I'm hoping that the climate may even prevent that(?).

My partner will settle in Spain immediately, and either try to get a job, or be a lady of leisure.

Thanks for the push in the right direction....I'm new on here, and still not sure where to find all the vast amounts of information I'm trying to find.


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## jojo (Sep 20, 2007)

bob_bob said:


> What sort of work are you doing Jo, is it better than nursing itself? I presume it pays better than your band when a practise nurse? The 'suits' are closing down a local A&E unit by us to save money and improve service although I don't see how a potential journey of ten miles will improve things. A small mental health unit was closed to save £3m a year, the new costs for integration and amalgamation of services are running at around £7m a year extra. My wife is a band nine so involved to a degree with financial planning and having been in the job for well over thirty years has a great depth of clinical knowledge and thankfully common sense; she tends to 'win her corner' more than loose it but we do feel sorry for the younger inexperienced charge nurses/ward mangers who often get trampled by bureaucracy. Thankfully 'we' are still delivering the goods down here.


I am officially a band 7, but thats not the work I'm doing right now. We're looking at Admission avoidance.

I think the difference between Spain and the UK healthcare is that Spain still works more on "gut instinct" and individual treatments and less on flow charts and protocols as they now do in the UK. Also it seems to me that Spanish people arent so willing to run to their healthcare provider unless its serious. 

That said, my knowledge of Spains healthcare is limited, but it does seem more effecient and effective

Jo xxx


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## Calas felices (Nov 29, 2007)

I don't think the 'suing' culture has yet arrived in the Spanish health service. Try and do something about a Spanish GP (maybe Russian, Croation,?) if they do something that seems to be culpable. Almost as much chance a diddly squat.


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## Chopera (Apr 22, 2013)

jojo said:


> I am officially a band 7, but thats not the work I'm doing right now. We're looking at Admission avoidance.
> 
> I think the difference between Spain and the UK healthcare is that Spain still works more on "gut instinct" and individual treatments and less on flow charts and protocols as they now do in the UK. Also it seems to me that Spanish people arent so willing to run to their healthcare provider unless its serious.
> 
> ...


My experience is the Spanish run to their doctors or urgencias at a drop of a hat. My (Spanish) wife will insist on taking our children to urgencias immediately with a temperature above 38, or if they are ill in any way. I'd say we go every 2 months on average. At first I thought it was my wife being panicky but now I've discovered they all do it. I read somewhere that the Spanish are culturally predisposed to want to go to someone and be told what to do in situations of uncertainty - something to do with paternalism apparently - and these days they use the doctors to provide that service.

Also when it comes to childbirth, my experience is that everything is done very mechanically and by the book in Spain. While friends in England have given birth in water baths, at home, or wherever they like, however they like, in Spain they rigidly follow a certain procedure, and are carefully monitored.

As I suspect has already been mentioned, the big difference in Spain is that nurses only have a responsibility to provide medication, not general care. So if someone has to stay in hospital overnight then a member of family or friend should go with them and stay with them. If you work then by law you are allowed a few days off work to stay with a close member of family in hospital (the state will reimburese the company).

Also we have occasionally used private hospitals in Madrid but our experience with state hospitals have been better, so we prefer to use them now. We have noticed the cuts as it takes longer to get an appointment for a checkup, and fewer hours are available in our local medical centre, but in Madrid at least, the service provided by state hospitals and phamacies is as good as ever.


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## jojo (Sep 20, 2007)

Chopera said:


> My experience is the Spanish run to their doctors or urgencias at a drop of a hat. My (Spanish) wife will insist on taking our children to urgencias immediately with a temperature above 38, or if they are ill in any way. I'd say we go every 2 months on average. At first I thought it was my wife being panicky but now I've discovered they all do it. I read somewhere that the Spanish are culturally predisposed to want to go to someone and be told what to do in situations of uncertainty - something to do with paternalism apparently - and these days they use the doctors to provide that service.
> 
> Also when it comes to childbirth, my experience is that everything is done very mechanically and by the book in Spain. While friends in England have given birth in water baths, at home, or wherever they like, however they like, in Spain they rigidly follow a certain procedure, and are carefully monitored.
> 
> ...


I guess it depends where you are and how you live. I found that folk in Spain were more self and family reliant, if they had a medical problem, their first port of call would be abuelita..., although the Spanish, in general do like a white coat lol!!!! I think the private hospitals in Spain are far more like the UK with their protocols and statistics etc. But its only my observations. I did do a stint working as a carer in a state hospital in Spain - doing the caring for those expats who had no one to do it for them. Does it work better that way than expecting nurses to do everything???? I think so, but in the UK we're very hot on good old H&S, which may be breached.......Also, the UK isnt as family orientated as Spain. Can you imagine folk in the UK going onto the wards to wash, shave and feed grandpa before work every morning??


Jo xxx


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## stevelin (Apr 25, 2009)

They do do things differently ! I recently broke the metatarsal bone in my foot from arriving at the local salude to xray and then t/f to hospital for plaster took 2 hours. I was also given blood thinning injection for the length of the plaster ( which I had to do myself) !!


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