My client Tony, a Brit who moved to Madrid over a year ago, has this to say about how you go about getting medical care in Madrid:

After the first flurry of becoming legal residents of Spain, la media naranja* and I talked about getting registered with a doctor at the local Health Centre. We are not often sick, but we thought it would be better to do the registration while we were well, rather than wait until one of us actually needed to see a doctor.

Needless to say, we did nothing about it, until a few days ago, when my half orange came down with some kind of chest infection. We went to the 'Centro de Salud' in our barrio (there's at least one in every barrio), and tried to register. We had gone with what we guessed might be the required documents - NIE, Social Security numbers and passport copies. It turns out we were wrong. Before you can see a doctor (for free) you need a Health Card (Tarjeta Sanitaria). Here's what they wanted before they could issue the card:

1) Empadronomiento - this is your registration with the statistics and census service. You'll have got this before registering for your NIE.

2) Asignación de Numero de Seguridad Social - a document from the Ministry of Social Security that states your Social Security number. You might think that presenting a payslip (if you are employed) that mentions your SS number, or if you are self-employed, any other document that has this number on it would be enough, but no, the Ministry of Health are very picky about this. They want this particular form. You can get it from any Social Security Administration Office. The two nearest us are at Calle de la Cruz, 7, near Puerta Del Sol, and Calle Zurbano, 73, near Gregorio Marañon Metro.

Unfortunately for me, after I'd hiked to the latter office through howling, bitterly cold wind and rain, they told me I had to get authorisation from half orange before they would produce the form. So I went back home, we completed the forms and the authorisation, and I went to the de la Cruz office. It's a fairly quick procedure - they want your original ID document (either your passport or your NIE) and a copy, and then they issue a letter that states your name and address, and your SS number.

3) Original NIE document. When I had gathered all of these bits of paper together, I went back to the Health Centre. No problem with mine, but better half was a problem because she could not find her original NIE document. So even though we know the number, and it's mentioned on her Employment Contract and several other documents that I showed them, the functionarios refused to issue a Health Card. They said she could see a doctor on payment of a €45 deposit. If she returned with her original NIE or an application form for a replacement, within five working days, the deposit would be refunded. This is hopelessly optimistic on the part of the Health people: the Police who look after these documents work on a glacial timescale, they can't even answer the phone within five days, never mind issue a document (my biased personal opinion, obviously).

I now have a letter from the Health Centre, and an assigned doctor - I can use this if I need to to access my right to free medical treatment in Spain (free, hah! As an autonomo I pay a fortune each month in Social Security payments). Poor other half, coughing and spluttering away, and desperately in need of medical attention, is denied it because of the idiotic documentation requirements of the Health (dis)Service.

I only hope that if and when we ever get to see a doctor, the 'service' is much less stressful and much more professional than what we've seen up until now. I'm not very hopeful.

*media naranja = half orange = other half.

Tags: Bureaucracy, healthcare