Especially for families with small children, one of the first concerns after moving to a new country will be to understand how the public healthcare system works. After several years with private healthcare at one of Bangkok’s top hospitals, my wife and I were a bit sceptical about what we would find here in Catalonia. It is not without a certain feeling of resignation I realize how many times my family has had reasons to search medical care since we came here in 2005.
Like in many other countries, all outpatient matters start with a visit to a primary health clinic, a centre de atenció primaria (C.A.P.). Our C.A.P. is located right in between the main shopping street Rambla principal and the local fresh market. The building can possibly be called modern but certainly not interesting so I wonder if the late Catalan King Jaume I who has lent his name to the institution would think of what he is being associated with these days.
During office hours, this C.A.P. accepts a limited number of emergencies, but usually you come here with an appointment. As soon as you have your CatSalut card, these can be made centrally through the Generalitat, either by calling 902 111 444 or through a web-based reservation system. The latter has the advantage that you put in your social security number by yourself, which means that you do not have to spell out your strangely sounding foreign name letter by letter over the phone.
When registering with CatSalut you also have the opportunity to select your doctor at the C.A.P. My wife and I have made different choices, but both of us are very content with the health care service provided to grown-ups. Rarely have we had to wait for more than 30 minutes for our turn and the doctors instil the confidence you want.
I must admit that we are a lot less happy with the paediatrician ward. We are content with the doctors we see, but have had to see far too many. It seems that substitutes are rather standard than exceptions here. We have learnt that there is a general lack of educated paediatricians in Catalonia, and that most likely explains why the doctors here seem over worked and the waiting time by rule is longer than one hour although you have an appointment. A piece of advice to anyone on the way here is to bring some distraction for your children. To me it is almost absurd that in a waiting room for children of all ages there is only one toy. In case you are interested, this is a wooden toy suitable for twoyearolds, so for us it is too basic for our older one and almost too advanced for the younger one.
Once you have reached the doctor you will experience what we see as a big benefit with Spanish public healthcare, at least compared to what we are used to from Sweden. Doctors here might be blamed to be a bit too happy to prescribe medicines, but once you have a prescription from a doctor connected to CatSalut, medicines are heavily subsidised. If you, like us, have two small children attending to kindergarten and pre-school respectively, you will appreciate this.
Specialist and inpatient care in Vilanova is handled by the local hospital Sant Antoni Abat, housed in a beautiful historic building. Sadly enough, the person who drew the modern extension of the complex must have been requested to make a building which could double up as a bomb shelter when needed. If not, I can not understand how you can come up with such a poor matching of old and new architecture. The interior of this place is far from inspiring but still hygienic and a lot more welcoming than the environment at C.A.P. Jaume I.
The part of the local public healthcare system which my family knows the best, however, is the hospital Sant Camil in Sant Pere de Ribes, a small inland town in between Vilanova and Sitges. This is where we are referred for certain kinds of specialist care. It is the only hospital in the area with a 24h presence of paediatricians so it acts as the urgency clinic for children during weekends. This is also where we have our local maternity ward, so our second son was in fact born there. Since my wife had some minor complications at the end of the pregnancy she had to spend about a week more than normal in the hospital, but except for being bored from not being able to leave the bed, she was positively surprised with the institution. Above all, she was extremely happy to meet an understanding, Castillano-speaking midwife who did a wonderful job in making her relax as well as in delivering the baby – an experience very different from the nightmares which she had in the weeks leading up to the big day.
To sum up, so far we are quite content with public healthcare and have not bought any private medical insurance. For any newcomer in Catalonia I can advice you to trust the public system to start with and add a private insurance only when you are sure that you need it. However, I must admit that than more than one person has told me that to rely on public healthcare is a luxury which only people in the outskirts of the Barcelona province can allow themselves. They claim that anyone with a busy schedule and living in the city centre has to have a private insurance, since the waiting time with the public alternative simply is too long.