Spanish Healthcare Overview with a Focus on the Ibiza Market for General and Intensive Care Nursing
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Spanish Healthcare Overview with a focus on The Ibiza Market for General and Intensive Care Nursing Prepared by Heidi Tomlin May/June 2011 For Confesso, NL Purpose: To provide market research on the Spanish healthcare system with particular focus on the market in Ibiza, Balearic Islands. To highlight the current provision and market for general and intensive care nursing staff. To inform on the qualifications, licenses and other skills or services required in the provision of these nursing services. 2 Contents 1 Spanish Healthcare System Overview 1.1 Healthcare Funding 1.2 National Organisation 1.3 Coverage Provided by the SNS 1.4 Resources and Activity of the SNS 1.5 Healthcare Expenditure 2 Facilities and Resources in Ibiza 2.1 Public Healthcare Facilities on Ibiza 2.2 Major Private Healthcare Facilities on Ibiza 3 Requirements to Work 3.1 Qualifications 3.2 Skills 3.3 Licenses 3.4 Contracts 4 Marketplace 4.1 Current Vacancies 4.2 Review of online Vacancies 5 Associations and Organisations 5.1 Main Organisations 5.2 Additional Organisations of Interest 6 Appendix 6.1 News Articles of Interest 6.2 Ib-salud Qualified Nurses Ibiza-Formentera 2011 6.3 Ib-salud Nursing Assistants Ibiza-Formentera 2011 6.4 Private Clinics/Healthcare Facilities in Ibiza 3 1. Spanish Healthcare System Overview The Spanish National Health System (Sistema Nacional de Salud, SNS) was historically controlled by the central government, but today each region takes individual responsibility and the only jurisdiction the central government has is for the overall budget. The Spanish National Health System has an extensive network of health centres and hospitals throughout the country which offer primary health care services (family/GP services, paediatrics and nursing, with midwives, physiotherapists and social workers). The Spanish health system combines both public and private healthcare and within each separate state free or low cost health care is given to those who contribute to the Spanish Seguridad Social (social security). Spain is divided into 17 autonomous communities including the North African regions, the Canary Islands and the Balearics; Ibiza is part of the Balearic Islands autonomous community. Healthcare in this region is coordinated by the Servicio de Salud de las Islas Baleares (IB-SALUD) and serves a population of 1,112,712, with a foreign population of 242,578. Health centres in Spain are located within 15 minutes of any place of residence and if necessary a patient can be seen at their own home. In rural areas and in small villages there are local surgeries open on certain days with visits from healthcare staff from the region. Hospitals offer specialised attention, with access via referral from primary healthcare services. There are also Accident and Emergency services available at hospitals and some health centres. Although there are waiting lists for operations in the Spanish health services, they are not as long as in many other European countries, and there is less of a queue because many people choose private healthcare instead, relying on the national health system just for emergencies. Generally speaking the country's medical facilities are considered good. In 1998 the Sistema Sanitario Público (public health service) brought in an official mandate for both doctors and patients outlining the service to which they are entitled and this is listed in all doctor’s offices in a leaflet entitled Carta de Derechos y Deberes (Charter of Rights and Obligations). Doctors in Spain are as highly qualified as in any other EU country, sometimes more so and under the Carta de Derechos y Deberes residents choose their own doctor and health care centre (Centro de Salud). The institution in charge of healthcare control is the Ministerio de Sanidad y Consumo. The ministry checks all relevant paperwork including qualification certificates and personal background of all surgeons and doctors, and this is the case for all medical personnel from other countries who want to work in 4 Spain. To practise medicine in Spain doctors must be registered with the relevant Medical Association in their individual province. A third of hospitals in Spain are independent and as the state system does suffer with waiting lists many people buy private health insurance and there is a plethora of private hospitals, particularly in the Costa del Sol, which boasts some of the best in the world. There are many advantages to private healthcare in Spain, like a wider choice of medical practitioners and hospitals, the reassurance of being treated by English-speaking professionals, and not least, privacy in the hospital with little or no waiting time. Ref: INE 2011 Ref: National Health System of Spain, 2010 prepared by the Health Information Institute. © Ministry of Health and Social Policy Ref: www.treatmentinspain.com 1.1 Healthcare Funding Healthcare is one of the main instruments of the Spanish redistributive income tax system, aimed to redistribute income amongst Spanish citizens: all citizens contribute according to their wealth level and receive healthcare services according to their own health needs. Healthcare for ordinary illnesses and non-occupational accidents in Spain is a non-contributory benefit funded through taxes and included in the general funding of each autonomous region. For 2009, the budget forecast of the autonomous regions was 58,960.3 million euros, which translated into 1,320 euros per covered person. Initial health budgets for the same year, allocated by the rest of the participants in the National Health System, in millions of euros, are: Central Government 4,685.7, Social Security 1,824.40 and civil servants mutual funds 2,060.5. The provision made by the local councils totals 1,068.9 million euros. However in the austere 2011 Budget, overall spending was cut by 7.7%, to 122bn euros. The Spanish economy is slowly recovering, although we do not expect to see positive net job creation until the second half of 2011. Given that the Spanish economy’s fiscal consolidation process cannot be postponed, the contraction in the public sector will continue to impede growth in the short term, but will now do so with special intensity in the autonomous regions that did not comply with 2010 deficit targets, and which must therefore implement a more ambitious plan to meet the 2011 targets. Overall, we expect the pace of growth in the Spanish economy to remain frail in 5 the short and medium term, with the economy growing by around 0.9% for the year as a whole. A sustained and job-creating recovery should start during the second half of 2011, with 2012 being the year when the Spanish economy gets back to around 1.6% growth, enough to generate net jobs, but not enough to significantly reduce the unemployment rate, given a normal scenario for labour force performance. Growth rates should vary widely among regions, but less so than in 2010. Their varying levels of exposure to economic drivers in 2011-2012, described above, will result in a widely dispersed recovery, especially in 2011. Despite the fact that the budget out-turn data for 2011 will be impacted by the autonomous financing system which is being comprehensively applied for the first time this year (implying a decline in the transfer payments to autonomous regions and less central government tax revenues due to a higher percentage being collected by autonomous regions), first quarter data indicates continued cutbacks to central administration expenditure, with decreases seen in all its items, except in interest expenses. Once again, the cuts were mainly in investment spending, current transfers, and to a lesser degree, in civil servant wages. At March 2011, cumulative tax revenues continued to show signs of recovery, although this improvement was somewhat more modest than that seen in previous months. In the autonomous regions, the latest available preliminary information regarding the 2010 close, shows an uneven commitment to the fiscal consolidation process, with generalised noncompliance with the stability target. Consequently, with the recovery in tax revenues still weak, and in a quarter in which the different autonomous regions prepared their fiscal adjustment plans, the fiscal adjustments are expected to mainly entail spending cuts, for which reason we expect to see an additional slowdown in autonomous region expenditures in the first quarter of the year. Therefore, the adjustment to current spending has been accompanied by a gradual moderation in public sector demand in real terms, for which reason public consumption should once again register almost zero growth in this first quarter of the year. In a similar vein, investment in non- residential construction probably also shrank in 1Q11, although part of this would have been due to the sharp downturn currently affecting the private construction business, in addition to public sector cuts. Ref: Spain Economic Outlook. Second Quarter 2011 BBVA Research 1.2 National Organisation The SNS health care delivery system is structured into two health care levels, Primary Heath care and Specialist Care. Primary Health Care makes basic health care services available within a 15- minute radius from any place of residence. The main facilities are the Health care centres, staffed by multidisciplinary teams comprising general practitioners, paediatricians, nurses and administrative staff, and, in some cases, social 6 workers, midwives and physiotherapists. Since primary health care services are located within the community, they also deal with health promotion and disease prevention. The principles of maximum accessibility and equity mean that primary health care also provides home care whenever this is necessary. Specialist Care is provided in Specialist care centres and hospitals in the form of outpatient and inpatient care. Patients having received specialist care and treatment are expected to be referred back to their primary health care doctor, who, based on the patient’s full medical history, including the medical notes issued by the specialist, assumes responsibility for any necessary follow-up treatment and care.