Spanish Healthcare Overview with a Focus on the Ibiza Market for General and Intensive Care Nursing

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

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. This ensures the provision of continuous care under equitable conditions, irrespective of the patient’s place of residence and individual circumstances, with care provided even in the patient’s home if necessary.

Health care services are distributed following a region-based organisation of health areas and basic health zones. Each autonomous region defines its own health areas according to various demographic and geographic criteria, but above all aiming to guarantee service proximity to users. Each health area comprises several basic health zones that constitute the territorial framework for primary health care delivery, and where primary health care centres are based. Each health area is assigned a general hospital where patients are referred to for specialist care. In some regional health care services there are intermediate organisational structures between the health area and the basic health zones.

1.3 Coverage Provided by the SNS

Services include preventive, diagnostic, therapeutic, rehabilitation and health promotion and maintenance activities:

• Public health • Primary Care • Specialist Care • Emergency care • Pharmaceutical services • Orthopaedic and prosthetic benefit • Dietary products • Health care transportation • Information and medical documentation services • Health care services paid for by third parties • Supplementary services provided by the autonomous regions • Portfolio of services offered by mutual societies

1.4 Resources and Activity of the SNS

7 Health Care Centres The SNS has 2,914 health centres and 10,202 local clinics where professionals from the zone’s health care centre go in order to bring basic services closer to the population.

Hospitals The SNS has 315 hospitals, equipped with 105,505 beds, and 4 Ministry of Defence’s hospitals contributing with 995 beds. There are also 20 hospital facilities owned by the occupational accident and work-related illnesses mutual societies, with 1,468 beds.

The remainder 465 hospitals are privately run and have 53,013 beds. According to the kind of care provided, from the total of 160,981 beds installed in Spain’s hospitals, 131,445 are located in 589 hospitals concerned with acute care, 72.9% of which are managed by the SNS. 37.2% of the 16,111 beds available in psychiatric care hospitals and 35.1% of the 13,365 beds for geriatric and long- term care are managed by the SNS.

Hospital-based High Technology If we exclude the dialysis equipment, computerized axial tomography -cat- is the most widespread high technology in hospitals and dependent facilities, with a total of 677 units and a ratio of 14.8 per million inhabitants. Magnetic resonance follows with 438 units and a ratio of 9.6 per million inhabitants.

Registered Healthcare Staff There are in Spain more than half a million graduated professionals who are enrolled in a professional society related to healthcare activity. The largest group is comprised by nursing professionals, numbering 250,139, followed by physicians, with 213,977, representing, 55 and 47 registered professionals per 10,000 inhabitants, respectively.

Nursing, with 83.3%, is where the highest overall percentage of women pre- dominance is found, followed by pharmacists with 70.3% of the total 61,975 registered. Dentists and veterinarians, with 25,697 and 28,188 registered professionals, respectively, have lower percentages of women, that is, 43.3% in the case of the former and 40.4% for the latter.

Although overall figure of medical professionals is still favourable to men, figures for the younger age levels clearly show more women in the professions, so the trend will reverse in coming years.

Health Care Centre Staff Public primary care health centres employ 34,126 physicians (27,911 family doctors and 6,215 paediatricians), 27,433 nurses and 21,606 non-healthcare staff. The ratio of physicians on the first level of care per 10,000 inhabitants (calculated according to population data provided by the National Statistics Institute) is 7.5.

Nursing, with women accounting for nearly 8 out of 10 workers, comprise the

8 group with the largest female component, followed by the non-healthcare staff with 75%. Among Family and Community Medicine specialists, the percentage of women is 47% and 64% in Paediatrics.

Hospital Staff 69,742 physicians provide their services in SNS hospitals and Specialist Care Centres. 27.7% of whom work in Internal medicine and medical specialties, 22.8% in the central services (clinical tests, microbiology, diagnostic radiology...) and 18.1% in surgery and surgical specialties. The ratio of medical staff working in public hospitals and Specialist Care Centres is 15.5 per 10,000 inhabitants. In public hospitals work 116.058 nurses, ratio of 25.9 per 10,000 inhabitants.

There are 16,555 physicians (ratio of 3.7 per 10,000 inhabitants) in hospitals acquiring postgraduate training. More than 98% of these physicians are being trained in hospitals belonging to the SNS.

Activity in Health Care centres The National Health System attends to more than 273 million medical consultations per year in Primary Care, a volume of activity that reaches over 300 million if we consider emergency care outside normal working hours and more than 406 million if we include nursing activities.

The yearly medical visit’s general attendance rate per inhabitant in the first level of care is 6.0 (6.1 for Family Medicine and 5.5 for Paediatrics), 2.9 for nursing and 0.7 for emergency care outside of normal working hours.

Activity in Hospitals More than 5.2 million hospital discharges are registered every year. Of which, 4 million (78.3%) are funded by the SNS.

Similarly, each year, there are 77.1 million consultations with the various medical specialists (87.3% funded by the National Health System), 26.3 million emergency cases are treated (77.1% with public funding) and 4.4 million surgical operations are performed, more than 1 million of which involve major ambulatory surgery. There were 491,042 births in hospitals, 124,561 of which were by caesarean section.

1.5 Healthcare Expenditure

Data for Spain place public healthcare expenditure, including long-term care expenditure, at 63,768 million euros, which represents 71.8% of the country’s total healthcare expenditure, which amounts to 88,828 million euros.

As a percentage of GDP, the total healthcare expenditure in Spain is 8.5%. Public healthcare expenditure accounts for 6.1% of GDP and represents an expense per inhabitant of 1,421€. From a functional dimension of the public expenditure on healthcare, hospital

9 and specialist services, with 54.0%, are those that represent a higher percentage of it, followed by the pharmaceutical benefit, 19.8%, and the primary care services with 15.7%. The public health services, with 1.4% of the expenditure, evidence an apparently small relative incidence, as a consequence in addition to the method of defining and classifying this activity in the accounting systems of the fact that the activities of public health, prevention and promotion are carried out basically through the Primary Care network and are not accounted for specifically.

As for the financial-budgetary classification, without including the expenditure on long-term care, the remuneration of personnel is the item with the greatest weight in public healthcare expenditure, with 43.4%. The activity arranged with the private sector represents 11.3% of this figure.

Public healthcare expenditure, Spain 2007

Hospital and Specialist Care Services Primary Heathcare Services

Public Heath Services

Colective Heath Services

Pharmacy

Ref: National Health System of Spain, 2010 prepared by the Health Information Institute. © Ministry of Health and Social Policy

2 Ibiza

Ibiza is served by IB-SALUT, the autonomous community health service for the Balearic Islands. This is then sub-grouped to the Area de Salut d’Eivissa – Formentera or Ibiza-Formentera Health Area.

The official languages in Ibiza are Balearic Catalan (local dilect is known as Ibicencan) and Castillian (Spanish), with English and German spoken by a high

10 number of residents. Italian, French and Dutch also widely spoken by the multi- national residents and locals.

Competition for healthcare jobs is high throughout Spain and so foreign nationals working here must speak fluent Castillian as an absolute minimum and are much more likely to be placed in public sector jobs if they also speak Catalan. For private clinics the languages required are dependent on the customer base and individual to each business.

2.1 Public healthcare facilities on Ibiza CS = Centre de Salut Health Centre UBS = Unidade basicas de salud Basic Health Unit

CS Can Misses Consulting Hours: M-F, 08:00-20:00 Emergencies: M-F, 08:00-17:00 • General medical attention

GPs: Dr. Francisco Cendón González Dra. Eva Pasamón Lara Dr. José Antonio Chumillas Belmonte Dra. Maria Tresserra Svab Dra. Carmen Roca Fusalba Dra. Maria Martín-Rabadán Muro Dra. Magdalena Pagés Amat Dr. Rricardo Llidó Visedo

Nurses: Raquel Cayuela Juesas José Martí Felis Bernarda Romero Polo Margarita Torres Boned Antonia Tur Torres Juan Diego Galdeano García Felicitas Jener Natta

Midwife: Mª Isabel Isidoro Moreno

One nursing assistant and five administration assistants.

CS Es Viver Consulting hours: M-F, 08:00-17:00 Emergencies: M-F, 17:00-09:00

• information and customer service • nursing

11 • midwife specialists • Family medicine clinic • Pediatric clinic and child care • Check nursing (adult and pediatric) • Blood and other samples collected • Care programs for chronic diseases: hypertension, diabetes, hyperlipidemia, obesity, respiratory diseases, etc.. • Social Work Unit • Physiotherapy Unit • Unit of Dentistry and Oral Health • Preventive activities and health promotion: vaccinations for children (school and colleges), flu vaccine, tetanus and hepatitis B

GPs: Dr. Rafael Cantos Escudero Dra. Inmaculada Garrido Megías Dra. Susana Ulloa Gasso Dra. Presentación Reyes García Dr. Jordi García-Jurado Durán Dr. Alberto Sanagustín Sánchez Dra. Raquel Utrillas Ortiz Dr. Luis García-Junco Quintana Dra. Violeta Vega Morales Dra. Catalina Torres Tur Dr. Adolfo Garijo Mazario

Pediatricians: Dr. Manuel Alonso Fernández Revuelta Dra. Carolina Marí Clapés Dr. Daniel Blanco

Nurses: Francisca Gómez Juan Kate Hopkins Esmeralda Gómez Pedreira Teresa del Castillo Sanz Mª Antonia Santos Turrión Esperanza Blázquez García Mª Gracia González Pardo Antonia Vaquer Vadell Isabel Perelló Martínez Luisa Reyes Ariza Mª Antonia Vaquer Vadell Catalina Tur Marí Teresa Muñoz González

Four psychologists, two physiotherapists, dentist, dental hygienist, social worker, two nursing assistants and nine administration assistants.

CS Sant Jordi Consulting hours: M-F, 08:00-17:00

GPs: Dr. Juan José Pérez de Olaguer Clavell Dr. Francisco Ribes Vidal Dra. Meritxell Ases Utrilla Dr. Carlos Franch Soler

Nurses: Immaculada García Madrigal Dolores Vargas Isabel de Blas Cerezo Jean Philippe Baena Monica Yern Moreno

Pediatrician: Dra. Dolores Alcántara Manzanares

One nursing assistant and three administration assistants.

CS Sant Antoni GPs: Dr. Jesús Picarzo Cano Dr. José González García Dra. Marta Gamarra Chuquillanqui Dra. Carmen Santos Bernabeu Dra. Mercedes Ricart Oliver José Dra. María José Ortiz Pérez Dr. Onofre Gassent Sanchis Dr. Jesús Ros Forteza

13 Dr. José Antonio Martínez Iglesias Dr. Jordi Bonatxe i Felici

Pediatricians: Dra. Esperanza Méndez Clapés Dra. Maria Constanza Català Dra. Norma Vagni

Nurses: Josefa Guibernau i Virgili Ángels Sanz Sobrino Ana López Mónica Ursa Gil María Carreras Ruíz Catalina Marí Guasch Eva Ayala de la Peña Lidia Roselló Valero Marina Tur Roig Vicente Torres Stockman Catalina Serra Sala María García Nuñez Montserrat Martínez Rodríguez

Midwife: Paz Pérez García

Two physiotherapists, two nursing assistants, a social worker and eight administration assistants.

Consulting hours: M-Sat, 08:00-17:00 Emergencies: M-Sat, 17:00-09:00, Sun & Holidays 09:00-09:00

• Administrative Unit attention: information and customer service; subpoena to health care, nursing and midwife specialists; visa recipes, health card, etc. • Family medicine clinic • Pediatric clinic and child care • Check nursing (adult and pediatric) • Unit of medicine and oral surgery • Blood and other samples collected by analytical • DOPPLER outpatient • Mental Health Unit • Radiology • Unit attention to women • Care programs for chronic diseases: hypertension, diabetes, hyperlipidemia, obesity, respiratory diseases, etc.. • Preventive activities and health promotion: vaccinations for children (school and colleges), flu vaccine, tetanus and hepatitis B

14 UBS Sant Josep Consulting hours: M-W, F, 09:00-13:00, Thu, 16:00-20:00 Dr. José Segador Parra Estrella Torres Sorà

UBS Sant Rafael Consulting hours: M, W & F, 09:00-10:10, Thu 18:00-19:15 Dra. María José Ortiz Pérez Catalina Marí Guasch

UBS Sant Agusti Consulting hours: Tue & Thu, 09:00-14:00 Dra. José Manuel Fraga Sardiña Ana Nicola Peñalosa

UBS Cala Bou Consulting hours: Mon & Fri, 09:00-14:00, Wed, 15:30-21:30 Dra. José Manuel Fraga Sardiña Ana Nicola Peñalosa

CS Santa Eularia Consulting Hours: Mon-Sat, 09:00-17:00 Emergencies: Mon-Sat 17:00-09:00, Sun & Holidays 09:00-09:00

GPs: Dr. Salvador Benito Mompo Dr. Luis Langa Laglera Dr. José Miguel Roig Royuela Dr. Carlos Rodríguez Ribas Dr. Abdul Sabsabi Dr. Antonio Pallicer Orzáez

15 Dr. Eduardo Fuentes García Dr. Salvador Chazarra Talens Dr. Antonio Ruíz Expósito Dra. Maria Alavés Buforn Dr. Jorge Llosá Céspedes

Pediatricians: Dra. Neus Bufí Ribas Dra. Victoria Portugués Ros Dr. Carlos Froilán Ferrari

Nurses: Gabriel Noguera Rodríguez Buenaventura Victoria López Mercedes Fournier Wynn Juana Belotto Esteve Victoria Niclós García Ángeles Aguirre Álava Rebeca Hernández Fry (Coordinator) Victoria Niclós García Dolores Núñez Castro Patricia Cruz Ballester Montserrat Martínez Rodríguez María Guasch Torres

Midwife: María Freixas Pujol

A dentist, a dental hygienist, a midwife, a physiotherapist, ten nurses, four nursing assistants and eight administration assistants.

UBS Sant Carles Consulting hours: Wed, 15:00-19:30, Mon, Tue, Thur & Fri, 09:00-14:30 Dr. Antonio Pallicer Orzáez Luis Fernando Torres Aparicio

UBS Santa Gertrudis Consulting hours: Mon-Thu, 18:30-20:00, Fri, 11:00-13:00 Dr. Carlos Rodríguez Ribas Juana Belotto Esteve

UBS Sant Joan Consulting hours: Mon-Fri 09:15-14:00 Dr. Rafael Vargas Vargas Carmen Cuadra García

UBS Sant Miquel Consulting hours: Mon-Fri, 09:00-11:30

16 Dr. A. Florit Anglada Carmen Cuadra García

CS Vila Consulting hours: M-F, 08:00-17:00 Emergencies: M-F, 17:00-09:00

• Administrative Unit attention: information and customer service; subpoena to health care, nursing and midwife specialists; visa recipes, health card, etc.. • Family medicine clinic • Pediatric clinic and child care • Check nursing (adult and pediatric) • Unit medical and oral health • Radiology • Blood and other samples collected by analytical • DOPPLER outpatient • Care programs for chronic diseases: hypertension, diabetes, hyperlipidemia, obesity, respiratory diseases, etc.. • Social Work Unit • Rehabilitation and Physiotherapy • Mental Health Care • Attention to oral health (PADI) • Social Work Unit • Preventive activities and health promotion: vaccinations for children (school and colleges), flu vaccine, tetanus and hepatitis B • Education group: intervention group advanced smoking cessation, diabetes education group, group nutrition education, workshop relaxation techniques, prevention of drug addiction and sex education for teenagers, etc.. • SUAPS • Teaching and research (medical residents, training, etc.) (Guias clinical research projects, etc.)

GPs: Dra. Consuelo Corrionero Soto (coordinadora)

Dra. Sonia Lacosta Ronco

Dr. Ignacio García Oliván

Dr. Marcelo Fernandez Oriol

Dr. Ángel Pastora Laguna

Dr. Antonio Tizón García

Nurses: Ana Ribas Ahumada Sara Luque Tur María José García García Maite García Barberena Erburu Cristina López Gavaldá

17 Marisa Bonillo Fajardo Mónica Montoliú Margarita Marí Ana Serra Tur Francisca Gómez

Nursing Coordinator: Estela Terrer

Pediatricians: Dr. Antonio Ruíz-Huerta Carbonell Dr. Alfonso Galván De La Hoz Dra. Cristina Sáenz De Santamaría Vázquez Dra. Mª Carmen Balverdi

A midwife, a psychiatrist, two psychologists, a physiotherapist, two dentists, two oral hygienists, a social worker, two nursing assistants and seven administration assistants.

UBS Jesus Consulting hours: M, T, TH & F 09:30-13:30, W 15:15-19:30 Dr. Juan José Lalanza Lasheras Francisco Villar Ramos

UBS Puig D’en Valls Consulting hours: M 15:15-19:30, T-F 09:00-13:30 Dra. Encarnación Ballesteros Martínez Antònia Serra Roig

CS Formentera Consulting hours: Mon-Fri, 08:00-20:00 Emergencies: Mon-Fri, 20:00-09:00, Sat, Sun & Holidays, 09:00-09:00

Central Services: Admission Analysis clinicians Histopathology Anestología and REANIMACION Hospital Pharmacy Hematology and haemotherapy Microbiology and parasitology Medicine work Intensive Medicine Clinical Neurophysiology Radiodiagnosis Rehabilitation Emergency department triage

Medical Services: Digestive aparatus Cardiology Dermatology surgical Endocrinology and nutrition Internal Medicine Nephrology Pneumology Neurology Psychiatry Medical Oncology Rheumatology

Surgical Services: General and Digestive Surgery Ophthalmology ENT Traumatology and orthopedic surgery Urology

Gynaecology and obstetrics Pediatric and Neonatal

GPs: Dr. Pedro Pizá Caffaro Dr. Isidoro Costa Escanellas Dr. Luis Martín Soledad Dra. Antonio Cordero Roselló

Pediatrician: Dr. César Augusto Zanetta

Nurses: Renata Serra Ferrer Francisco Damián Salamanca Juana Planells Prats Onofre Sáez Avilés

Midwife: José Luis Noguera Benasser

Hospital Can Misses Can Misses Hospital serves around 130,000 people on Ibiza

Massive building work began in May 2010 by www.arup.com to extend the facilities, providing 45,853 sqm, which will double the current floor area of

19 22,186 sqm. The first of four buildings should be completed in June 2011 at which time select departments will start to move from the original building on the same site.

Can Misses performed 8,194 operations in 2010, 16.3% more than in 2009. As of December 31, 2010, no patient had to wait more than five month for an operation. At that time there were 1,026 people awaiting intervention, 32 less than the same date in 2009.

Source: El Diario

Medical Services: • Cardiology • Gastroenterology – Endoscopy • Dermatology • Endocrinology • Hematology • Internal Medicine • Neurology • Neurophysiology • Oncology • Pediatrics • Pneumology • Psychiatry • Rheumatology • intensive care unit (ICU)

Surgical Services: • Anesthesia • Surgery • Gynecology • Obstetrics • Otolaryngology • Ophthalmology • Traumatology • Urology

Central Services: • Pathology • Pharmacy • Radiodiagnosis • Rehabilitation • Emergency

Source: www.asef.es (website of the Govern de les Illes Balears, Area de Salut d’Eivissa I Formentera)

2.2 Major Private Healthcare Facilities on Ibiza Grupo Policlinica; La Policlínica Ntra. Sra. del Rosario

POLYCLINIC GROUP, which includes the Nuestra Señora del Rosario Polyclinic, a high quality private hospital in Ibiza Town.

40 specialisms and over 272 professionals, including 45 doctors.

In close collaboration with Eiviconsulta, there are several counselling centers attached to the Polyclinic, as well as the Ibiza Ambulance Complex and the Santa Eulalia Seniors Centre, opened two years ago. This is the first private retirement residence in the Balearic Islands. The complex is equipped with demotic art systems which makes it one of the most technologically advanced buildings in the world of health care in Spain and Europe.

During the year they conduct between 3,800 and 3,900 surgeries. The center registers about 14,000 rooms, 90,000 visits and 21,000 emergency room visits. Also, serves about 400 patients in neurosurgery, 700 in maxillofacial surgery and performs approximately 1,000 trauma and 600 general surgeries.

A total of 81 beds, which includes nine newly expanded Intensive Care Unit ICU beds.

Clinical Analysis Unit Anesthesiology Gastroenterology and Endoscopy Cardiology General Surgery, Gastroenterology, Vascular and Thoracic Laparoscopic Surgery Maxillofacial Surgery Cosmetic Surgery Dermatology Vascular Doppler Cardiac Catheterization Hospital Pharmacy Internal Medicine General Medicine Pulmonology Neurosurgery Neurology, E.E.G. and Electrographs Psychology and Neuropsychology Obstetrics and Gynecology Odonto Ophthalmology Oncology Osteopathy Otolaryngology

21 Pediatrics Chiropody Childbirth Preparation Psychiatry Radiology Hyperbaric Medicine Service Trauma and Orthopaedic Surgery Intensive Care Unit (U.C.I.) Physiotherapy and Rehabilitation Unit Emergency Urology

Clinca Lasain www.clinica-lasain.com

Private clinic in Ibiza providing mainly cosmetic services including: • Sclerosis and varicose veins treatment • Lymphatic drainage • Mesotherapy for cellulite and obesity • Botox • Cutaneous implants and cosmetic surgery • Wrinkle correction, lip filler, brow with semi or permanent • Cosmetic Surgery – for the correction of breast reduction or implants, belly, nose, facial ligting, eyelids, ears, and liposuction

Clinic Balear www.clinicbalear.com

Clinic owned by Grup Balear Balear Clinic founded in 1981, is the leader in the Balearic Islands in the provision of outpatient health care services. An extensive network of centers and more than 50,000 annual treatments. Company formed by one side, by all medical clinics in more than 24 points in the Balearic Islands (Mallorca, Menorca and Ibiza), and secondly, by a team of doctors, nurses, specialists, receptionists and administrative staff poured into the health of their patients 24 hours, 365 days a year.

They offer a wide variety of medical specialties, with immediate appointments in most of them, constantly expanding with new specialisms.

• Balearic clinic dental • Laboratory analysis • Transfers land and sea across the spanish territory • Medical service in clinic no appointment • Ats / due in clinic • Conventional radiology • Ambulance service • Clinical analysis

22 • Medical specialties

Services available at their other centers in the Balearics: • Rehabilitation • Radiology

Galeno Clinic 24-hour emergency clinic in Sant Antoni.

Centro Medico Santa Eulalia www.centrosantaeulalia.com

Approved centre for check-ups for the psycho-physical driver's licenses, certificates and other weapons and a member of the Catalan Association of Medical Examination Centres.

Services:

• Certificates and / or psychological and medical reports for driving licenses, weapons permits, private security etc. • Consultation service for health advice (general) attached to the main health insurance companies • Ophthalmology

Instituto Biologico de la Salud www.ibizasalud.com

The Biological Institute of Health: Medical Director I.B.S. is Dr. Carmelo Sansano, Internal Medicine specialist and expert in Biological Medicine and Homeopathy, as well as organotherapy, ozone therapy, hyperthermia and orthomolecular medicine.

They use diagnostic methods that have proven more effective and reliable early detection of disease and assessing risks and implement health care treatments and better, more effective, with fewer side effects and more advanced and do all this activity with the highest quality.

Dr. Carmelo Sansano Dª Leire Salmerón, Physiotherapy Nurse D. Kei Arai. Craniosacral, Balancing & Rebalancing Dª Isabel Kidston. Administrative Director Dª Heike Hoffmann, Secretary

Services

23 • Massage, Physical Therapy and Recovery • Biological Analysis • Natural Medicine and Biological Homeopathy Neuraltherapy Organotherapy Phytotherapy Aromatherapy Furter • Ozone Therapy • Carboxy • Colon Hydrotherapy • Hyperthermia – Oxitermia • Three-phase oxygen • Chelation • Orthomolecular Medicine • Pulsed Magnetic Fields • PAPIMI • Psicofonoterapia • Body Detox • Pediatric Homeopathy • Day Hospital Ozone Therapy Oxygen Body Detox Chelation Orthomolecular Serum Repolarizante • Biological Cures • Antiaging Medicine • Stop Smoking

See appendix 6.5 for additional data on private clinics on Ibiza.

3 Requirements to Work

3.1 Qualifications

The core nursing qualification is the DUE or Diplomado/a Universitaria en Enfermeria.

Nursing education in Spain is developing rapidly in accordance with the European Union growth and within an international globalization movement.

Since nursing education was integrated into the university level in 1977, the only academic recognition for such an education in Spain was the three-year diploma degree (DUE). Nurses had to move into other disciplines in order to achieve

24 academic growth or advance their nursing studies abroad. Currently and in compliance with the Bologna declaration for the Higher European Education Area, nursing education in Spain is being transformed into a program, which recognizes bachelor, master and doctoral degrees in this field.

In January 2005, the Spanish Government published the guidelines for the undergraduate, master’s and doctoral levels, and finally, in October 2007, it established the regulations for the official university education.

TCAI (Technicians in critical care nursing assistants) is the other relevant qualification in nursing. This examiniation can be taken locally (refer to news article in Appendix 5.1).

Nurses that studied in other EU countries should have their qualifications automatically recognised under the EU’s Sectoral Directive system. However, the recognition process can be difficult and unnecessarily complicated with problems arising if training was completed before the EU Directives were put in place.

The professional association in Spain is the Spanish Nurses’ Association (Organización Colegial de Enfermería, www.ocenf.org). The website is only in Spanish but includes a list of the colegios throughout the country, so that you can contact your nearest one to apply for registration.

As with all recruitment businesses, it is advised that the revelant checks on candidates be made including criminal and professional misconduct. Candidates are also likely to need to supply full details of their immunisations and any professional indemnity insurance.

3.2 Skills As mentioned previously, key language skills are Catalan, Castilian and then English and German.

3.3 Licenses All nurses, whether working in the public or private sector, must be registered in their local Provincial College of Nurses. The registration can be transferred to other regions. Entry requirements include a birth certificate, the professional title or proof of completing the College education or an official receipt for application for the professional title.

All EU nationals have the right to find employment in Spain without a work permit. If you spend more than 183 days in Spain during once calendar year you become liable as a resident for tax purposes and must register for your NIE which a joint Fiscal Identity Number and Residency Certificate.

25 Nationals of other countries may need specific visas to enter and work permits to train or be employed in Spain.

For all permanent public sector jobs in Spain, you need to take the oposiciones - public exams which are held every year and for which places are limited. However, you can get short-term contract work, as long as you do the following:

• Get a copy of your registration certificate • Get an official translation of the above • Contact the Ministerio de Educacion y Ciencias for an official certificate. • Register at the bolsa de trabajo at your local hospital

Bear in mind that the process above can take up to a year.

3.4 Contracts In order to obtain a work contract with a Spanish employer, you will need your NIE number first. To get the same rights as a Spanish employee you will need a work contract that is at least 6 months in duration.

You must then register with the Spanish Security office (Seguridad Social) and for this you will need to take your work contract and NIE. Any spouse, partner or child is also entitled to medical cover. An additional “beneficiary” form must be completed, and the Marriage Certificate, Certificado de Convivencia and Birth Certificate(s), as appropriate, should be produced with the other paperwork.

Working mothers with a child under 3 years of age can apply for child benefit, by completing and presenting Form 140 "Deduccion por Maternidad" to the Hacienda (tax office).

You will receive a temporary card that shows your social security number. This card should be taken to your local social security clinic and you should register with a doctor. This will instigate your permanent health card.

4 The Marketplace

The health institutions that create the most jobs for nurses are public institutions, mainly those run by the Autonomous Communities.

The rest of the public institutions (municipalities, military hospitals, etc.) and private institutions are also elements to consider, but generate fewer jobs than the aforementioned.

The government, as they are obliged by law to give equal opportunities, regulate the access system called selection systems, through the competitive examination

26 system currently regulated by Law 55/2003, of December 16 of the Statutory Regulatory Framework of Personal Health Services.

Selection can be made through the opposition system where most appropriate in terms of the socio-professional group that can access the tests or functions to be performed. The opposition is holding one or more tests designed to evaluate the competence, suitability or fitness of applicants to perform the corresponding functions, and to establish their priority.

The competition consists of assessment of competence, fitness and suitability of applicants to perform the corresponding functions through the assessment scale according to the most significant aspects of the relevant curricula, and to establish their priority. The call may establish criteria or scores to overcome the competition or any of its phases.

The competition will consist of the consecutive, and in order to determine the call of the two systems.

The regular staff appointments as fixed will be issued in favor of candidates who obtain higher scores on all tests and evaluations, earning a nomination for the permanent performance of the duties arising from such appointment. Selection of staff shall be temporary regulated through procedures that provide the maximum flexibility in the selection, based on the principles of merit, ability, competence and advertising. These appointments will be made on grounds of necessity, emergency or development programs temporary cyclical or extraordinary health services personnel may appoint temporary regulated. These interim appointments may be of a temporary or replacement.

Normally all the provinces have their bags for work, while in some cases centralized and decentralized in others, it would be advisable that those interested in seeking employment, requesting information on the services headquarters or regional health institutions where they inform each individual case.

Organizacion collegial de Enfermeria

The labour market showed no change in Q1 of 2011 Job market figures remained stable in 1Q11. Adjusting for seasonal and calendar effects, although the economy was still unable to create jobs, the rate of growth in unemployment continued to slow. Social security affiliation numbers fell at virtually the same pace as in the previous quarter (-0.3% qoq SWDA compared to -0.2% in 4Q10), while unemployment rose more slowly at 0.1% qoq SWDA (from 0.5% qoq in 4Q10) The Labour Force Survey (LFS) for 1Q11 confirmed the same trend. Employment fell in line with expectations, mainly for non-seasonal reasons (-256,500 jobs gross, -86,400 SWDA). Despite the slight fall in the active population (-43,000), job destruction –concentrated in indefinite employees and industry and construction workers– prompted an uptick in unemployment to 21.3% and a stagnation in the temporality rate to 24.8% (Chart 18).

Ref: Spain Economic Outlook. Second Quarter 2011 BBVA Research

4.1 Current Vacancies advertised by IB-SALUT:

Optional Analysis Specialist Clinicians Monday, 13 December 2010 Qualifications required: Degree / DA or Doctor of Medicine and Surgery, Biochemistry, Pharmacy, Biology or Chemistry. Medical pharmacist, Biology / a, Chemical / Specialist in Clinical Analysis. Type of Contract: Temporary. Interview: Must demonstrate the requisitions of qualifications required in that role (Title of Licenciado and Specialist in Clinical Analysis)

The selection of a square with the character of a group sustitución run the administrative functions for the health area of Ibiza and Formentera Friday, 26 November 2010 Qualifications required: Technical Engineer, University Diploma, Architects, Vocational third tiers or equivalent or get it inside of conditions outside of the presentation of requests.

The selection of a square with a group of possible administrative nature of the administrative functions for the health area of Ibiza and Formentera Print Email Friday, 26 November 2010 Qualifications required: Bachiller (LOE) Bachiller (new law), bachillerato polivalente Unified, higher Bachiller (1957 plan), technician, technical specialist. Foreign degrees must be approved by the Ministry of Education. Type of Contract: Temporary.

SC medical Formentera Friday, 01 October 2010 Place of work: Hospital of Formentera. Qualifications required: Degree in Medicine and Surgery. Type of Contract: Indefinite.

4.2 Review of work offered online (June 2011) www.ubes.com Pharmacist required. www.ibizajobcentre.com No nursing vacanices www.thinkspain.com No nursing vacanices www.trabajos.com www.indeed.es

28 Date: 08/06/2011 Business: Sociedad de Prevención de Fraternidad Muprespa Title: Nursing Requirements: Diplomado/a en Enfermería (DUE). Minimum years experience: 1 Permanent Contract Salary dependent on candidate 07:30 - 15:00, Monday to Friday www.infojobs.net One advert for doctor in San Antonio.

DUE,NUTRICIONISTA,OPTOMETRISTA Y PODÓLOGO/A Date: 09-06-2011 Employeers: ADECCO MEDICAL & SCIENCE Location: Mallorca, Menorca and Ibiza

Qualifications: Diplomado Requirements: -Diploma in Nursing, nutrition, optometry and podiatry. -Resident in Mallorca, Menorca and Ibiza Permissions of Labor and approvals, in the case of professionals foreigners.

4.3 Competitor Recruitment Agencies www.mediempleo.com www.adecco.es

5 Associations and Organisations

5.1 Main Organisations www.EnfermeriaBalear.com

Union Balear de Enitdad Sanitarias www.ubes.es The BALEAR UNION HEALTH INSTITUTIONS was established in 1985 as an association of companies doing work in the private health sector.

This association has as its mission the determination to join forces so that its

29 partners provide a health service of high efficiency and high quality to the entire population of the Autonomous Community of the Balearic Islands.

Members: Hopsitals: Clinica Juaneda Clinica Juaneda Menorca Clinica Rotger Hospital Cruz Roja Hospital General de Muro Hospital Sant Joan de Deu Mutua Balear Policlinica Miramar Policlinica Ntra. Sra. Rosario (Ibiza) Policlínica Virgen de Gràcia (Menorca) USP Clínica Palmaplanas

Diagnostic & Treatment Centres: Billy Boots Servicio de Rehabilitzación Clinic Balear Centro Policlínico Quirúrgico Institut Oftàlmic de Mallorca (IOM) Instituto balear de Oftalmología (I.B.O.) Laserclínic Servicios Medicos Palma Eiviconsulta, S.L. Instituto Balear de Infertilidad, Ginecología y Reproducción (IBILAB) ASEGURADORAS Mapfre Caja Salud RESIDENCIAS Sa Copa Residencia Geriátrica

Key Staff: Dª Carmen Planas Palou, President, T: 971 476049, E: [email protected]

D. Gabriel Uguet Adrover, Vice President, T: 971 476049, E: [email protected]

D. David Medina García, Vice President, T: 971 476049, E: [email protected]

D. Sergio Bertrán Damián, Vice President, T: 971 476049, E: [email protected]

D. Antoni M. Fuster Miró, Manager, T: 971 476049, E: [email protected]

Joana Binimelis Bennàsar, Administration, T: 971 476049, E: [email protected]

SATSE Sindicato de Enfermeria, Illes Balears www.satse.es

With over 20 years of history, the Union of Nursing, SATs, is an organization of more than 76,000 nurses. SATSE implementation has a majority in the health sector and is characterized by its defense of the nurses, both the profession and the professionals who practice it. Through its constitution, the Union of Nursing has managed to bring the voice of nursing across all areas of negotiation and decision making. Young, dynamic and progressive, SATSE work to ensure compliance with the statutes of Nursing and the defense of the nurses, represent and provide all the support information, legal, and union training they might need.

SATSE’s existence reflects the need to defend nursing professionals, providing solutions and answers to their problems and demands. SATSE, social agent, advocates a public health model, supported by statutes that uphold the principles of universality, equity, solidarity and free which is based on the General Health Law.

The implementation of the Union of Nursing, State, and its structure has about 3,000 union delegates distributed in all workplaces in the country. The bodies of SATSE are structured in a decentralized manner at three levels: National, Regional and Provincial. Their main objective is the defense of nursing professionals and its bylaws.

General Secretary Tera Jorge Donoso [email protected]

Deputy Secretary Espinola Sergio Tortosa [email protected]

Secretary of Union Action Ana Tobes [email protected]

Can Misses section (Ibiza & Formentera area)

Hospital de Can Misses c/ Barrio de Can Misses, s/n. CP 07800 Ibiza. T: 971.39.72.90. E: [email protected] SATSE Delegates: Carmen and Mercedes

FSP-UGT Balearic Islands (Federation of Public Services) http://balears.fspugt.es

The FSP-UGT is made up of Public Employees serving in ministries, autonomous bodies and Social Security, Justice Administration, Autonomous Regions, Private

31 and Public Health, Post Office, Local Authorities, the employees of entities or indirect management companies in public service, as well as first job seekers with work opportunities in public Administration.

To better serve the needs of the membership, there are five sections: General Administration of the State (AGE), Regional, Local Health and Social Services, Postal, and departments or groups, such as Police, Fire, Justice , AENA and Prisons.

Among others, the most important services they provide to partners and affiliates include: Legal Office to advise members individually, Training, own training plans in different areas of administration, managed by Forum for Training and Publishing Islands Islands, Inc., Office of Risk Prevention, accident insurance in case of death (after one year of continuous membership in UGT), liability insurance for certain groups, leisure homes, tax returns, etc. ...

The FSP-UGT work on the harmonization of laws and agreements which are necessary to achieve decent pay, training systems and promoting appropriate and adequate social security. They also produce alternatives for different public services to ensure both the human development of Public Employees, and the maximum efficiency and best service to the community as best way to achieve another of our main objectives: the protection of Public Services.

Secretary General - Aurelio Martinez Guerrero de Penon Secretary Administration and Finance - Pedro Vera Mora Secretary Action Association - Barron Miguel Angel Romero Labour health secretary, Women and Youth - Maria Antonia Salva Mut Secretary of Education - Margaret Enriquez Gonzalez Secretary-sector AGE - Pedro Homar Ferragut Regional Administrative Secretary sector - George Reyes Crehuet Secretary Local Government sector - Teba Antonio Vicens Secretary Organization - Miguel Herranz Bonet Postal industry secretary - Catherine Oliver Sagrera Executive Secretary - Mundita Bustins Pons Institutional Secretary - Maria Antonia Rodriguez Tovar Secretary healthcare sector, and Dependency Services Sociodanitaris - Aurora Lopez Mendez

5.2 Additional Organisations of Interest

• Asociacion Nacional de Enfermeria de Cuiadados Intensivos Pediatricos y Neonatales www.anecipn.org • Federacion de Asociaciones de Enfermeria Comuniatria y de Atencion Primaria www.faecap.com • Asociacion de Enfermeria Comunitaria (AEC) http://enfermeriacomunitaria.org/web/

32 • Asociación Española de Enfermería en Traumatología y Ortopedia (AEETO) • Asociación Española de Enfermería de Especialistas en Análisis Clínicos • Asociación Española de Enfermería en Cardiología (AEEC) • Asociación de Comares Valenciana • Asociación de Enfermería Comunitaria • Asociación Española de Enfermería Deportiva (AEED) • Asociación Nacional de Enfermería e Investigación del Deterioro de la Integridad Cutánea (ANEDIDIC) • Asociación Española de Nomenclatura, Taxonomía y Diagnósticos de Enfermería • Asociación Española de Enfermería Docente • Asociación Española de Enfermería de Admisión, Archivo, Codificación y Documentación • Asociación Española de Enfermería en Anestesia, Reanimación y Terapia del Dolor • Asociación Española de Enfermería Endoscópica Digestiva (AEEED) • Federación de Asociaciones de Enfermería Comunitaria y de Atención Primaria • FAME (Federación de Asociaciones de Matronas de España) • Asociación Nacional de Enfermería de Cuidados Intensivos Pediátricos y Neonatales • Asociación de Enfermería de Equipos de Terapia Intravenosa • Asociación Catalana de Llevadores • Asociación Sindical Gallega de Matronas • Asociación Andaluza de Matronas • Asociación Española de Enfermería Especializada en la Lesión Medular Espinal (ASELME) • www.todoenfermeria.es •

6 Appendix

6.1 News Items of Interest

The Ib-Salut agreement with private healthcare providers and 23 centers will be financed with 18 million in two years

May 26, 2011 by Diego Feliu, www.tablondenoticias.com

The Acting Minister for Health, Vicenç Thomas, adopted in early March a party of 25 million euros to set up private centres with the island's 180 kinds of elective surgery in all specialties and top rated prices.

The general director of Ibsalut, Josep Pomar, gave a deadline of March 11 for bids for clinics and hospitals that were interested in offering their services to the Ib- Salut. 23 companies offered to be healthcare providers and service charges far below the maximum established by the Servei de Salut. In principle, the maximum budget to finance the diversion of patients to the centers was 7,776,158 euros contract for the remainder of 2011 and EUR 17,940,395 for 2012.

On the forth day, the general secretary of the Ib-Salut, Javier Cavero, decided to award the framework contract to all bidders who submitted bids for different lots for the amount expected in 2012 but now will be to finance two years. Ie 7,776,158 euros for 2011 and 10,164,237 for 2012. Therefore, Servei de Salut has saved the amount foreseen for this year as the start of 2012, will now pay the exercises.

Public centres will have this amount of nearly 18 million to set up their surgeries, and are still are Espases Llatzer which will have more budget for it. In both cases exceed 6 million euros. Manacor Hospital, 1,800,000 euros and the District of Inca almost 2 million.

This measure aims to reduce waiting lists for scheduled operations. The new head of Health People's Party government will now supervise the private management of these public services.

58 nursing assistants in Ibiza and Formentera are already tenured El Diario, Ibiza 12 May 2011

The Department of Health, Ibiza and Formentera celebrated the inauguration of the permanent positions for technicians in critical care nursing assistants (TECA) with a welcome event.

At 9.30 am in the Auditorium of the Can Misses Hospital took place on the act of taking possession of the technicians in critical care nursing assistants who have passed the competitive examination of the Servei de Salut de les Illes Balears for places Area called Salut d'Eivissa i Formentera. Just 58 were nursing assistants who have taken up permanent position: 49 at the Hospital Can Misses, 3 Primary Ibiza, 4 Hospital de Formentera and 2 Primary Formentera.

The welcome ceremony was chaired by the Manager of the Health of Ibiza and Formentera, Julio Villar, together with the rest of the team: the Managing Director, Alberto Fernandez Cladera, the Director of Primary Care, Barriuso Lisardo Gonzalez, Director Nursing, Norberto Sanchez, Medical Coordinator of Primary Care Teams, Carmen Santos, and Inmaculada García, Coordinator of Nursing Primary Care Teams.

For Julio Villar, this act is of great importance because "means that the technical team of nursing assistants of the Balearic Islands to develop their career with the degree of security offered a permanent position on the other hand is essential to consolidate a professional group about the future that awaits us with the new hospital and changes in organizational model that arise. " You are always for change and I encourage you to continue with the same determination as you to be critical and critical "is now closed. Finally, Norberto Sanchez, congratulated and welcomed the 58 technical assistants in nursing and has been valued very welcomes the fact that of 170 nursing assistants technicians are there in the

35 health area of Ibiza and Formentera, 58 already have tenure, 34% in this competitive examination.

The restructuring of the Ib-Salut causes 31 resignations and primary care nursing They claim that the order of the Councillor removed addresses and Primary Care Nursing El Diario, Ibiza, 19th April 2011

About three o'clock in the afternoon yesterday the director of nursing, nursing coordinators of the health centers of the Balearic Islands and the hospital nursing supervisors resigned en bloc, motivated by the order of the Balearic Islands Councillor of Health restructured Management of the Health Area of Ibiza and Formentera, which, denounce disappear addresses of Nursing and Primary Care. The Area Manager said hours after it is "an error in the wording" of the order and guaranteed to keep both figures.

A total of 31 employees of the Primary Care Nursing and Health area of Ibiza yesterday afternoon presented their resignation en masse in protest against the order of the Balearic Salut Councillor regulating the structure of the Department of Health and eliminates Address of Nursing and Primary Care, as reported yesterday Cemsatse and CSIF unions. "We are all supervisors and coordinators of the Balearic Islands," said Carmen Ortiz, a member of the union's nursing SATs. Among those who submitted the resignation is also the director of Nursing, Norberto Sanchez, hospital sources said. The decision was made yesterday after two o'clock in the afternoon, after meeting the director of the Ib-Salut, Josep Pomar, held with staff to inform them of Can Misses career in healthcare. Workers took advantage of the presence of nursing Pomar to ask about the new structure of the health area, some critics have processed "without the workers' and what they learned to see it published in the Official Gazette of the Balearic Islands last Thursday. Carmen Ortiz said the scuffle between Pomar screams and workers could be heard outside the hall. Before this meeting took place one between Patricia Gómez, coordinator of nursing care of the Department, and the manager of the Department of Health, Julio Villar, say the unions.

A spokesman for the Health Area of Ibiza and Formentera said at first they had no record of any resignation has been submitted. A few hours later in July Villar also declined to confirm this. Carmen Ortiz explained that the joint letter of resignation was submitted about three in the afternoon check in the hospital and the manager himself called on workers to rethink their decision, something that the nurses refused ensuring that it would step back "not for air." Villar recognized that knowing the intent of the workers had asked to resign to reflect, but would not confirm who had submitted the letter. The manager called it 'belated overreaction "the behavior of coordinators and nursing supervisors who resigned just over an hour after his meeting with Josep Pomar.

Similarly, ensured that the directions of Nursing and Primary Care and will not disappear, as so far only depend on the management and care of a director and the workers have interpreted it. He said this is a misunderstanding because of a

36 wording 'unclear' in order to rectify over the week. A spokesman of the Department of Health said yesterday morning that the legal services of the Department and were "studying the wording 'in order to replace it and denied it was a' reverse 'motivated by opposition from the template.

"He corrected and I hope it returns to normal. Yes it is very busy and that has created alarm but will be resolved, "insisted the manager, said the sole purpose of this new management structure is to" unify the management of the hospital in Formentera with the hospital Can Misses. " From the entry into force of the order (last Friday) Villar is not only the health area manager but also from the hospitals. The hospital manager will Formentera not own, but a medical director and a director of nursing, the manager assured. According to a spokesman for the Area Health the new wording will change some of the names of the organs that make up the management to adapt to the current. The order provides: address management, direction and other assistance to Ibiza to Formentera, management of financial resources and general services, human resource management, emergency management and emergency management and patient management and information systems.

Spokesmen for the Department of Health and the Balearic Islands Health Area pitiusa refused yesterday to provide more information on the specific changes that will involve the implementation of this new order. Carmen Ortiz said yesterday that the restructuring had already tried to apply the Son Dureta hospital in Mallorca and in Menorca Mateu Orfila and that the Department had to turn back because of opposition from workers. The Department of Health Spaniard refused to confirm this and to detail why we need this restructuring of the Health Area of Ibiza and Formentera.

No Minster of Nursing Staff El Diario, Ibiza, 19th April 2011

Carmen Ortiz, a member of the union's nursing SATs, yesterday accused the Balearic Islands Councillor of Health, Vicenç Thomas, "no nursing staff." "The minister has publicly demonstrated this order to know who the nurses and the valuable contribution made by the healthcare system," he insists. The union is demanding that the Govern "remove" this order and that "guarantee" the continuity of the addresses and primary care nurses' work as now. ""Management of Nursing was established 30 years ago and disappear is a setback," he lamented Ortiz, who said that the director of nursing, Norberto Sanchez learned of the new structure of the health area to see it published in the Official Gazette of Balearic Islands. "He has done everything back to the workers and with the support of the manager, who has not had his team," he complained.

Teresa Arce, delegate of the CSIF, also yesterday demanded the withdrawal of the order. "The directions of Nursing and Primary are diluted in the seven directions that form the new management," he complained. The two explained that in addition to the disappearance of nurses from this direction affects nursing assistants, midwives and physiotherapy staff, which also depend of

37 Nursing, and ensured that amounts to more than 600 people in Ibiza and Formentera.

Both said that if the Department does not repeal the order will continue the protests, which began this morning with a concentration outside the hospital.

Over 300,000 residents in Spain are not entitled to free medical assistance

By: thinkSPAIN , Monday, April 25, 2011

AN estimated 300,000 people living in Spain have no entitlement to free healthcare.

The ministry of health says literally hundreds of thousands are forced to take out private health insurance policies, despite the fact that Law 14/1986 states that anyone resident in Spain has the right to free medical care.

Those who fall into the loophole include people whose dole money has run out, but who have an income exceeding the Spanish minimum wage of 641 euros a month.

They also include those who have never worked, except sporadically or for cash in hand. And even certain professions, such as lawyers and architects, who do not form part of the mainstream social security regime for the self-employed due to their line of business, are unable to take advantage of free healthcare as they are not 'paying into the system'.

However, even those who wish to pay social security in order to have free medical treatment are unable to do so if they do not work.

Despite the law stating that all residents must have access to healthcare, in practice, anyone who is not on the social security system is denied this right. It means that most early retirees – even from EU countries – are not entitled to it. The situation would be the same for Spanish nationals in this situation, but early retirement is extremely rare unless on health grounds, and even frowned upon, given that there is little culture for investing in private pensions.

Marciano Sánchez, of the Federation of Associations in Defence of Public Health (FADSP) says the law of 1986 superseded previous legislation which stated that only those who paid into the system could be treated free of charge.

Lawyer Santiago Herrera – another professional who is unable to get free healthcare due to his trade – says: “We are asking for the State to fulfill its duties concerning our rights. The system has changed and social security payments no longer determine cover for medical assistance – it is paid out of other contributions, such as income tax.”

38 www.ibsalut.es

Can Misses professionals have had a first contact with the future on a visit to hospital outpatient block. About 40 doctors and nurses, among whom were the heads of the Gynaecology and Obstetrics (Rodolfo Moreno), Pediatrics (Bartholomew Boned), Dermatology (Lluis Cros), Internal Medicine (Josep Maria Tugues) Neurology (José Luis Paraju) Gastroenterology (María José García Gutiérrez), Hematology (Joseph Balanzat), the nursing supervisor of outpatient visits (Lola Campos), accompanied by Health Area Manager of Ibiza and Formentera, Julio Villar, Medical Director, Toni Cuñat of Nursing, Norbert Sanchez and Managing Director, Alberto Fernandez, the three plants examined outpatient block exploration and cabinets to be opened soon.

After a year of exhaustive work on plans for professionals in the design and organization of the first building to be launched from the four that make up the new hospital complex, on May 4 came time to discuss the proposed site improvements that were made and collected in almost all. From now on weekly visits are planned for the rest of the Can Misses Hospital staff know and become familiar with the new facilities. Initial reactions have been positive since "plan everything seems really small and very spacious consultations" said José Balanzat Service (Hematology). In the same vein, M ª José García, Chief of Gastroenterology, plan in hand, ran his satisfaction with Lola Campos (Supervisor of Nursing Consultation) the space for their service.

17 services have already requested to start operating in the new block once it is completed the work. It is estimated that the building is given by the construction in late June and from there begin their equipment. For Julio Villar, Area Manager of Ibiza and Formentera Health, "is a priority to involve professionals in the design and organization of the new hospital. We will allow a change in organizational model with the patient as protagonist, with high-resolution queries to resolve in one visit, diagnosis, testing and treatment. A more agile and effective. From now on we must look first impressions of professionals to coordinate the transfer and that this ensures that both patients and professionals have optimal conditions in the new building. We will do things slowly and ensuring higher quality care "

Can Misses performed 8194 operations in 2010, 16.3% more than in 2009 The manager of the Department of Health says it has boosted the performance of the operating room, reducing the time they are not operating El Diario, 14th February, Ibiza

Open the operating room in the afternoon and reduce cleaning time and preparation to avoid losing time are the measures which, from a year ago has applied the Can Misses hospital management to increase the activity and minimize the surgical waiting list. Similar measures (more doctors and hours of operation) have been applied in 2010 to reduce both the number of patients as long as these waiting for a consultation with a specialist. Although the data can be improved, the manager, Julio Villar, is pleased with the activity of Can Misses

39 in 2010.

IBIZA | MARTA TORRES Professionals Can Misses Hospital made last year a total of 8194 surgeries, 1,151 more than in 2009, implying an increase of 16.34%, as explained last week the heads of the health center, headed by the manager of the Health Area of Ibiza and Formentera, Julio Villar. The manager was "very pleased" with the hospital's data and also noted that the December 31, 2010 there was no patient Pitiusan that took more than five months waiting to enter the operating room. At that time there were 1026 people awaiting intervention, 32 less than the same date in 2009.

The manager explained that this reduction is due mainly to the effort made by professionals at the hospital to meet the new management plan launched last February, a year ago. "There has been increased activity, there is less waiting list, patients wait less and the process is more orderly," says Alberto Martin, director of Management. For the manager, one of the keys to these data is the "best performance" of operating rooms. Villar Martin and detailed the optimization of operating rooms has increased from 46.1% of net use (ie the total time that is taking place) to 63.1%. That is, it has increased the time being operated in the operating room and reduced the time lapses between each operation. "He has done a great job of coordination and organization," said the manager. The admissions director specified that schedules were adjusted so that no time is wasted waiting for the cleaning of the operating room because the patient is not ready for surgery or, for example, because missing a prosthesis. In addition, the operating rooms were opened for the afternoon.

The hospital officials emphasized the timeout lengths. In this regard noted that in 2010 increased the number of patients less than 90 days waiting for an intervention, which said they should have tried to minimize possible people who had spent more time waiting. In this regard noted that, unlike 2009, there is no one to wait over 150 days and that users wait between 90 and 150 days have passed from 300 in 2009 to 130 in 2010. Thus, the average delay was reduced from 69.7 days to 54.4. The waiting time ranges from 41.3 days of oral and maxillofacial surgery to 64.6 ophthalmology.

For queries External consultations, ie with the specialist, rose last year by 10.4%. It made 141,983 visits, 13,427 more than in 2009. The manager indicated that they have hired specialists (cardiologist, a pulmonologist, an orthopedic surgeon, an ophthalmologist and maxillofacial surgeon, among others) and also have provided more office hours. Villar explained that the lists were opened citation to the doctors, that is, they can access the agendas of the specialists and make an appointment date and time for patients. The delay for the first query has been reduced from 56.7 days on average in 2009 to 29.3 in 2010. The medical director, Toni Cuñat, said waiting lists at this time does not depend on space and time, an idea in which he explained the manager. "The ability of the consultations is packed. There in the afternoon, some have moved to primary care, "he said noting that there are some health queries Rehabilitation, Dermatology, Gynecology and Orthopedics. New physicians have taken the time off, those who

40 wanted to increase their hours have gone by the afternoon and those over 55 who have invoked their right not to offset your salary guards have more hours in response, explained the manager.

Villar said the increase in demand for services such as Accident and Ophthalmology, directly linked to longer life expectancy of society, and stressed that the first consultations in oncology are performed within seven days and treatment is initiated before 30. "With the cold data is less waiting who is General Surgery, with 7.4 days and more, Urology, with 67.6 days," said Alberto Martin. The goal, said the manager, "is that patients with more expected to wear off and waiting to accumulate in the early stages. This is sort of demand. " In this regard, he noted that the number of patients waiting more than two months for a consultation with a specialist has increased from 1753 in 2009 to 281 in 2010 (83.9% less).

Villar July amounted to 289 the number of patients at the end of the year were "in box" that is awaiting an appointment. "There is no secret, but in 2009 there were over 2,000 in this situation," he said.

At the end of 2010 there were 289 patients waiting to give them a date for the specialist, a figure that surpassed the 2,000 in 2009

Awarded 111 permanent positions for nurses in the island of Ibiza A total of 91 corresponds to Can Misses Hospital and 20 primary care El Diario, Ibiza 30th June 2010

The Official Butlletí de les Illes Balears (BOIB) has published the award of 111 seats still nursing the island of Ibiza, in the 722 that correspond to all the Islands, said yesterday the Department of Health.

From Ibiza, a total of 91 were awarded in hospital Can Misses, although more than half were already part of the hospital staff on an interim basis. The other 20 were assigned to different health centers in Primary Care.

From Monday have begun to incorporate their jobs all those who come from outside the island of Ibiza and will continue throughout the month of July. With the imminent addition of personnel selected by the Tender Offer category Employment ATS / DUE has created a host office and counseling personnel. This service is coordinated by the Director of Nursing Can Misses, Isabel Zaldivar, who also welcomed the addition of these 111 fixed seats for the island of Ibiza. This increase in staff for that department is the result of the resolution signed last April 14 by the Minister of Health, Vicenç Thomàs, which was convened by an open competition to fill vacancies in the category ATS / DUE. This was an old request of the medical staff of this hospital.

About half of new permanent positions at Can Misses already covered on an interim basis, according to the hospital in Ibiza.

Nurses travel abroad to work

By: The CB Friday , Friday, September 10, 2004

About 200 nurses have left the Costa Blanca in the past year to work abroad, sources confirmed this week.

Of the 15,000 qualified nurses in the Valencian Community, a third are unemployed. The obvious choice is to move abroad to countries where there is a shortage of personnel including Italy, Portugal, France, the United Kingdom and even Canada. In these countries, they are offered contracts of between six months and two years.

In order to create more employment, the nursing college together with the health ministry are considering offering nurses the chance to work as home help to patients with mental health problems.

Health authorities say the cost of residential care is between 50 and 70 euros a day, whereas a nurse earning 1,200 euros per month can care for up to 30 patients, a big cost saving.

The Balearic Islands have for the first time with a Strategic Health Research

Last updated: 16/04/2010

The President of the Government of the Balearic Islands, Francesc Antich, and the Minister of Health and Consumption, Vincent Thomas, presented the world of health research and the Strategic Health Research, which first made in the Balearics. The Government has firmly committed to give impetus to knowledge as a tool to structure the improvement of quality of life of citizens of the islands.

The Strategic Health Research is budgeted at 28,239,592 euros between 2010 and 2013 that will come from public funds of the Ministry of Health and Consumption and fundraising from other Spanish and European public institutions and organizations in private. The plan was carried out in a participatory way and caters to the need to design a structured process and planned to serve as a basis for developing measures for coordination, dissemination and promotion of health research in the Balearic Islands.

The budget breakdown by year is as follows: 6,807,695 euros per year, 6,903,360 euros for 2011, 7,486,283 and 7,042,254 euros for 2012 to 2013.

The Department of Health and Consumption increased its budget for 2009 a 5.06% and reached 1254 million euros

Last updated: 12/12/2008

The Department of Health and Consumption increased its budget for 2009 to 1.254 million, representing 5.06% more than in 2008 and translates into about 60 million more. The sector with the largest increase is primary care, rising 12%.

The Minister of Health and Consumption, Vincent Thomas, appeared today in the Budget and Finance Committee of Parliament to explain that the money will be used next year to fulfill its program of government.

Thomas pointed out that 35% of the budget of the Autonomous Community Health and is intended to set the stage in which the fall of 2009 and estimates that are defined by five factors:

1 .- The 2008 budget inertia: The Department of Health and Consumer Affairs has a deficit in the period 2003-2007 of 250 million euros, which has required a year of austerity, optimization of resources in id'efectivitat management. Nevertheless, the Department has fulfilled the objectives set for 2008: a) Increase of professionals: 67 physicians have joined in primary care, 23 pediatricians and 42 nurses (allowing a lower ratio of patients per physician 8.7%) and 99 doctors and 101 nurses in hospital care for hospitals. In total, 332 are professionals who give more attention to users in the health system. b) Promote new infrastructure in primary care, development of infrastructures that have benefited about 100,000 people. 34 million being invested in basic health centers and units already under construction, 10 new centers were planned and 7 basic units for 2009 and we are improving and expanding various centers already in operation. In total, an estimated investment of 51 million. c) In the field of hospital care, has completed the reform of one of the flags of the psychiatric hospital, has improved the service portfolio of the Hospital Mateu Orfila, as soon inaugurated psychiatric day hospital, has continued the work of the Hospital Son Swords have been given all the steps to realize the commitment of the Department have a new hospital in Ibiza.

2. The conditions of health workers require significant improvements in 2008 - immersed in a working environment deteriorated, resulting largely from the lack of planning. That led to a strike that was overcome by agreements that have improved working conditions and salaries of workers. The consolidation of agreements on human resources has resulted in a significant budget increase for 2009. 3. Economic environment: the ongoing economic crisis, which is motivated by different external factors, necessary to go very carefully when doing economic planning of the Ministry. 4. Consequences of an unfair funding: Since the validity of the current regional financing system in 2002, the Islands have continued to add 900 million euros. Based on this funding, the Balearic admitted for the year 2009 the amount of 879.9 million. S'en The situation was only partly offset by the Conference of Presidents sponsored by the Government of Jose Luis Rodriguez Zapatero, who has allowed increases of 52.8 million additional funding for 2008 and 53.07 million for 2009. 5. The will of the government and the Ministry to carry out all the objectives of

43 parliamentary strengthening primary care, as a true gateway to the system by increasing resources, improving infrastructure and proposing new organizational models. Also, the development of social and health structures and mental health, improving the performance and implementation of public health policies as a key concept impregnador health in all policies.

Composition of the budget Revenue The 1.254 million which will manage the Department of Health and Consumer Affairs are broken down into 932.9 billion from the state (74%) and 315 million provided by the Autonomous Community (26%). In addition, there are other 5.2 million for specific programs that are financed from the government and Ministry of Health and an increase of 73% compared to the 3 million received in 2008. The most important programs are: • Specific collaboration agreements of palliative care (114,084 euros), and domestic violence (91,206 euros). Total: 205,290 euros. • Funding for the strategy of the natural normal part Atencio: 97,029 euros. Funds to develop common electronic history: 200,000 euros. • Fund to develop the Dental Care Program Child (PADI), as based on the agreement, the Ministry provides half the funding for the program: 270,839 euros. • Increase of 1, 5 million corresponding increase of funding in respect of good management of temporary disability.

Health Service Priorities Regarding the actions developed by the Health Service include six main themes contained in its Strategic Plan, which applied during the next 3 years: • The improvement of accessibility and waiting times: the front line will be maintained in 2008, focusing efforts on specific diseases. The aim is that people expect less, especially those who suffer illnesses because of their characteristics can not wait. In any case, keep commitments and forecasts generics collaboration with the private sector if it happens. • An effort to promote the appropriate use of healthcare, through information and education campaign among the population about the best alternatives for each problem and an intervention in the internal management of care, especially emergencies, which strengthened the role of nurses. • Develop a plan to improve the personalization of care, which includes partnerships with Social Affairs in the area of attention to immigrants, the implementation of the guidelines received from patients and users, scanning expectations and satisfaction and also, language standardization that makes it possible for any citizen may no longer be understood in their language. • Develop a HR Plan that aims to improve staff satisfaction in what it includes: or analysis of the working environment. Enhancements or new members of qualifying organizations. The development of career incentives to new criteria that allow the best professionals or analysis of the needs of

44 professionals in the coming years or development plans security and preventing violence. • In 2009 will be held estatutaritzacio commitments that were established in the previous term and will represent an important turning point for Foundations Son Lazarus and Manacor. • To boost the role of nurses at all levels of care, has a strategic plan designed to promote a model of care with care methodology and a careful assessment model.

Primary Care Primary Care of Islands will have 175.5 million in 2009, which means 14.28% of the budget of the Health Service and an increase of 12% compared to 2008, when 155.8 million has . This item will allow reaffirmed commitment to the strategy objectives and develop 21 AP to adapt the templates to the needs, reform and build new schools, promoting professional development and bring services to the population.

Only investment, primary 16.5 million allocated to Primary Care Improvement Plan (not including the construction of new schools), an increase of 7.9% compared to 2008, when the amount was 15 million. The activities will focus on removing barriers and facilitating access to schools, to develop a more modern and realistic maintenance plan.

In this line, from the Headquarters of the Ib-health, as applied Comprehensive Improvement Plan, to enhance the functionality and the provision of care at health centers, 14 in total. This concept uses 5 million of the investment section.

6.4 Private clinics in Ibiza

There is a huge number of small private practices covering the full spectrum of medical and health realted services:

N.B. The practices below have not been verified to confirm current operational status. If a full survey of every practice is required this can be carried out.

ANTONIO JOSE OLLER ENDOCRINOLOGY AND NUTRITION NUTRITION SPECIALIST MASTER Metge Riera Ferrer, 16-18 - 2 º Tel: (+34) 971 307 666

MEDINA PEDRO GARCIA PAEDIATRIC Tel: (+34) 971 190 001

Conill LUIS MADRI OTORHINOLARYNGOLOGY Tel: (+34) 971 315 010

CLINIC DR. THOMAS GENERAL MEDICINE MEDICAL Tel: (+34) 971 313 121

MOHSEN BODDOHI Hosseini MEDICAL DERMATOLOGY Tel: (+34) 971 316 311

46 PEREZ LUIS DELGADO MEDICAL Traumatology and Orthopedics Tel: (+34) 971 392 188

BALEAR Urological Institute UROLOGY MEDICAL SPECIALISTS Josep Maria Quadrado, 1 Tel: (+34) 971 191 053

ROSA MARIA ESTEBAN GIMENO OBSTETRICS AND GYNECOLOGY MEDICAL SPECIALISTS Avenida España, 16 Tel: (+34) 971 303 819

LIA MARIA JESUS GARCIA OBSTETRICS AND GYNECOLOGY MEDICAL SPECIALISTS Carlos V, 12 Tel: (+34) 971 313 053

AGUIRRE JOSE MARIA ABAD DENTISTRY MEDICAL SPECIALISTS Madrid, 5 Tel: (+34) 971 392 248

JAVIER RUIZ BLANCO PSYCHIATRY MEDICAL SPECIALISTS Antoni Jaume, 2 Tel: (+34) 971 310 122

MEDINA PEDRO GARCIA PEDIATRICS MEDICAL SPECIALISTS Avenida España, 18 Tel: (+34) 971 300 235

Casanova ROMAN ROSA OPHTHALMOLOGY MEDICAL SPECIALISTS Hannibal, 8 Tel: (+34) 971 310 723

RODRIGUEZ LUIS MORI GENERAL MEDICINE MEDICAL Ignasi Wallis Avenue, 8 Tel: (+34) 971 315 762

FERRER JUAN PONS PEDIATRICS MEDICAL SPECIALISTS Venda des Coloms, 3-5 Tel: (+34) 971 318 787

47 EGEA GINES CIRERA RHEUMATOLOGY MEDICAL SPECIALISTS Hannibal, 8 Tel: (+34) 971 310 721

JIMENEZ MARIA CORRAL OPHTHALMOLOGY MEDICAL SPECIALISTS Castilla, 21 Tel: (+34) 971 303 416

JOSE ANTONIO MONTES OLLER ENDOCRINOLOGY AND NUTRITION MEDICAL SPECIALISTS Av Macabich Isidor, 63 Tel: (+34) 971 306 191

JOSE ANTONIO MONTES OLLER ENDOCRINOLOGY AND NUTRITION MEDICAL SPECIALISTS Metge Riera Ferrer, 10 Tel: (+34) 971 399 085

CASTELLO BARTOLOME FRANCISCO FERRER GENERAL MEDICINE MEDICAL Arago, 67 Tel: (+34) 971 304 507

PITIUSAS urological SL UROLOGY MEDICAL SPECIALISTS Francès Pere, 46 Tel: (+34) 971 311 231

JUAN MARI MARI OTOLARYNGOLOGY MEDICAL SPECIALISTS Avenida España, 44 Tel: (+34) 971 303 111

REVOLT MANUEL FERNANDEZ-ALONSO PEDIATRICS MEDICAL SPECIALISTS Murcia, 2 Tel: (+34) 971 302 785

JOSE LUIS MORAGUES Bolado OPHTHALMOLOGY MEDICAL SPECIALISTS Av Macabich Isidor, 25 Tel: (+34) 971 307 614

JOSE LUIS MORAGUES Bolado OPHTHALMOLOGY MEDICAL SPECIALISTS N'Escandell Ca, 1 Tel: (+34) 971 301 043

DENTAL Palmaplanas MEDICAL SPECIALISTS ORAL AND MAXILLOFACIAL SURGERY Orvay i Vicent Serra, 47 Tel: (+34) 971 194 704

EVICONSULTA GENERAL MEDICINE MEDICAL Archduke Louis Salvator, 10 302 902 354

SANTIAGO SERRA TUR OBSTETRICS AND GYNECOLOGY MEDICAL SPECIALISTS Av Macabich Isidor, 52 Tel: (+34) 971 315 616

FRANCISCO JAVIER RIPOLL GUASCH GENERAL MEDICINE MEDICAL Bartomeu i Av Ramón Tur, 2 Tel: (+34) 971 314 968

KING ROD GENERAL MEDICINE MEDICAL Pg Vara de Rey, 24 Tel: (+34) 971 315 252

EMERGENCY MEDICAL SERVICE DELIVERY SL GENERAL MEDICINE MEDICAL Germans Torres Tur i, 9 Tel: (+34) 971 318 324

EIVISSALUT ACUPUNCTURIST Avenida España, 36 Tel: (+34) 971 393 185

JOSEP GUIMERA RIVAS MEDICAL SPECIALISTS Orthopaedic Surgery Avenida España, 29 Tel: (+34) 971 305 850

SL PITIUSAS Eye Center OPHTHALMOLOGY MEDICAL SPECIALISTS Av Macabich Isidor, 20 Tel: (+34) 971 193 224

PIO SILVINO AVELLA NELSON OBSTETRICS AND GYNECOLOGY MEDICAL SPECIALISTS Gaspar Puig, 1 A

49 Tel: (+34) 971 190 078

PUIG JOSE MARIA JULIA GENERAL MEDICINE MEDICAL Balears, 24 Tel: (+34) 971 192 730

PITIUSAS IBIMEDIC SL GENERAL MEDICINE MEDICAL Vicent Fra Nicolau, 23 Tel: (+34) 971 193 585

AUROTA CENTER HOMEOPATHIC Archduke Louis Salvator, 11 Tel: (+34) 971 392 269

BIOLOGICAL INSTITUTE OF HEALTH HOMEOPATHY MEDICAL Canaries, 40 Tel: (+34) 971 193 798

ANTONIO LOPEZ ROAD DIGESTIVE MEDICAL SPECIALISTS Carlos V, 12 Tel: (+34) 971 310 214

PHYSIO CENTER MEDICAL SPECIALISTS PHYSICAL MEDICINE AND REHABILITATION Riquer Josep Llobet, 17 Tel: (+34) 971 392 214 Doctors in San Antonio / Sant Antoni de Portmany San Jose / Sant Antoni de Portmany

JUAN GARCIA SERRA PEDIATRIC MEDICAL LATE Tel: (+34) 971 342 318

IMMACULATE CONCEPTION GUIJO VALLES ACUPUNCTURIST Far, 3 Tel: (+34) 971 345 617

GALENO CLINIC AMBULANCE Medical Clinics Avenida Dr. Fleming, 5 Tel: (+34) 971 342 525

50 COOKTOP DENTISTRY MEDICAL SPECIALISTS General Balanzat, 1 Tel: (+34) 971 340 925

San Jose / Sant Josep MIGUEL JESUS CANO PICARZO FAMILY MEDICINE AND COMMUNITY HEALTH Avenida Dr. Fleming, 9 Tel: (+34) 971 345 321

Port des Torrent, S / N Tel: (+34) 971 345 200 Doctors in Santa Eulalia / Santa Eulalia des Riu San Juan / Sant Joan de Labritja

MEDICAL CENTER SANTA EULALIA Avda Ricardo Curtoys, 1 Tel: (+34) 971 332 300

JERUSALEM MEDICAL CENTER GENERAL MEDICINE MEDICAL Tel: (+34) 971 338 373

KLAUS GEORG DILLER GENERAL MEDICINE MEDICAL Puget painter, 1-A Tel: (+34) 971 330 670

ALBERTO CIRIA URIARTE GENERAL MEDICINE MEDICAL Platja Es Canar, S / N Tel: (+34) 971 338 818

FRANCISCO JAVIER PEREZ DE PETINTO Bermejillo HOMEOPATHY MEDICAL Mar, 2 Tel: (+34) 971 336 543

EIVICONSULTA GENERAL MEDICINE MEDICAL St. Joan, 2 Tel: (+34) 971 332 504

MARION PETRA RODH MEDICAL OPHTHALMOLOGY St. Joan, 2 Tel: (+34) 971 332 759

51 PAELZ RENATEE GENERAL MEDICINE MEDICAL Ptge. Algemesí, 2 Tel: (+34) 971 332 511

MANFRED Bressler GENERAL MEDICINE MEDICAL San Jaume, 60 Tel: (+34) 971 319 117

PORT DES HOMEOPATHY MEDICAL Molins de Rei, 10 Tel: (+34) 971 338 155

San Juan / Sant Joan MIGUEL DE LOS SANTOS PRUNES PUIG GENERAL MEDICINE MEDICAL Macabich Isidor, S / N Tel: (+34) 971 334 722 General medicine, chiropractors, pediatricians, urologists, orthopedists, dermatologists, nutritionists, ondontólogos, ophthalmologists, gynecologists, otrorrinolaringólogos, endocrinologists