British people coming to live in Tenerife from the UK will be familiar with the concept of a Patients’ Charter, a list of rights for NHS users. In Spain, access to the public health service is restricted mainly to those who are making social security contributions, either through their employer or as self-employed individuals, or who are EU pensioners (including British, of course) whose cover is provided by reciprocal arrangement between their pension-providing country and Spain.
Whilst Spain does not have a separate Patients’ Charter in the way the UK does, there is nonetheless an equivalent list contained within the Canarian healthcare legislation. I have put the link to the full law (Ley 11/1994, de 26 de julio, de ordenación sanitaria de Canarias) in the links page, and HERE is the page for further links within the Oficina de Defensa de los Derechos de los Usuarios Sanitarios (Office for the Defence of Patients’ Rights). What follows is the list as it is effective for patients using the health system here.
You have the absolute and guaranteed right by law:
- To respect for your personality, dignity and privacy and not to be subject to unfair discrimination unless absolutely essential for medical reasons.
- To medical confidentiality.
- To register a complaint and receive an answer in writing (in the final instance, you should submit your complaint on THIS form to the Oficina de Defensa de los Derechos de los Usuarios Sanitarios (the complaints department of the regional government’s health department).
- To participate in healthcare activities and, in particular, the orientation and evaluation of the service.
- To adequate, comprehensible and appropriate information about factors, situations and causes of risk for individual and collective health; about the rights and responsibilities of users and beneficiaries of the Canarian Health System; and about healthcare services and provisions and conditions for their use.
- To supporting documentation concerning your state of health when required for legal purposes.
- To health promotion and education.
- To appropriate provisions and services of healthcare within the available resources.
- To obtain medication and healthcare products considered necessary to promote, preserve or restore health.
- To equality of access to and use of healthcare services.
- To choice of doctor from those in your municipality and to specialists according to resources and public needs.
- To free access to Accident and Emergency faculties in your area.
- To choice of health centre or public hospital within the limits of optimization of public resources and availability.
- To be assigned a doctor, and a locum in case of absence, who will ordinarily assume responsibility for assistance when required.
- To receive complete and continuous information in comprehensible terms, both verbal and in writing, about any process, including diagnosis, prognosis and alternative treatments. This information to be provided also to the patient’s family if necessary.
- To not be given, as a patient, any diagnostic procedure or experimental therapy without previously having granted free consent in writing and agreed with the doctor responsible and the medical authorities.
- To free choice between options presented by a doctor, with prior written consent being required from the patient for any intervention, except where it would be dangerous for public health for a doctor not to intervene, or where the patient might not be capable of making a decision (in which case the right devolves to the patient’s family, or judicial authority if a family either does not exist or cannot be found), or where emergency intervention is required.
- To refuse treatment.
- To have an appropriate written record throughout any process, and to receive a report when dischargedfrom hospital.
- To be informed of the economic cost of provision of services received.
- To receive, in all centres, services and healthcare establishments, a copy of all rights and responsibilities governing your relationship with the same.
- To a second opinion.
- To special procedures and health programmes, subject to availability, in the case of children, the elderly, the mentally ill, those with chronic and disabling illnesses, and those specifically recognized as belonging to groups at health risk.
- To require the medical faculty, in the case of the mentally ill in voluntary admission, to re-examine periodically the need to be kept in.
- To have enforced admissions, in the case of the mentally ill, carried out in accordance with article 211 of the Civil Code.
In addition to these rights, patients have the following duties:
- To comply with medical instructions and public health orders, both general and particular.
- To tolerance of healthcare measures adopted for the prevention of risk, health protection, or in the fight against threats to public health, as well as collaboration with the same.
- To use, look after, and enjoy the installations, services and provisions of the Canarian Health System in a responsible manner and in accordance with the corresponding rules.
- To respect the personal and professional dignity of healthcare personnel.
- To observe the rules, as well as being loyal, truthful and supportive in acquiring provisions from the system.
- To follow prescribed treatments.
For the sake of fullness, HERE is an information leaflet answering Frequently Asked Questions from the Canarian Government’s Health Dept, Sanidad, and HERE is a leaflet providing general information about the system. HERE, too, is a brief EU list of health benefits that European nationals enjoy while travelling within Europe.
On a tangential note, I am sometimes asked about blood donation. There are often calls for blood donations, whether because supplies in general are running low or because a particular group is needed. Unfortunately, anyone, whether British or not, who was in the UK for more than twelve months (consecutively or in total) between January 1980 and December 1996, the period in which meat was not controlled cannot heed these calls because Spain, like most other EU countries, has rules in place due to fears about CJD. This information has been confirmed to me personally by the British Foreign Office, and in addition, the Spanish emergency services confirm it thus:
En relación a su consulta, por normativa de la UE, no puede trasfundirse sangre de personas (británicos o no) que hayan estado más de 12 meses (consecutivos o en total) en Reino Unido entre 1980 y 1996, la etapa en la que la carne no estaba controlada.