Spain’s public healthcare system has a strong reputation inside the country, and the latest official data show that it is not just a safety net, but the default option for most people who live there.
According to the Barómetro Sanitario 2025, prepared by Spain’s Ministry of Health and the Centro de Investigaciones Sociológicas (CIS), four out of five adults used public primary care at least once in the previous year, and nearly three in four residents would choose a public hospital over a private one for inpatient care.
Healthcare in Spain: a regional public system with national guarantees
Spain’s healthcare in practice is a mix of a universal public system and a large private sector. Access to sanidad pública (public healthcare) normally depends on residency status and social security contributions, although schemes exist for those who do not qualify through work.
Management of public healthcare is devolved to Spain’s 17 autonomous communities. The Barómetro Sanitario 2025 highlights how this regional structure translates into sharply different user experiences:
- At national level, 51.6% of the population give a positive rating to the way the public healthcare system works.
- The regional gap is wide:
- Cantabria records the highest positive rating, at 66.4%.
- Andalusia sits at 38.8%, the lowest in the country.
Primary care in Spain: where residents first turn
Primary care, or Atención Primaria, is the backbone of public healthcare in Spain. It is organised through local health centres, known as centros de salud, where residents are assigned a médico de familia (family doctor) and usually a nurse.
This is the first port of call for most non-emergency health problems, prescriptions and referrals to specialists.
How satisfied are primary care users?
The 2025 CIS survey highlights just how central primary care is in everyday life:
- 80.8% of people aged 18 and over used public primary care services at least once in the previous year.
- Among those users, 80.4% rated the care received as good or very good.
Regional differences in satisfaction with primary care
Satisfaction with public primary care is high overall but varies by region, reflecting differences in management, staffing and local investment:
- Around 90% of primary care users in Cantabria and the Basque Country give a positive rating.
- More critical views are found in:
- Andalusia
- Valencia (Comunitat Valenciana)
- Galicia, which records the lowest satisfaction levels in the country, with positive ratings below 73%.
Waiting times to see a family doctor
Waiting times are one of the most sensitive issues in healthcare in Spain, and the survey paints a mixed picture. For people who cannot get a same-day or next-day appointment, the average delay to see a family doctor is 9.15 days at national level.
Public vs private hospital care: why most people still trust the state
Public hospitals as the default choice for serious treatment
Hospital care is one of the clearest areas where resident preferences are visible. The Barómetro Sanitario 2025 shows that public hospitals remain the anchor of the Spanish health system:
- 73.9% of citizens say they would choose public hospitalisation, as opposed to 23.9% who say they would opt for private hospital care.
How patients rate public hospital stays
Alongside preferences, the survey also measures direct patient experience with inpatient care. Public hospital admission emerges as one of the best-rated elements of healthcare in Spain:
- 81.4% of patients give a positive rating to their public hospital stay.
- The national average score is 7.02 out of 10.
What this means for foreigners using healthcare in Spain
Public healthcare as a realistic first option
For many foreign residents who register correctly for sanidad pública, public healthcare in Spain is a realistic main option rather than a last resort. Private insurance is often used as a complement to broaden choice or shorten waits in certain areas.
Regional differences to factor into relocation plans
The same survey also makes clear that the experience of healthcare in Spain is not identical everywhere.
Northern regions such as Cantabria, Asturias and the Basque Country frequently appear at the top of satisfaction rankings. On the other hand, some southern and peripheral areas tend to show higher proportions of critical ratings or lower scores for aspects such as primary care satisfaction, system functioning, and hospital experience.
For English-speaking readers considering living in Spain, these findings suggest that the choice of region can influence healthcare as much as factors such as climate or housing costs.
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