Catalonia surpasses Madrid in all health spending indicators
The demonstration by health workers against the health management of the president of the Community of Madrid, Isabel Díaz Ayuso, followed by the strike called by the Metges de Catalunya union for the end of January, have put public health at the center of the debate. Neither of the two health systems leads the rankings, neither for investment, nor for personnel, nor for waiting lists. In fact, these two territories are the ones with the highest proportion of people affiliated with a private mutual: 38% in Madrid and 33% in Catalonia, compared to 24% for the state average, according to data from the employers’ association Unespa (Union Association of Insurance and Reinsurance Entities) obtained by Verificat.
Catalonia surpasses Madrid in all indicators of health spending, although, in most cases, both communities are at the bottom of the regional ranking and below the state average. Even so, Madrid has more medical personnel per inhabitant, but with fewer beds, operating rooms and day beds. As far as waiting lists are concerned, in Catalonia it takes more or less twice as long to get an appointment for surgical interventions than in Madrid.
Catalonia spends more on healthcare
According to the consolidated figure for real spending, Catalonia allocated 6.3% of its GDP to Health, compared to 4.7% in Madrid in 2020, the last year for which data is available, according to the Public Health Expenditure Statistics (EGSP) published by the Ministry of Health. These are the two autonomous communities that allocate a lower percentage of their GDP to public health, both below the state average (6.9%). Making the per capita calculation, Catalonia is in the middle of the list, with 1,760 euros per inhabitant, some 120 above the average. Madrid occupies the penultimate position (1,491 euros per person). Focusing solely on primary care, Catalonia is also ahead: 226 euros per inhabitant compared to 158 in Madrid.
But Catalonia has reduced more primary spending than Madrid since the economic crisis broke out in 2008, according to data from the EGSP. In 2020, the Catalan administration spent 5.2% less than in 2009, while the decrease in Madrid was 1.6%.
Less medical staff, more nursing
Closer to the state average is the number of medical personnel. In Catalonia, 3.4 professionals work for every 1,000 inhabitants, a figure that Madrid exceeds by three tenths. Both communities are around the state average (3.5), as indicated by data from the Ministry of Health for 2021. Regarding nursing staffthe two communities tie at 4.3 professionals per 1,000 inhabitants, two tenths below the average.
With regard to primary care personnel, Catalonia slightly exceeds Madrid (0.73 doctors per 1,000 people compared to 0.68 in Madrid), but both are below the average, of 0.77, according to the statistical portal of the ministry. More marked is the lack of primary nursing personnel in the Community of Madrid: 0.51 per 1,000 people, below the 0.68 in Catalonia and the state average of 0.66.
Another of the classic indicators to assess the quality of the public healthcare system is the available hospital beds. In 2020, in Catalonia there were 3.83 beds in operation for every 1,000 inhabitants, leading the regional ranking and well above the 2.73 in Madrid.
Beyond the resources of both health systems, the statistic that is probably most present in the life of citizens is the waiting time to obtain an appointment at the health center, to see a specialist or to enter the operating room. And here, Catalonia is far behind Madrid. On average, it is necessary to wait almost three months to access a consultation, one month more than in Madrid, according to data from the Ministry of Health.
To be operated, the wait is longer. The time varies greatly in different specialties: the fastest is cardiac surgery, which entails a 58-day wait in Catalonia and 47 in Madrid. In all the others, the Catalan lists are twice as long as those in Madrid: for general surgery, five months in Catalonia and two in Madrid; for gynecology, 4.3 months in Catalonia and 1.8 months in Madrid; for traumatology, five and a half months in Catalonia and two months and a week in Madrid, and similar figures for vascular surgeries.