Doctor Strikes, Longer Waits and Private Clinics: Spain’s Public Health System Under Pressure in 2026

Spain’s National Health System is starting 2026 in a fragile position. Waiting lists are growing, doctors are mobilising for more strikes, and a rising share of “public” care is now being delivered in privately run hospitals and clinics. For residents and expats who depend on the system, the big question is how these trends will affect day‑to‑day access to doctors, specialists and hospital care.

Public health leaning more on private hands

Official reports show that, over the last decade, regional health services have steadily increased their use of private hospitals to provide publicly funded care. In some regions, close to a third of hospitals that treat public patients are run by private companies under long‑term contracts or management concessions.

These arrangements range from outsourcing specific services, such as diagnostic tests and elective surgery, to full hospital management by private groups. Supporters argue that this helps cut waiting lists and invests in modern facilities, while critics worry about profit motives, transparency and long‑term costs to the public purse.

Doctor strikes, burnout and staffing gaps

At the same time, Spain has faced repeated waves of industrial action by doctors and other healthcare workers. In late 2025, unions called large national strikes to protest the updated framework statute for health staff, highlighting problems with long shifts, overnight on‑call demands and pay that lags behind other EU countries.

Medical associations warn that these conditions are pushing many professionals to seek jobs abroad or move to purely private practice inside Spain. If this trend continues, it could deepen shortages in public hospitals and health centres, making it harder to reduce backlogs or maintain services outside big cities.

Longer waiting lists and regional inequalities

Recent data and regional reports point to longer waits for surgery and specialist appointments in several autonomous communities. Some regions manage to keep delays relatively contained, while others are seeing patients wait months for operations such as hip replacements, cataract surgery or non‑urgent scans.

These gaps add to long‑standing differences between urban and rural areas, where smaller hospitals and health centres often struggle to recruit specialists. People who can afford it are increasingly turning to private insurance or paying for private consultations, while those fully dependent on the public system must navigate longer queues and uncertainty over when they will be seen.

Government plans to “re‑shield” public healthcare

In response to concerns about outsourcing and private influence, the central government has announced plans for a new law to reinforce public control over the health system. Draft proposals aim to limit how far key services can be handed to private operators and to tighten rules and transparency for public–private contracts.

Cases such as the controversy around the privately managed hospital in Torrejón de Ardoz, where management practices sparked debate about waiting lists and business incentives, have become symbols in the argument over where to draw the line. The planned law is presented as a way to “shield” universal healthcare, although critics say the details will matter more than the slogans.

What all this means for residents and expats

For people living in Spain, the result is an increasingly mixed system. Public healthcare remains the foundation and is still highly regarded in many areas, but private providers and insurers now play a much larger role in everyday care, especially for those who want faster access or more choice of specialists.

Residents who rely solely on the public system should keep an eye on local news about strikes and regional measures, and build in extra time when planning non‑urgent procedures. Expats who combine public entitlement with private insurance may find that private clinics help bridge gaps in access and waiting times, but they should still understand how their local health centre and hospital are organised, and how any new “re‑shielding” law could affect service delivery in the years ahead.