Spain’s health care system is in a precarious condition warns the WHO’s adviser in Europe


Tomas Zapata, the WHO’s adviser in Europe has warned that Spain’s health care system is in a precarious condition.


Tomas Zapata, the WHO’s regional adviser for human resources in Europe, has warned that Spain, like most neighbouring countries, has a problem with its health system that is of great concern.

He voiced his thoughts during an interview with EFE while in Madrid this Thursday, December 1, participating in a conference on Primary Care. The event was organised by Spain’s Ministry of Health.

“During the pandemic, workers were exposed to high levels of workload, high stress, and anxiety. Now there is a feeling of fatigue, and at the same time they can that the working conditions in many European countries are not as they should be in terms of workload, labour flexibility, and conciliation”, Zapata explained.

He pointed out that during a 2019 collegiate survey it was revealed that up to 40per cent of doctors in Spain had a temporary contract. The organisation intends to conduct a comparative study with the salaries of doctors and nurses in different countries.

Zapata claimed that currently, health spending in spain – with respect to the Gross Domestic Product (GDP) – is relatively “cheap or efficient compared to other systems”, with wages one of the main causes.

Having trained as a family doctor in Madrid, he said he believed that the main problem is in Primary Care. Family doctors, paediatricians, and nurses. are overloaded. “If we have health workers who are on leave due to depression, exhaustion, or burnout”.

The WHO adviser assured that Europe in general has arrived at a “critical moment”, but believes that there are some countries that “are doing better. By this he meant that they have very good long-term planning that allows them to project what the needs of health workers will be in the next 10 or 15 years. 

Spain, in his opinion, is also progressing. He cited a report for the Ministry of Health in which a projection is made to the year 2028 and 2035. It laid out the different medical specialties and the needs that there will be.

This planning is important, he said, so as not to produce an “excess” of workers, as happened 30 years ago in Spain, though neither to fall short. A first measure in the short term, according to Zapata, is to “retain those who we have”.

The second is to attract new people, especially young people, to specialties such as nursing, since Spain is below the European average not only in the number of active professionals but also in training.

“There must also be a consideration regarding the role that nurses play in the provision of services”, stressed Zapata. The adviser is the author of a report on the situation of human resources in 53 countries in the European region that offers devastating data: in one in three countries, at least 40 per cent of doctors are over 55 years of age, that is, they retire in ten years. 

However, the data handled by the WHO do not corroborate the exodus of professionals that some headlines warn about. “What we see is that, more or less, around 300 doctors emigrated in 2020”, said Zapata, recalling that our country is a “nett recipient of doctors”. 

“That does not mean that the exodus cannot increase in the future, especially with the young generations that come prepared speaking different languages”, he added.

“We have to start taking action now if we want to replace all the family doctors who are going to retire in the next 15 or 20 years”, he continued, referring to Primary Care investment in Spain, where the greatest staff deficit occurs.

It is an essential speciality for the World Health Organisation, because, he assured, health systems that invest in Primary Care “achieve good health results, and in a very efficient way”.

Spain invests 14 per cent of its total health spending in Primary, one point above the 53 countries in the European region, but the data – he points out – is “very bad”, below what would be desirable. In Spain he pointed out, financing of hospital care has continued to increase while primary care has increased a lot less, that is, the gap is getting bigger and bigger.

The consequences of not investing in primary care, warned the WHO expert, are already being seen: the ER is saturated, and this is not an “efficient” way of caring for patients. In addition, Zapata predicted that in a few years it will also end up having an impact on hospital care, as reported by

Another of the difficulties that Spain is encountering, in the opinion of the WHO, is to attract health professionals to work in rural areas. Economic incentives, improvements in working conditions, providing houses with good facilities and fast internet connections are some of the measures that the organisation recommends so that rural areas are not deprived of doctors.


Thank you for taking the time to read this article. Do remember to come back and check The Euro Weekly News website for all your up-to-date local and international news stories and remember, you can also follow us on Facebook and Instagram.

Chris King

Originally from Wales, Chris spent years on the Costa del Sol before moving to the Algarve where he is a web reporter for The Euro Weekly News covering international and Spanish national news. Got a news story you want to share? Then get in touch at

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  • Start to listen to the profesionals on the ground to improve the system to a workable level, so many health profesionals voices were muffled in the pandemic and fatique now is a typical symptom of a state run health service organised by bureaucratic none profesionals!

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