Spain's healthcare system
One of the world's leading edge systems
While
the mere mention of its name conjures up images of
Moorish temples, ancient windmills and Flamenco dancers,
Spain is also a country which has been modernizing
rapidly and is now on the leading edge in many sectors
of the world economy.
A vibrant economy The country has seen the fastest economic
development in Western Europe since the 1960’s. It’s
economy is the
eighth-largest in the world, and the fifth-largest in
Europe. Regarded as the country with the highest quality
of life in Europe, Spain has a very high standard of
living, and is now surpassing other comparable developed
countries such as the UK, Germany, and Italy. After a
steep plunge in late 2008 and throughout 2009, the
economy stabilized in the first quarter of 2010.
Decentralization changed everything With a
population of about 40 million and a healthcare
expenditure of 7.5 percent of the total GDP, Spain has
seen its healthcare system experience great changes in
recent times. The most significant of these changes has
been decentralisation of the country’s 17 regions.
Started in 1981, the decentralization process culminated
in January 2002 and lead to a significant change in the
healthcare scenario of the whole country.
Decentralization gave regional healthcare authorities
the autonomy to plan, change and upgrade the
infrastructure thereby leading to enormous development
in the healthcare technology scenario especially in the
usage of information technology, which had earlier taken
a back seat in terms of technology advancement. The
present 17 comunidades are rising to the challenge by
upgrading the healthcare infrastructure to make the
system more efficient both for the healthcare provider
and the patient. This is spurring tremendous
opportunities in the healthcare IT sector across the
whole country.
The majority of
healthcare services in Spain are owned by the regional
health service, which is part of the public healthcare
system. Although public hospitals account for only about
39.0 percent of the total hospitals in Spain, they
contribute up to about 69.0 percent of the total
hospital beds. In certain regions like Catalonia,
private hospitals contribute i[ to 31 percent of the
total hospital beds. But it is the public healthcare
system, which caters to the majority of the citizens.
Adding to the healthcare expenditure is the fact that
the finance for the regional healthcare system is from
the taxes paid by the citizens and there are many
immigrants, who also benefit from the low cost of
healthcare in the country.
Modernizing the healthcare system Prior to
decentralization, Spain’s central government controlled
all health planning decisions for the country. Since
then, the healthcare system has improved in terms of
both efficiency and distribution of health services. One
of the reasons for this improvement is that the regional
health systems are more capable in adapting themselves
to specific healthcare demands and regional preferences.
This is leading to increased development as all regions
are making investment decisions for new healthcare
solutions. As a result, the regions have successfully
developed a frontline healthcare system network. A new
law on “Cohesion and Quality of the National Health
System,” further accelerated the growth of the
healthcare system by establishing three basic principles
of equity of access, quality guarantee and citizens
participation. This change has lead to the regional
governments looking for new techniques to modernise
their healthcare system. The regional governments have
realised that they could abide by the law by successful
adoption and implementation of e-health tools. This
would be working towards implementing systems to
facilitate seamless data flow, thus making the
healthcare system more efficient.
Spain’s medical device industry Valued at
US $4.8 billion in 2010, the Spanish medical market
ranks fifth in the EU-27 and eighth in the world.Nevertheless, medical spending per capita is on
the low side for an EU-27 country. Over 80% of medical
production is exported, therefore imports represent the
majority of the market. As a result, Spain has one of
the world’s largest medical trade deficits. Consumables
are the largest medical sector, followed by orthopaedic
& implantable products, diagnostic imaging apparatus and
dental products. Net medical production was valued at
US$1.5 billion of which exports amounted to US$1.3
billion in 2008.
Spain has a strong
medical device manufacturing sector, which tends to be
based around Madrid and Barcelona. Companies, however,
tend to be small and concentrated at the low to medium
technology end of the market. Major export categories
included medical supplies, syringes, needles & catheters
and X-ray equipment. Morpheus Medical is one of the
latest acquired Spanish producers; Aircraft Medical, an
Edinburgh-based medical devices company, announced this
acquisition in May 2009.
A
sector monopolized by foreign companies Medical
imports rose by 5.1% in 2008, reaching US$4.2
billion. Most of the medical market is supplied by
imports, mainly from the USA and other EU-27 countries;
leading EU-27 countries are Germany, the Netherlands,
France, Belgium and the UK. Imports of consumables
represent the leading individual import category, equal
to 20.9% of the total. Orthopaedic & implantable
products represented 18.3% of total imports.
Spain had 804
hospitals in 2008, of which 319 were public and 485
private. Health services in Spain have been
decentralised since 2002, therefore the medical industry
needs to liaise with 17 regions separately. Increased
regional autonomy has resulted in greater medical
equipment disparities. In 2009, Spain has around 6,000
high-end technology equipment units, mainly including
CAT, MRI and mammography units. There are 50 operational
PET units, of which half of them are PET-CAT. Also,
there are 140 centres with nuclear medicine units. The
diagnostic imaging sector is monopolised by foreign
companies.
In June 2009, the
Hospital de la Santa Creu i Sant Pau in Barcelona signed
a ten-year agreement for Philips Healthcare to manage
the imaging technology needs of the hospital's imaging
diagnostics department at a fixed monthly fee. The
agreement includes management of equipment from imaging
specialties including MR, CT, nuclear medicine, X-ray
and ultrasound. As a result of the agreement, Hospital
Sant Pau will become an international reference site for
Philips Healthcare, a major move in a sector monopolized
by foreign companies.
DFAIT
funds are a promising first step Canada’s
medical technology sector has so far left a very small
footprint in Spain’s healthcare market. This is a
situation which Canada’s Foreign Affairs and
International Trade Ministry hopes to change by offering
to pick up the tab for some of the costs involved in
meeting and dealing with Spanish healthcare authorities
and business interests. While very modest in size,
this funding is a promising first step in assisting
Canadian medical device manufacturers to venture forth
into a market with considerable potential for growth. A
group of TMTA companies participated in mission in mid
February 2011. TMTA hopes that Ontario
manufacturers will take advantage of further opportunities
to venture into the Spanish market. Any
company interested in registering or wanting more
information about Spain and a medical device mission can
contact TMTA by phoning Marcel Lafleur at 705.328.2518
or emailing marcel@tmta.ca
