With Spain’s Covid-19 vaccine campaign almost into its third month, some of the challenges of vaccinating millions of people as quickly as possible are being exposed.
One of those cracks in the system is foreign pensioners who are not registered with the public health system, instead receiving medical care in Spain through private health insurance.
Firstly, be assured that the Spanish government has emphasised that no distinction will be made between citizens and non-citizens and has pledged to vaccinate everyone in the country, regardless of their legal status and that includes those not registered with the social security system, including ‘illegal' immigrants and the homeless.
“All those living in Spain will be able to receive the vaccination against the virus as the campaign unrolls. Vaccination is universal, it includes all people,” insisted a Health Ministry spokesman.
But Spain’s vaccine supplies are only in the hands of the public health system and not private health suppliers, which leads to the question, how will Spain’s Health Department know of my existence and contact me if I’m not on public health records?
The first thing to remember is that you’re not alone.
Spain’s National Statistics Institute reported at the start of 2021 that there were 5.4 million foreign residents in Spain, but according to Spain’s Social Security and Migrations Ministry only 2.07 million of them are affiliated to the country’s social security system.
However, these 3 million 'invisible' foreigners also have their access to public health services guaranteed since Spain’s former Minister of Health María Luisa Carcedo approved Royal Decree 7/2018 on universal access to the National Health System.
As soon as Spain’s vaccine campaign plan was drafted, another former Spanish Health Minister, Salvador Illa, ‘passed the buck’ to the regional authorities in terms of how they should handle their Covid-19 vaccine strategy, including how to go about vaccinating foreigners and anyone under the radar.
So as with so many other big matters in Spain, decisions aren’t centralised and what one region might do to call up and contact those who aren’t registered on the regional public health system, another comunidad autónoma might do differently.
The same problem arose during 2020’s flu vaccine campaign, as private clinics and pharmacies didn’t have access to supplies because they were entirely in the hands of Spain’s public health centres. Many foreigners in Spain who weren't on the system didn't get the flu jab.
So far Spain’s Health Ministry has recognised the difficulties in reaching outside-the-system groups, but not necessarily foreign pensioners not using public healthcare.
“Some groups with access barriers to the health system would be more difficult to reach out to (for example, people without residency documents or the homeless).”
The latest advice
“The line that the Spanish government has given us is that the private insurance companies, which are called mutuas, are currently coordinating with the regional health authorities on how the vaccine is going to be rolled out to those with private health insurance,” Martyn Standing, from the Department of Health in Alicante's British Consulate, said during the latest Facebook Q&A by the British Embassy in Spain.
“If you need to get an update on this, we would suggest you contact your private health insurance company because they are currently working with public authorities and should be able to give you an update on when you’ll receive your vaccination.”
“They’re registered at the town hall and pay their municipal tax but don’t figure in local healthcare records,” Paloma Hoffmann-Vevia, former president of the association of foreign residents of Benissa (Alicante) and a former lawyer at the European Commission told national broadcaster RTVE.
“They don’t have access to the Spanish public health system for a number of reasons, from having had private insurance in their home country to other reasons that aren’t allowing them to use the S1 form to gain access to the public health card”.
One of the most outspoken voices relating to the plight of German, English, Irish, Swedish and other ‘invisible’ foreign pensioners in Spain says there’s an easy solution.
“Manage the vaccine rollout through the census (town hall/padrón) and not through the records of local health centres,” she told RTVE.
“With a joint effort between the town halls and the health centres, this whole collective would be covered.”
“In small places I believe this is how it is being done already. It’ll be harder in locations with bigger populations but volunteer groups can be set up who help to coordinate and close the gap between both sides and do the correct tracking and tracing of this population group.”
Maureen Payne, President of Age Concern in Costa Blanca Sur, told The Local Spain that “some private health insurers were offering a document to their customers in Spain that allowed them to get a temporary SIP (health card) through their local public health centre, which then would allow them to get the vaccine,” adding that British consular services were best positioned to advise on this depending on the person's location and circumstances.
This, as reported by Clínica Benissa (a private health centre in Alicante province where this scheme has been tried and tested) is dependent on what each municipality chooses to do.
Here at The Local we’ll continue to push for answers relating to this particular group’s situation and share with you all the latest information on the vaccine rollout for other foreign groups in Spain.
You can find out more about the vaccine for foreigners who aren’t on the public health system by clicking on the article below.