My friends recently paid 250 euros for consultation and treatment at a private hospital for their baby girl. After several days of excessive coughing, wheezing, crying and listlessness, the couple, who had only recently moved to Barcelona from Ireland, were terrified their daughter had become seriously ill and, overwhelmed by the confusion surrounding a foreign healthcare system and an alien language and culture, they sought refuge in the comfort of a private hospital which boasted English-speaking doctors. After a day of tests and questions, the consultant was able to explain in fluent English that their baby had a common viral infection, and they were administered cough medicine.
Seeking out medical treatment in Spain can be a little daunting, particularly if your Spanish is not fluent. Yet, when you are adapting to life in another country and subjecting your body to a change of climate, diet and plumbing system, this is the time you need to know about healthcare in Spain.
In Spain, public and private healthcare complement each other, and it is far more usual to have insurance. There are medical centres everywhere, most of which will be covered by one or more of the main private insurers. However, there is a public healthcare system, as well as provisions by voluntary organisations such as the Red Cross. Walk into any medical centre and if they don’t provide social cover, they will point you in the direction of a surgery that does.
Emergency Treatment & E111
All residents of the European Economic Area (EU Countries + EFTA states: Iceland, Liechtenstein & Norway) can get emergency treatment from the public sector with their passport and the E111. The E111 is a document stating that you come from the EEA and are entitled to free or reduced cost treatment. Only problem is, if you read this you’re most probably not going to have one. You are supposed to apply in the country you come from before travelling abroad, for example you can pick up an application form in your local UK post office. Now Don’t Panic! You can still have one faxed to you. If you have a national insurance number in the UK you can call up 0044 191 218 7547 or 0044 191 218 7777 which will get you to the national health & pensions department. There they’ll ask you for your national insurance number, when you departed on your holiday, your date of birth, your address in the UK and your nationality. Once happy that all makes sense they’ll either send the E111 to an address you give them or fax it over to your hotel or hostel you’re staying at. You could even have it faxed to the hospital, but it might get complicated on the communication part. In any case, if you’re resident in the centre of town you should go to Hospital Clinic, emergency entrance found at C/ Casanova 143, and explain to the receptionist that the E111 is on its way. They will normally give you emergency treatment even without the E111 expecting to see it come their way soon.
Should you be a resident of the EEA and not from the UK, call your consulate or public health provider for more info on how to obtain your E-111. Generally it should be obtained from your social service provider before you leave your country. Should you come from outside of the EEA you should make sure you have your own medical cover through travel insurance or private cover here in Spain.
For more info on the E-111 visit europa.eu.int and search for E111 Form
Public Health Care
The E111 is only meant for emergency treatment, should you wish to reside for any longer period of time in Spain it would be most wise to sort yourself out with adequate cover. The first step is to get registered at the local town hall, known as Padrón Municipal. Here in Barcelona the Office at Ramellers 15, on Pl. Vincent Matorell deals with those issues. Their opening times is Monday-Friday 8:30 – 17:30.
To register you are required to show your Id and proof of address. This can be achieved by a gas, water or electricity bill, the tenancy agreement or a telephone bill with your name on it. Where the phone bill has to be for a fixed land line! Mobile phone bills don’t count. Should you not have any of these at hand you can get the person who is on the tenancy agreement to come with you to the government office and confirm in person that you reside with him or her.
Once you have completed this step you will be issued with a document confirming your Empardonamiento and are told where to find your nearest medic. Him/her you present the said document on your first visit and (s)he’ll register you with the health service and your medicard will be posted to you.
Should you have booked your travel ticket using a credit card you might even be covered by a travel insurance already, find out from your card issuer about their policies.
Being accepted by the public institutions might just not cut the mustard. In some cases you have very long waiting lists, and the hospitals can often be overcrowded. Horror stories of seriously injured people passing out in the waiting rooms of hospitals and the nurses ignoring them as they obviously are having a nap, make you wonder about the level of commitment the public sector has towards its wounded.
There is a good choice of inexpensive health insurance for private cover, which could well be worth considering if you hope to stay in Barcelona for the long term. If you hope to obtain residency, medical cover may be a necessity.
Different Plans are available on the market from 20€ a month, which gives you basic dental and a wide array of services obtainable at the Delphos Hospital only, to 50€ a month for the full adeslas package giving you cheaper dental and access to doctors all over Cataluña and all sorts of treatment with hundreds of specialists and several medical clinics in Barcelona alone. Some other policy providers tailor their services to the English speaking market and offer a limited list of English spoken specialists at premium rates. It has come to our notice that many medical institutions in Barcelona don’t ask for any proof of ID when admitting patients and only ask for the medical card.
For emergency treatment by the public sector go to Hospital Clinic Emergencies Entrance which lies on c/ Casanova 143 (Metro: blue L5, Hospital Clinic).
For private emergency medical treatment try Barcelona Centro Medico 612 Diagonal 2o – 14, 93 414 0643, 24hour 639 303 464 (also English spoken)
Children can receive special attention at Hospital Sant Pau (Metro: blue L5, Hospital Sant Pau)
For an English spoken dentist visit Nicholas Jones BSD, 607 332 335, view Advert on last page. Initial examination free of charge.
If you want to obtain Private Medical Insurance here in Spain, Denis Boyle will be able to help you out on 93 321 0799.
For life threatening emergencies you can always call 112
It is easy to tell who has recently arrived in Barcelona as they buzz with a new lease of life, bursting with uncontrollable energy. The Mediterranean spirit makes people wake up from a life long hibernation, rekindling the urge to go out, meet people and share in the ever-active social scene of the city. However, things like taking precautions and being informed with regards to your options can more challenging with the language – culture barrier. When dealing with personal issues such as the health and state of your or your partner’s body, information is even more vital. This month our helping hand touches a sensitive area, so if you’re not planning on starting a family- read on.
The good news is, everybody is entitled to health care on the National health Service whether they are legal, tax payers, EU members or not. For details on how to obtain the medical card and documents needed to see a doctor/gynecologist take a look at the article Doctors in BCN (Pg. 17) of July’s edition. Back issues can be found on our website (www.barcelonaconnect.com/newsletter ). In order to receive a prescription for the pill or other contraceptive methods, you must make an appointment with the gynecologist (ginecólogo). Normally this is a female doctor although it could be a male doctor. Contraception is not free in Spain and you will have to buy it on prescription from a Pharmacy. If you have a medical card, however, it will greatly reduce the price. Condoms (Preservativos) are not freely available in Spain on the National health Service either. Instead you must buy them from a Pharmacy or a supermarket. The Catalan Anti-Aids Association, located on C/Junta Comerç 23 - Raval, gives out between 3 and 6 free condoms for every visit.
There are 36 Family Planning Clinics in Barcelona where you can also go to receive advice about contraceptive methods. For a full list of Family Planning Clinics, visit http://www.bcn.es/english/ihome.htm and go to the section on health and Care. Scroll down until you find the section on Family Planning. Click on the word Family planning at the top of the advanced search option and you will see a complete list of Family Planning Centres (private and public). Details, such as opening hours, can be found out by clicking on each centre individually. There is usually one doctor who can speak enough English for you to communicate, although this depends on the clinic.
The Morning After Pill
A Gynecologist is also the person who must prescribe you the Morning After Pill, should you need it. You can obtain it at either your local doctor’s surgery or Family Planning Clinic. If you happen to need it on Saturday or Sunday, you can go to the Emergencies (Urgencias) department that is generally located within the same building as the Doctor’s Surgery. It is a good idea to request an anti nausea pill to take with the Morning After Pill, or avoid taking it orally. Make sure you ask your doctor’s advice on how to best avoid nausea.
This is obviously a stressful situation to find oneself in, and if you aren’t certain what to do, perhaps talk to someone outside your circle of family and friends.
It is not possible to get an abortion on the National health Service although you can apply for economic help that is given to people without resources (sin recursos): people without family, jobs or money. To do this you must contact your local family planning centre. To verify what family planning clinic would be most appropriate for you to visit, telephone the National health Line (902 111 444) and enquire about assisted abortions. You will be asked your address and told which office corresponds to you. You must telephone your clinic and request an appointment, informing them that it is for an abortion for a person without economic means.
Ninety seven percent of Spanish abortions take place in private clinics. When Barcelona Connect made enquiries about costs, an abortion for a pregnancy up to 12 weeks with a local anaesthetic cost €330, while an abortion with general anaesthetic cost €450. There are three private abortion clinics in Barcelona:
• Agrupación Tutor Médica (Calle Berguedà, nº 19, Tel: 93 419 26 26, www.tutormedica.com)
• Centro Casanovas (Sepúlveda 80 (local 1), Tel: 934 269 734, firstname.lastname@example.org)
• Centre Mèdic Les Corts (Nicaragua, 128-130, baixos, Tel: 934 308 708, email@example.com
The following addresses might also provide you with useful information about contraception and abortion:
• FIAPAC International Federation of Abortion and Contraception Professionals www.fiapac.org
• ACAI Association of Oficial Clinics for the Voluntary Cessation of Pregnancy www.acaive.org / firstname.lastname@example.org
• FPFE Spanish Federacy of Organizations for Family Planning www.fpfe.org / email@example.com
If however you decide that you want your baby to be born here in Barcelona, finding an English speaking doctor is definitely a good idea. The National health Service also offers medical supervision and treatment during and after pregnancy, for both legal residents and non-residents. You will be issued a Pregnancy Card (Carné de Embarazo) that will detail the proceedings of your pregnancy and should be carried at all times, including during the birth.
Barcelona is renowned for being an exciting and vibrant city, with a large population of young people, and a nightlife and activities agenda to match. Its Mediterranean climate and perpetual presence of tourists on holiday only adds to the general mood of gaiety, especially in the city centre. However, for a lot of foreigners who have moved out here there are also some more difficult moments, when nostalgia for friends and family back home hits hard, or when the challenges of living in a different country seem overwhelming.
Some of the most usual grievances can include feeling the pressure to live up to a 24-hour party lifestyle, and maintaining a social life that is hard on the body as well as the wallet. Work related issues can include difficulties in finding a job, especially for non-Spanish speakers, and then living with the day to day reality of a job that you probably wouldn't be doing if you were back in your home country. Most short to medium term expats would agree that living in Barcelona is a lifestyle choice rather than a career choice, and when the lifestyle falls short of expectations things start to get more difficult.
People travel for many different reasons, with a desire for new experiences and personal development generally placed at the top of the list. However, according to psychiatrist Peter Zelaskowsi, some people leave their home country to resolve difficulties they've had only to find that after a short while abroad these problems have become worse.
Aside from the issues surrounding adaptation to living in another culture, the linguistic difficulty of being faced with not one but two completely different languages here is not to be underestimated. Those who feel that the quality of their lives could be improved by overcoming psychological obstacles might already be considering finding out about counselling and support groups here in Barcelona. The first step is to understand how the mental health and support system works here. We spoke with psychiatrist Peter Zelakowski, who explains.
"Here in Spain, the mental health system is more geared towards psychiatry; there is less of a culture of psychotherapy." The difference between psychology and psychiatry is that whilst the former is the science that deals with mental processes and behaviour (how people think, interact, and react), psyciatry deals with the diagnosis and treatment of mental disorders. Those who speak a reasonable level of Spanish could start by discussing the issues that are troubling them with their doctor. However, it is generally quite difficult to get a referral to a public practicioner unless one is in need of quite serious psychiatric help. Another option would be to contact a private English speaking psychologist or therapist.
The organisation NEST, or Network of English Speaking Therapists is a group of practitioners with different specialisations in the areas of education, mental health, and mental and spiritual development. Some of its 10+ members also work in Catalan, Spanish, French, and German.
Barcelona NEST member Connie Capdevila Brophy, a qualified Clinical Psychologist, and couple's and family therapist firmly acknowledges that it is perfectly normal to be affected by the significant changes caused by moving abroad. "Moving to a new community may be one of the most stress-producing experiences a person or family faces.” For children, moves are even more difficult if accompanied by other significant changes , such as a death, divorce, loss of family income, or need to change schools. The older the child, the more difficulties due to change of peer group." This would also apply to those whose move coincided with other difficult circumstances.
Connie goes on to explain that everyone experiences the culture shock in different ways; it involves change, not necessarily negative. It's normal to feel a degree of disorientation, as adjusting to a new culture takes time. Some people may adjust to living in Barcelona but may never integrate into the host culture. Useful advice for helping one adjust is to be open to the differences, and to learn about the new culture and language. Some of the warning signs that a person might benefit from discussing their situation include that after the initial excitement, they might start experiencing emotional or physical signs such as withdrawl, boredom, sleeping excessively or suffering from insomnia, drinking excessively, beginning to stereotype the host culture or people, and to idealize their own culture. Be aware of warning signs that last a few months, including changes in appetite, social withdrawal, a drop in grades (in the case of children,) irritability, sleep disturbances or other dramatic changes in behaviour or mood.
As well as personal counselling, there are support groups here which are held in English and which can be a useful first step towards resolving problems such as addictions.
They have 10 meetings in English every week in Barcelona, and according to one member, every group follows the code of being autonomous to the extent that it doesn't affect the AA as a whole. The programme is the same the world over, and is based on a commitment to the 12 steps to recovery and attendance of regular meetings. A sponsor helps one work through these steps. Meeting locations are in Pl. del Pi, Barceloneta, Pl. Espanya and Lesseps. Meeting times, precise locations, and more info are available at www.aabarcelona.org, or by calling the English info-line 616 684 338. All meetings are open, and if you are concerned about yourself or anyone else give them a ring.
This is a support group for users and ex-users. They have two meetings every week, on Wednesdays and Saturdays at 12pm, at C/ Cardenal Casaña 16 (Metro: Liceu). This small community offers support for those who share the experience of addiction, and who can speak with others who have been exactly where they are. Although they are not in contact with the medical authorities and cannot provide referrals, the group always tries to do what it can for those who seek help. According to one member, however, it is extremely difficult for someone to get a complete detox treatment here unless they speak some Spanish or Catalan. Each district in Barcelona has its own centre for helping people with a drugs problem, and the best way to find one's nearest centre is by calling the information line 934120412. Many of the people who work there speak some English.
Connie Capdevila Brophy: Tel 93 217 9841
Peter Zelasowski: www.groupworks.info,
Tel 93 675 9276