Public Policy Dynamics Spain #5

by RPP colleagues

Health and Politics in Spain

Total COVID-19 cases:3,178,356
14-day total COVID-19 cases per 100,000:117
14-day change:-52
Total COVID-19 deaths:72,085
14-day rise:3,272
  • The call for early elections in Madrid has caused great institutional turmoil, revealing the rupture of relations between the conservative party (PP) and the centrist Ciudadanos party (Cs), which until now governed in coalition in the Spanish capital. This could affect the pacts at national level and strengthen the current government, if Ciudadanos chooses to offer greater support to the Socialist party in Congress.
  • The Ministry of Health continues to update national health plans. After approving the new Cancer Strategy in February, the Newborn Screening Programme has now been extended, an information exchange network with special emphasis on rare diseases is being promoted, and a Precision Medicine strategy is being developed.
  • 7.5% of the population (3.5 million people) have already received at least one dose of the Covid-19 vaccine, and the Government expects to speed up the process in the next months. The infections rate continues to decline gradually, amid the adoption of new restrictive measures ahead of the Easter Holidays.


  • The political agenda has been disrupted by the announcement of government changes in at least two regions. On Wednesday (10 March), the Ciudadanos party (Cs) in the region of Murcia made public the breakdown of relations with its partner in government (and majority party in the region), the conservative Partido Popular (PP). The government will change political colour after the no confidence motion tabled by Cs together with the Socialist Party (PSOE), the main opposition party in the region.
  • In expectation that Cs will repeat this action in other regions where it governs in coalition with the Partido Popular (PP), conservative regional leaders are anticipating their moves. In the Community of Madrid, the regional president, Isabel Díaz Ayuso, has announced the dissolution of the Assembly and called for elections in May. The current president (PP) is expected to strengthen her power, although the composition of the next regional government is uncertain at this stage, as a shift to the left wing is not ruled out if opposition parties get overall most votes.
  • These moves mark a rupture in relations between the right-wing party PP and Cs, while also heralding a shift in the distribution of power that could have effects on future pacts in Congress, where the votes of Cs could provide great support for the national government (Socialist Party, PSOE) rather than the current unstable dependence on nationalist parties. On the other hand, these decisions advance an impending rupture within the Cs, to be resolved by the top leadership in the coming weeks.
  • At a national level, this week's (8 – 12 March) government control session in Congress has also been particularly tense, amid a strong criticism from the opposition parties on the management of the pandemic. Particularly, the Parliament urges the adoption of policies in light of rising unemployment, as the latest Eurostat statistics present an adverse scenario for Spain, which is double the European average unemployment rate (among young people, it is close to 40%). The President Pedro Sánchez has boasted about the measures taken to combat Covid-19, stating that “they have prevented a 25% drop in Gross Domestic Product and the destruction of three million jobs”. 



  • On 11 March, Carolina Darias, the  health minister, reported on the general action lines of her Ministry during a Parliamentary Hearing. Darias will focus on the implementation of the Strategic Framework for Primary Care, the integration of the needs of rare diseases in a global planning of health coverage, and the update of the Mental Health Strategy. The activation of the Investment Plan for High Technology Equipment in the national health system, which will respond to the diagnostic, therapeutic and monitoring needs of the pathologies with the greatest health impact (rare, oncological and neurological diseases), is a further noteworthy initial step around Darias’ tenure over the Health Ministry.
  • On Rare Diseases World Day, Darias announced the creation of a network platform that will enable the sharing of information and knowledge between the European Reference Networks (ERN) with the Reference Centres (CSUR) of the national health system (and between the national centres themselves).
  • Further, the Spanish Government has informed about the inclusion of 3 endocrinometabolic diseases into the Neonatal Screening Programme of the National Health System, bringing the minimum number of diseases detected at birth to a total of 10 across the country.
  • The Ministries of Health and Science are also developing the guidelines of the new Spanish Strategy for Precision Medicine announced in the Plan for Science and Innovation presented in July 2020 by Pedro Sánchez. With a budget of €25.8 million, this Strategy aims to “implement a new way of doing medicine, linked to scientific knowledge and the ability to exploit all available information to increase the quality and efficiency of the health system", according to the Ministry. The new plan will identify and improve the management of patients who are distinguished by their genetics, prone to a disease or by their response to treatment.



  • Covid-19 public health indicators have slightly improved in most of the communities, and this relief can be seen in a decrease in pressure in the ICUs, though this effect has been heterogeneous across the country. The Ministry of Health has reported 4,013 infections and 291 deaths since 8 March, and the 14-day cumulative incidence has fallen again to 139 cases per 100,000 inhabitants, sitting at levels similar to those in August 2020. This is casting doubts on whether the target incidence (50 cases per 100,000 population) will be reached by the start of Easter holiday period.
  • The Minister of Health and the regional health authorities met on 10 March to agree on measures to prevent the spread of Covid-19 in the run-up to Easter. The Government aims to start the restrictions next week, to reduce movement between regions during the San José bank holidays (19 March). Although the agreements of the Interterritorial Council are not binding, regions are in practice often guided by them. Consensus is proving difficult to be reached, mainly as the regions of Madrid and the Canary Islands are requesting special treatment in view of the anticipated arrival of tourists.
  • The vaccination campaign in Spain is developing at a steady pace: 7.5% of the population (3.5 million people) have already received at least one dose, and the Government expects to speed up the process in the next months, as more vaccines are received. In this regard, Carolina Darias has confirmed that in April the company Pfizer will supply Spain with 4.8 million doses.


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