Ministry of Health (Spain)
| Ministerio de Sanidad | |
 | |
_14.jpg) Headquarters of the Ministry of Health | |
| Agency overview | |
|---|---|
| Formed | 4 November 1936 |
| Preceding agency |
|
| Type | Ministry |
| Jurisdiction | Government of Spain |
| Headquarters | Casa Sindical Building Madrid, Spain |
| Annual budget | € 1.02 billion, 2026 |
| Minister responsible |
|
| Agency executives |
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| Website | Ministry of Health (in Spanish) |
The Ministry of Health (MISAN) is the department of the Government of Spain responsible for proposing and executing the government policy on health, planning and providing healthcare as well as the exercise of the powers of the General State Administration to assure citizens the right to health protection.[1] The Ministry is headquartered in the Paseo del Prado in Madrid, opposite the Prado Museum.
Healthcare in Spain is provided by the National Health System, a decentralized organization composed by the regional health systems and the National Institute of Health Management, the health agency of the central government that provides health care to the autonomous cities of Ceuta and Melilla. According to Eurostat (2023 data), Spain spends 9.2% of its GDP on health, approximately €138 billion ($161 billion).[2]
According to the Annual Report of the National Health System 2024, the total expenditure of the Spanish health system in 2022 was 134 billion euros (99.3 billion corresponding to the public sector and 34.7 billion to the private sector). This represented 2,805 euros per capita and an expenditure of 10% of the Spanish GDP. As of 2022, regarding human resources, the Spanish public and private health sectors employed around 900,000 professionals. Of these, 212,201 were medical professionals, 284,232 nursing professionals, and 382,731[a] were other types of health professionals.[3]
The Minister of Health is the head of the department and is appointed by the Monarch on the advice of the Prime Minister. The minister is assisted by four main officials: the Secretary of State for Health, the Secretary-General for Digital Health, Information and Innovation of the National Health System, the Department's Under-Secretary and the Commissioner for Mental Health. The current Health Minister is Mónica García since November 2023.
History
Early period
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Between the 18th and 19th centuries, Spain began to develop its own institutions dedicated to public health. The first of these institutions was the Royal Supreme Health Board (Spanish: Junta Suprema de Sanidad del Reino). This Board, created in 1720 by King Felipe V, aimed to relieve the Council of Castile of its workload and thus create a body that could immediately provide solutions to the problem of the plague, which at that time had arrived by sea from Marseille, France.[4] This body, in addition to debating health measures and advising the monarch, was dedicated to rationalizing and systematizing the scattered health legislation of the time.[5]
In 1847, the minister of the Interior, Manuel de Seijas Lozano, drove a complete reform of the institutional health framework, which involved the abolition of the Royal Supreme Health Board and its replacement by two bodies: the Royal Health Council and the Directorate-General for Health.[6] In this way, while the former had merely advisory functions, the Directorate-General for Health (known nowadays as Directorate-General for Public Health), assumed the executive functions and brought together all the health responsibilities of the Ministry of the Interior, the department responsible for health matters at that time.[6] A few days earlier, a new structure for the Department had been approved, and it was the Directorate-General for Charity, Prisons, and Health that assumed these powers.[7] All these reforms were consolidated with the approval of the Health Act of 1855.
Inception
State powers in this area remained with this department until 1933, when the Undersecretariat for Health and Charity was transferred to the Ministry of Labour, which then became known as the Ministry of Labour and Health.[8]
However, the first ministry focused on health was created on 4 November 1936, during the premiership of Francisco Largo Caballero, as the Ministry of Health and Social Assistance, with a woman holding a cabinet portfolio for the first time in the history of Spain: Federica Montseny.[9]
During that period, Montseny planned childcare centers, soup kitchens for pregnant women, prostitution shelters, and she elaborated a list of professions for disabled people, as well as drafting the first an abortion law in Spain.[10][11] The civil war prevented the minister from developing her projects, in addition to the short life of the ministry.
As stated, the ministry was short-lived. When Juan Negrín replaced Largo Caballero as prime minister, he disbanded the department and its powers were divided between the Ministry of Labour (social affairs) and the Ministry of Education (healthcare) by a Decree of May 1937.[12] After the Spanish Civil War, the responsibility returned to the Ministry of the Interior until 1977.
Return to the Interior Ministry
Throughout the dictatorship of Francisco Franco (1939–1975), health care responsibilities remained structured as first established by the 1855 Health Act, with the Directorate-General for Health as the main driving force behind public health policies, and this agency was integrated once again into the Ministry of the Interior. These aspects were ratified by the National Health Basis Act of 1944, which did not change the structure established a century earlier.
Democratic period
Once the dictator died, Spain began the democratic transition and, during the premiership of Adolfo Suárez, the Department, now called Ministry of Health and Social Security, was recovered by Royal Decree 558/1977, of July 4, which merged the responsibilities in health matters that until then were managed by the Ministry of the Interior, as well as the powers over Social Security that were then held by the Ministry of Labour.[13][14]
At that time, the department consisted of two undersecretariats (one for the Department's general affairs and other one for Health Management), a Technical General Secretariat, and six Directorates-General: Personnel, Management and Financing; Benefits; Social Services; Healthcare; Pharmaceutical Regulation; and Public and Veterinary Health.[15]
For a short period between February and November 1981, Health was once again merged with Labour. Royal Decree 2823/1981, restored it to full ministerial rank but this time without social security which remained within the Department of Labour. With this reform the Ministry acquired competencies over Consumers Affairs (through the National Institute for Consumers Affairs). During the first years of the premiership of Felipe González and the National Health System and the National Transplant Organization were created thanks primarily to the impulse of the minister Ernest Lluch.
With the victory of the People's Party in the general election of 1996, José Manuel Romay Beccaría was appointed Minister of Health and Consumer Affairs, a position he held throughout the 6th Legislature. Under his direction was created in 1997, the Spanish Agency of Medicines and Medical Devices. In the 7th Legislature Celia Villalobos became minister (2000–2002) and achieved notoriety by her handling mad cow disease. She was succeeded by Ana Pastor Julián (2002–2004). The mad cow crisis precipitated the creation in 2011 of the Spanish Food Safety Agency, named since 2007 as Spanish Food Safety and Nutrition Agency.
At the beginning of the 8th legislature, Elena Salgado assumed as Health Minister (2004–2007). With her, in 2004 the National Drugs Plan, attached to the Ministry of the Interior, was shifted to the Ministry of Health. Eight months before the end of the legislature, the scientific Bernat Soria assumed the office of Health Minister. In the next legislature Soria was confirmed as Minister of Health and Consumer Affairs, and he was succeeded by Trinidad Jiménez in 2009 following a cabinet reshuffle. Under Jiménez Social Policy was returned to the health portfolio, including the Institute for the Elderly and Social Services (IMSERSO), previously under Education.
Under minister Leire Pajín (October 2010-December 2011), responsibilities on equality issues were added to her duties, previously under a separate ministry of its own, and also assuming the Institute of Women and the Institute of Youth. At the beginning of the 10th legislature Ana Mato became minister and the Ministry assumed (only functionally) the Charles III Health Institute (which still belonged to the Ministry of Economy). In addition, in January 2014 the Spanish Agency for Food Safety and Nutrition and the National Institute for Consumer Affairs merged giving rise to the new Spanish Agency for Consumer Affairs, Food Safety and Nutrition.[16] On 24 November 2014, Mato resigned after being implicated in the corruption case known as Gürtel. On 3 December 2014, Alfonso Alonso succeeded her.
After the 2016 cabinet reshuffle, Dolors Montserrat was appointed Minister of Health and one of his first measures was to raise the rank of the Director of the National Transplant Organization to Director-General in order to strengthen this institution.[17] Barely 1 year later after the assumption of Montserrat, the Güertel case that provoked the resignation of minister Mato also provoked in June 2018 the fall of the Rajoy government through a motion of no-confidence driven by the Leader of the Opposition Pedro Sánchez. After the success of the motion, Sánchez appointed Carmen Montón as Health Minister and the Ministry transferred the competences over equality to the Ministry of the Presidency. Montón also strengthen the consumers affairs competences by recovering the Directorate-General for Consumers Affairs and regained universal healthcare for undocumented immigrants.[18] She resigned after three months in office after a degree scandal[19] and María Luisa Carcedo succeeded her. Carcedo continued with the program established by Montón on fight against pseudosciences[20] and recovering the Observatory of Women's Health.
A major restructuring occurred in 2020. The Department of Health lost all its competences on consumer affairs and social services, that were transferred to the ministries of Consumer Affairs and of Social Rights and 2030 Agenda, respectively. However, in exchange, the department assumed the government policies on drugs. During this time, Carcedo was replaced by Salvador Illa, who had to face the COVID-19 pandemic. It was precisely as a result of this pandemic that in August 2020 the department underwent a major reform in its structure, recovering the position of Secretary of State for Health (which already existed between 1979 and 1981) as second-in-command and creating the General Secretariat for Digital Health, Information and Innovation of the National Health System.[21]
Following Illa's resignation at the beginning of 2021, Carolina Darias took over and promoted the creation of a National Agency for Public Health, with the aim of improving the prevention and management of future diseases.[22][23] She also restored the right of single, lesbian, bisexual and transgender women to access assisted reproduction in public health care, which had been suppressed in 2014.[24]
Darias resigned in March 2023 and was replaced by José Miñones. In his brief eight-month term, Miñones officially ended the COVID-19 pandemic and promoted the right to be forgotten for cancer survivors, meaning that anyone who had suffered from cancer would not be required to declare their condition when applying for a loan or taking out insurance.[25]
In November 2023 Mónica García assumed the office, focusing her term in mental health. For this purpose, she created a Commissioner for Mental Health.[26]
Organization
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The minister of health, a member of the Council of Ministers, is the most senior official of the department. The minister establishes the ministry's general policy and appoints the rest of departmental officers.
The minister is assisted by a secretary of state for health, in everything related to healthcare, an under-secretary for the day-to-day management of the department and a commissioner, with the rank of under-secretary, for mental health.
The Ministry of Health is organized as follows (in bold those who depend directly on the minister):[1]
| Ministry Organization (2026) | ||
|---|---|---|
| Minister | Cabinet (Chief of Staff) | |
| Secretary of State for Health |
General Secretariat for Digital Health, Information and Innovation in the National Health System | |
| Directorate-General for Digital Health and Information Systems in the National Health System | ||
| Directorate-General for Public Health and Health Equity | ||
| Coordination Centre for Health Alerts and Emergencies | ||
| Directorate-General for the Common Benefits Package of the National Health System and Pharmacy | ||
| Directorate-General for Health Professions Regulation | ||
| Government Delegation for the National Drugs Plan | ||
| Spanish Agency of Medicines and Medical Devices | ||
| National Transplant Organization | ||
| National Institute of Health Management | ||
| Under-Secretary | Technical General Secretariat | |
| Deputy Directorate-General for Human Resources | ||
| Deputy Directorate-General for Economic Management and Budget Office | ||
| Deputy Directorate-General for Citizen Services and Inspectorate-General of Services | ||
| Deputy Directorate-General for European Funds Planning and Coordination | ||
| Division for Information Technologies | ||
| Division for General and Administrative Affairs | ||
| Commissioner for Mental Health |
Technical Office for the Transition of the Mental Health Model | |
| Division for Mental Health Prevention, Promotion and Protection | ||
In addition, the Department has two advisory bodies:[1]
- The Advisory Council for Health and Social Services, as an advisory and assistance body in the formulation of health policy.
- The Committee of the professions of the health and social sector.
Headquarters
The department's first headquarters were located in the Palace of the Marques of Campo, in the city of Valencia, during the brief period that the Ministry existed between November 1936 and May 1937.[27][28]
Currently, since 1977, the Ministry of Health has its main headquarters in a building located on the Paseo del Prado in Madrid.[29] This building is known as the "Casa Sindical" (Spanish: Trade Unions House), as it was built between 1949 and 1951 to house the National Delegation of Trade Unions[30] until its suppression in 1971, after which the office of the Minister for Trade Union Relations was housed here.[31]
Since 2020, due to the division of the powers of the Ministry of Health, it shares headquarters with the Ministry of Social Rights, Consumer Affairs and 2030 Agenda.
Others
In addition to the main headquarters, some bodies and agencies have their own headquarters, namely:
- The Government Delegation for the National Drugs Plan, based in the central Plaza de España.
- The Spanish Agency of Medicines and Medical Devices, in a building on the outskirts of the capital.
- The National Institute of Health Management, which is housed in the former headquarters of the National Institute of Social Insurence.
- The National Transplant Organization, located in a Madrid government complex in the vicinity of Cuatro Torres Business Area, which also houses facilities of the Carlos III Health Institute.
Budget
- Health policy and regulation 725.5 (71.0%)
- Healthcare and pharmacy services 212.7 (20.8%)
- Central services 39.5 (3.87%)
- Digital health policy 28.9 (2.83%)
- National Drug Plan 15.1 (1.48%)
As mentioned above, the Spanish healthcare system is decentralized and the Spanish regions are responsible for health policy.
For fiscal year 2026, the Ministry of Health has a consolidated budget of €1.02 billion,[32] while the total education expenditure of all administrations in 2022 was €134 billion, which represented a 10 % of GDP.[3]
The budget can be divided in five main areas:[32]
- Central services (Program 311M), which funds the Ministry’s central services and administrative structure.
- Health policy and regulation (311O & 313B), covering general health policy, public health, external health, health quality, and regulatory development.
- Healthcare and pharmacy services (313A & 313D), which finance the definition and management of healthcare benefits and pharmaceutical policy within the National Health System, including pricing, reimbursement, and organ donation and transplantation.
- Digital health policy (313E), aimed at promoting digitalisation, data systems and innovation within the National Health System.
- National Drug Plan (231A), which supports actions focused on drug addiction prevention, treatment, and reducing the social and health impacts of drug use.
In addition, Programme 000X (“Internal Transfers and Disbursements”) is excluded from the analysis, as it consists of transfers between public sector entities and would otherwise lead to double counting and distort the overall budget.
Audit
The Ministry's accounts, as well as those of its agencies, are internally audited by the Office of the Comptroller General of the State (IGAE), through a Delegated Comptroller's Office within the Department itself. Externally, the Court of Auditors is responsible for auditing expenditures.
Likewise, the Congress of Deputies and Senate health committees and the Congress-Senate Joint Committe on the Study of Addiction Problems, exercise political control over the accounts.
List of officeholders
Notes
- ^ This number only includes public employees.
See also
- Civil Order of Health
- History of Spain
- Politics of Spain
- Cabinet of Spain
- List of Spain-related topics
References
- ^ a b c "Royal Decree 718/2024, of July 23, which develops the basic organic structure of the Ministry of Health". www.boe.es. Retrieved 27 July 2024.
- ^ "Healthcare expenditure statistics - overview". ec.europa.eu. Retrieved 26 April 2026.
- ^ a b "Informe Anual del Sistema Nacional de Salud 2024" (PDF). www.sanidad.gob.es (in Spanish). pp. 99–111.
- ^ "Felipe V sí cerró las fronteras españolas a tiempo: así combatió la peste de Marsella". El Español (in Spanish). 14 April 2020. Retrieved 7 April 2025.
- ^ Ministry of Culture. "Institution - The Royal Supreme Health Board (Spain)". www.pares.mcu.es (in Spanish). Retrieved 7 April 2025.
- ^ a b Ministry of the Interior (24 March 1847). "Royal decree of 17 March 1847 abolishing the Royal Supreme Health Board and reorganizing this service" (PDF). Boletín Oficial del Estado. Retrieved 4 April 2025.
- ^ Ministry of the Interior (13 March 1847). "Royal decree approving the new structure given to the Ministry of the Interior of the Kingdom" (PDF). Boletín Oficial del Estado (in Spanish). Retrieved 7 April 2025.
- ^ "ABC SEVILLA 23-12-1933 página 19 - Archivo ABC". www.abc.es (in Spanish). 6 August 2019. Retrieved 7 April 2025.
- ^ La Sanidad y la Asistencia Social durante la Guerra Civil. Federica Montseny (ed.), 23 de diciembre de 1933 Archived 2011-09-24 at the Wayback Machine
- ^ SER, Cadena (16 September 2021). "La historia valenciana de Federica Montseny, la primera mujer ministra de España". Cadena SER (in European Spanish). Retrieved 7 April 2025.
- ^ Cristina (27 August 2021). "Federica Montseny: la primera ministra de España, muy a su pesar". Ethic (in Spanish). Retrieved 7 April 2025.
- ^ "Decreto disponiendo la nueva denominación de los departamentos ministeriales a partir de la fecha de la promulgación de este Decreto" (PDF).
- ^ Office of the Prime Minister (5 July 1977). "Royal Decree 1558/1977, of July 4, restructuring certain departments of the Central State Administration". www.boe.es (in Spanish). Retrieved 11 April 2025.
- ^ [1]ABC Hemeroteca. Nuevo Gobierno sin grandes sorpresas. 5 July 1977
- ^ Ministry of Health and Social Security (30 July 1977). "Real Decreto 1918/1977, de 29 de julio, sobre estructuración del Ministerio de Sanidad y Seguridad Social". www.boe.es (in Spanish). Retrieved 11 April 2025.
- ^ "Royal Decree 19/2014, of 17 January, by which the autonomous bodies of the National Institute of Consumption and the Spanish Agency for Food Safety and Nutrition are consolidated into a new autonomous body called the Spanish Agency for Consumer Affairs, Food Safety and Nutrition and its statute". www.boe.es. Retrieved 13 April 2019.
- ^ "Royal Decree 485/2017, of May 12, which develops the basic organizational structure of the Ministry of Health, Social Services and Equality". www.boe.es. Retrieved 13 April 2019.
- ^ "Spain approves law that returns to free universal health care model". www.efe.com. Retrieved 13 April 2019.
- ^ Jones, Sam (12 September 2018). "Spain's health minister quits over degree scandal". The Guardian. ISSN 0261-3077. Retrieved 13 April 2019.
- ^ Güell, Oriol (14 November 2018). "Spain moves to ban pseudo-therapies from universities and health centers". El País. ISSN 1134-6582. Retrieved 13 April 2019.
- ^ "Royal Decree 735/2020, of August 5, which establishes the basic organic structure of the Ministry of Health". boe.es. Retrieved 5 August 2020.
- ^ Linde, Pablo (23 August 2022). "El Gobierno aprueba la creación de la Agencia Estatal de Salud Pública sin decidir su ubicación". El País (in Spanish). Retrieved 11 April 2025.
- ^ SOLER, SOFÍA (23 August 2022). "¿Para qué sirve una Agencia Estatal de Salud Pública? Obesidad, crisis climática y otros retos más allá de la COVID". RTVE.es (in Spanish). Retrieved 11 April 2025.
- ^ "Sanidad financiará la reproducción asistida a mujeres sin pareja, lesbianas y trans". La Vanguardia (in Spanish). 5 November 2021. Retrieved 11 April 2025.
- ^ "El gallego José Miñones deja el Ministerio de Sanidad, que liderará Mónica García". El Español (in Spanish). 20 November 2023. Retrieved 11 April 2025.
- ^ "Sanidad nombra al médico Pedro Gullón director general de Salud Pública y crea el Comisionado de Salud Mental". El Español (in Spanish). 9 January 2024. Retrieved 11 April 2025.
- ^ "La historia valenciana de Federica Montseny, la primera mujer ministra de España". Cadena SER (in European Spanish). 16 September 2021. Retrieved 28 April 2026.
- ^ MORENO, P. (24 June 2018). "El Plan de Ciutat Vella refuerza la protección de 13 sedes de la República". Las Provincias (in Spanish). Retrieved 28 April 2026.
- ^ Auñón Muelas, Paco (26 May 2022). "Juan Zavala, el arquitecto que dejó su nombre en Cuenca junto a un legado bibliográfico". Cadena SER (in European Spanish). Retrieved 28 April 2026.
- ^ Bonet Correa, Antonio; Ureña, Gabriel (1981). Arte del franquismo (in Spanish). Ediciones Cátedra. p. 71. ISBN 978-84-376-0287-5.
- ^ "Las centrales sindicales, legalizadas". El País (in Spanish). 29 April 1977. ISSN 1134-6582. Archived from the original on 14 August 2014. Retrieved 28 April 2026.
- ^ a b Secretariat of State for Budget and Expenditure (1 January 2026). "2023 Ministry of Education' Budget, extended to 2026" (PDF). www.sepg.pap.hacienda.gob.es. Retrieved 26 April 2026.
External links
- Ministry of Health (in Spanish)