Ministry Of Health (Spain)

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. 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 (2022 data), Spain spends 9.7% of its GDP on health, approximately $142 billion (€131.1 billion).

According to the Annual Report of the National Health System 2023, the total expenditure of the Spanish health system in 2021 was 132 billion euros (94.7 billion corresponding to the public sector and 37.3 billion to the private sector). This represented 2,789 euros per capita and an expenditure of 10.94% of the Spanish GDP. As of 2022, regarding human resources, the NHS had 868,758 professionals. Of these, 205,366 were medical professionals, 293,600 nursing professionals, and 369,792 were other types of health professionals.

The Minister of Health is the head of the department; he or she 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

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 (). 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. 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.

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. 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. 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. 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.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.

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. 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. 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.

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.

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 Plan on Drugs, 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. 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. 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. She resigned after three months in office after a degree scandal and María Luisa Carcedo succeeded her. Carcedo continued with the program established by Montón on fight against pseudosciences 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.

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. 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.

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.

In November 2023 Mónica García assumed the office, focusing her term in mental health. For this purpose, she created a Commissioner for Mental Health.

Structure

The Ministry of Health is organized as follows (in bold those who depend directly on the minister):

* The Secretariat of State for Health
** The General Secretariat for Digital Health, Information and Innovation of the National Health System
*** The Directorate-General for Digital Health and Information Systems for the National Health System
**** The Deputy Directorate-General for Digital Health Services
**** The Deputy Directorate-General for Health Technological Infrastructure
*** The Deputy Directorate-General for Health Information
** The Directorate-General for Public Health and Health Equity
***The Deputy Directorate-General for Border Health
***The Coordination Centre for Health Alerts and Emergencies
***The Deputy Directorate-General for Health Promotion, Prevention, and Equity
***The Deputy Directorate-General for Environmental and Occupational Health
***The Deputy Directorate-General for Healthcare Quality
***The Division for HIV, STI, Hepatitis and Tuberculosis Control
** The Directorate-General for the Common Catalogue of Services of the National Health System and Pharmacy
*** The Deputy Directorate-General for Pharmacy
*** The Deputy Directorate-General for the Services Catalogue of the NHS and Compensation Funds
** The Directorate-General for Professional Management
*** The Deputy Directorate-General for Training and Professional Management
*** The Deputy Directorate-General for Cohesion and High Inspection of the NHS
**The Government Delegation for the National Plan on Drugs
***The Deputy Directorate-General for Programs Coordination
***The Deputy Directorate-General for Institutional Relations
***The Deputy Directorate-General for Management
* The Undersecretariat
** The Technical General Secretariat
*** The Deputy Technical General Secretariat
*** The Deputy Directorate-General for Regulations
*** The Deputy Directorate-General for Appeals and Relations with the Administration of Justice
*** The Deputy Directorate-General for Institutional Relations and Publishing
** The Deputy Directorate-General for Human Resources.
** The Deputy Directorate-General for Economic and Budgetary Management.
** The Deputy Directorate-General for Citizen Services and Inspectorate-General of Services.
** The Deputy Directorate-General for Planning and Coordination of European Funds
** The Division for Information Technologies
** The Division for General and Administrative Affairs
*The Commissioner for Mental Health
**The Technical Office on the Transition of the Mental Health Model
**The Division for Mental Health Prevention, Promotion and Protection

In addition, the Department has two advisory bodies:

* 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.

Ministry agencies

*Spanish Agency of Medicines and Medical Devices
*Spanish Agency for Food Safety and Nutrition
* National Transplant Organization
*National Institute of Health Management

List of officeholders

Office name:
*Ministry of Health and Social Assistance (1936–1937)
*Minister of Health and Social Security (1977–1981)
*Minister of Health and Consumer Affairs (1981–2009)
*Minister of Health and Social Policy (2009–2010)
*Minister of Health, Social Policy and Equality (2010–2011)
*Minister of Health, Social Services and Equality (2011–2018)
*Minister of Health, Consumer Affairs and Social Welfare (2018–2020)
*Minister of Health (2020–present)

Notes

See also

* History of Spain
* Politics of Spain
* Cabinet of Spain
* List of Spain-related topics

References

External links

Ministry of Health

{{DEFAULTSORT:Ministry Of Health (Spain)
Health
Spain
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Ministries established in 1977
1977 establishments in Spain
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Health care in Spain