Healthcare
Hospitals in Spain and on the Costa del Sol explained
How Spanish hospitals work for newcomers: public vs private, going to urgencias, getting a referral and the main hospitals on the Costa del Sol.
Updated: October 2026
Sooner or later most people who move to Spain end up in a hospital, whether for a scan, a specialist appointment or a late-night trip to A&E. This guide explains how public and private hospitals differ, when to go to urgencias, how referrals work and which hospitals serve the Costa del Sol.
How the hospital system is organised
Spain’s public health system, the Sistema Nacional de Salud (SNS), is run by the 17 regions. In Andalusia that means the Servicio Andaluz de Salud (SAS); in Madrid it is SERMAS, in Catalonia CatSalut and so on. The rules are broadly the same everywhere, but appointment systems, apps and waiting times differ from region to region.
Hospitals sit at the second level of the system. Your first stop is normally the local health centre (centro de salud), where your family doctor (médico de familia) decides whether you need a specialist or hospital care. To use the public system you need to be registered and hold a regional health card (tarjeta sanitaria). Our guide to healthcare for foreign residents explains who qualifies and how to register.
Public and private hospitals compared
Most people in Spain use public hospitals, and many large teaching hospitals are public. Private hospitals are used by people with private health insurance or those paying themselves. Many expats use both: the public system for serious or long-term conditions, and private care for quicker appointments.
| Topic | Public hospital | Private hospital |
|---|---|---|
| Access | Health card and referral from your GP (except emergencies) | Insurance card or direct payment, usually no GP referral needed |
| Cost | Free at the point of use if you are covered | Covered by your policy or paid per visit/procedure |
| Waiting times | Can be long for non-urgent surgery and specialists | Usually shorter |
| Language | Mainly Spanish; interpreters vary by hospital | English-speaking staff common in coastal areas |
| Complex care | Major trauma, transplants, intensive care units | Varies; serious cases may be transferred to public hospitals |
Waiting lists are a real factor. According to the Ministry of Health’s waiting list statistics, the average wait for planned surgery across Spain was around 121 days at the end of 2025, with big differences between regions and specialities. Urgent and cancer cases are prioritised.
Going to urgencias (A&E)
Every public hospital has an emergency department (urgencias) open 24 hours a day. In a life-threatening situation call 112, which works free from any phone and can connect you to an ambulance. For less serious problems, many towns also have out-of-hours primary care points, often called urgencias de atención primaria or PAC, which are faster than a hospital for things like a high temperature or a minor injury.
- Triage: patients are seen in order of medical priority, not arrival time, so non-urgent cases can wait several hours.
- What to bring: your health card or insurance card, passport or NIE/TIE, a list of your medication and any recent test results.
- Not yet covered? Emergency care is never refused, but if you have no public coverage or EHIC you may receive a bill afterwards.
- EU visitors: the European Health Insurance Card (EHIC) gives access to necessary care in public hospitals on the same terms as locals.
How to get referred to a specialist or hospital
- Book an appointment with your family doctor through your region’s app, website or by phone. In Andalusia this is done with the Salud Andalucía app or ClicSalud+.
- The doctor examines you and, if needed, issues a referral (derivación or interconsulta) to the relevant hospital department.
- The hospital or your health centre contacts you with a date, usually by SMS, letter or through the app. Keep your phone number and address up to date.
- After the specialist visit, tests or surgery are scheduled from the hospital, and follow-up often goes back to your family doctor.
If you have private insurance you can normally book a specialist directly, although some policies require authorisation (autorización) from the insurer before scans or operations. Always check this before the appointment to avoid an unexpected bill.
Main hospitals on the Costa del Sol
Which public hospital you use depends on where you are registered. These are the main ones in Málaga province:
- Hospital Regional Universitario de Málaga: the province’s largest hospital (still widely known as Carlos Haya), including the Materno Infantil hospital for women and children.
- Hospital Universitario Virgen de la Victoria (El Clínico): large teaching hospital in the west of Málaga city, serving much of the western coast.
- Hospital Universitario Costa del Sol: in Marbella, the main public hospital for the western Costa del Sol from Fuengirola towards Estepona.
- Hospital Comarcal de la Axarquía: in Vélez-Málaga, covering Nerja, Torrox and the eastern coast.
- Smaller public centres: high-resolution hospitals in Benalmádena, Estepona and the Guadalhorce valley, plus hospitals in Ronda and Antequera inland.
On the private side, well-known hospitals include Vithas Xanit Internacional in Benalmádena, Quirónsalud in Málaga and Marbella, and several international clinics in Marbella and Estepona. Check which of them work with your insurer before you need them.
Practical tips for a hospital stay
- Family support: in Spanish public hospitals relatives often stay with the patient and help with basic care, so plan who can be there.
- Language: ask whether an interpreter or a telephone translation service is available, or bring someone who speaks Spanish.
- Reports: ask for your discharge report (informe de alta) and keep copies; most regions also show them in their health app.
- Insurance: if you rely on private cover, read our guide to insurance in Spain to see what to look for in a health policy.
Useful links
- Salud Andalucía app (Servicio Andaluz de Salud)
- Ministry of Health: waiting list summary, December 2025 (PDF, Spanish)
- European Commission: what the EHIC covers
- Healthcare in Spain for foreign residents
- How to become a resident in Spain
FAQ: hospitals in Spain
Can I go straight to a public hospital without a referral?
Only to urgencias. For specialist appointments and planned treatment in the public system you need a referral from your family doctor.
Will I be charged at A&E as a tourist?
EU visitors with a valid EHIC are treated like locals in public hospitals. Visitors without it, or anyone using a private hospital, should expect to pay or claim through travel insurance.
Can I choose which public hospital I go to?
You are assigned a hospital based on your address, but several regions, including Andalusia, allow you to request a different specialist or hospital under certain conditions. Ask at your health centre.
Do public hospitals have English-speaking staff?
Many doctors speak some English, especially on the coast, but it is not guaranteed. Bring a Spanish speaker or use a translation app for important conversations.
Disclaimer: This article is general information only and is not medical advice. Rules, waiting times and services can change – always check with your health service or a doctor before you act. In an emergency, call 112.
