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A new report from Spain's Ministry of Health lays bare a big shift in how public healthcare is delivered. Three out of every ten public hospitals are now under private management, up 36.8% from 106 in 2011 to 145 by 2023. Spending on these privately run facilities has jumped 85% in that time, hitting €4.8 billion last year.

 

The study points out how what started as a rare fix has turned into everyday practice. "Collaboration with private entities has gone from being an exceptional resource to becoming a structural practice, which implies diverting a growing part of the public budget to companies whose logic responds to profit, not to the general interest," the ministry notes. This reliance shows up elsewhere too, like beds in private centres rising from 13.7% to 17.8% of the National Health System's total, and operating rooms from 8% to 10.7%.

 

It's especially noticeable in places like Catalonia and Navarre, where private setups form a big chunk of the infrastructure. Public money also funds over a third of hospital stays and 17.6% of discharges in non-SNS private hospitals, plus 21% of major outpatient surgeries and day cases.

 

Health Minister Mónica García plans a new public management law for early 2026 to limit public-private partnerships and protect the system from investment funds, especially amid concerns at the privately managed Torrejón de Ardoz hospital, which involved leaked audio recordings where the manager of the privately run facility (Ribera Salud group) allegedly instructed staff to lengthen waiting lists, reduce certain procedures, and prioritise profitable cases to boost company earnings.

 

After Tuesday's Council of Ministers meeting, García said, "This report shows the reality, the Torrejón crisis shows the consequences, and the future public management law shows the solution."

 

The report questions if this model brings real gains in efficiency or patient outcomes, flagging risks around planning and oversight as public cash flows to private pockets year after year.