Madrid
Spain is moving to curtail healthcare privatization and increase oversight of public hospitals managed by private companies under a new law. The legislation, set to be enacted, aims to reverse a trend that began with a 1997 law and has led to arrangements like those at the Alzira de Ribera Salud and Quirón in Madrid. The move underscores growing concerns about the influence of private entities in the country’s public health system.
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The new Law on Public Management and Integrity of the National Health System will effectively conclude the privatization of healthcare, allowing it only in exceptional circumstances. These include situations where public provision is not feasible, financial sustainability and efficiency are guaranteed, and the service meets standards for quality, continuity, accessibility, and affordability.
A key component of the law establishes a mandatory, pre-approval evaluation process for any public-private partnerships. Regional authorities will be required to justify the demand for such collaboration in a report, which will then be analyzed by a committee of experts, and technicians. Agreements with non-profit organizations will be prioritized over those with for-profit companies.
The legislation will also prohibit contracts where a private company both constructs a hospital and manages its operations. The law also provides a pathway for the public sector to reclaim control of previously privatized hospitals, with the High Health Inspection offering guidance on the reversion process. A group of experts will conduct a study within one year to review all existing hospital and healthcare center privatizations.
To enhance transparency and accountability, regional authorities will be obligated to regularly publish detailed information regarding contracts, agreements, health outcomes, and service quality. Existing contracts and agreements established before the law’s enactment will remain under their original terms.
The legislation comes amid scrutiny of private healthcare providers in Madrid. A recent report revealed that Ribera Salud, which manages the Hospital de Torrejón, also operates a large diagnostic laboratory that has faced criticism for prioritizing profit over patient care, according to El PaÃs. The Community of Madrid is investigating the concession awarded to Ribera Salud following reports that a company executive instructed doctors to reject patients deemed unprofitable, as reported by El Mundo Today.
The new law builds on previous efforts to address concerns about privatization, including a move announced February 9, 2026, to repeal the 1997 law that initially opened the door to models like Ribera Salud and Quirón, according to Cadena SER.
