Ministry of Health (Spain)


The Ministry of Health 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.
The 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.
The Ministry is headed by the Minister of Health, who is appointed by the King of Spain at request of the Prime Minister, after hearing the Council of Ministers. The Minister is assisted by two main officials, the Secretary-General for Health and the Under Secretary of Health. The current Health Minister is Salvador Illa.
According to Eurostat, Spain spends 6.2% of GDP on health, approximately $83 billion.

History

Early period

References can be found to the action of Government in public health and welfare in the 19th century. The Royal Decree of 9 November 1832 created a Ministry of Development, which included powers over "the field of health with the infirmaries, water and mineral baths" and "charitable institutions". A further Royal Decree of 10 March 1847, created a Department of Health, one of six that made up what is now the Ministry of the Interior.

First ministry

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, 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. This ministry was short-lived. When the Prime Minister of the Republic, Juan Negrín, replaced Francisco Largo Caballero, the ministry was abolished and its powers were transferred to the Ministry of Labour and to the Ministry of Public Instruction by a Decree of May 1937. After the Spanish Civil War, the responsibility returned to the Ministry of the Interior until 1977.

Democratic period

The Health Ministry was created again in the Constituent Legislature in 1977, integrating responsibilities for Health that were hitherto managed by the Ministry of the Interior, and the powers of the Undersecretariat for Social Security.
Royal Decree 1558 of 4 July 1977 established the ministry in its current form, including responsibility for Social Security. Staffing consisted of two undersecretariats, a Technical General Secretariat and six Directorates-General: Staff, Management and Finance; Social Benefits; Social Services; Healthcare; Pharmaceutical Management and Public Health 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 Labour ministry. With this reform the Ministry acquired competencies over 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 and achieved notoriety by her handling mad cow disease. She was succeeded by Ana Pastor Julián. 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. With her, in 2004 the National Plan on Drugs, belonged 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, previously under Education.
Under minister Leire Pajín, responsibilities on Equality issues were added to her duties, previously under a separate ministry of its own, and also assuming the Institute for Women and the Institute for Youth. At the beginning of the 10th legislature Ana Mato became minister and the Ministry assumed the Charles III Health Institute. 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 servicies, 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.

Structure

The Ministry of Health, Consumer Affairs and Social Welfare is organised in the following superior bodies:
In addition, the Department has two advisory bodies:
Ministry of Health and Social Security
Ministry of Work, Health and Social Security
Ministry of Health and Consumers
Ministry of Health and Social Policies
Ministry of Health, Social Policy and Equality
Ministry of Health, Social Services and Equality
Ministry of Health, Consumers Affairs and Social Welfare
Ministry of Health