Spanish Council of Ministers Approves Draft Law to Strengthen Public Management and Integrity in National Health System
The Spanish government advances public healthcare management by approving a draft law focused on integrity, transparency, and limiting privatization in the National Health System.
- • Spanish Council of Ministers approves draft law on public management and integrity of SNS.
- • Law prioritizes public management and universal, equitable healthcare access.
- • Limits indirect management to exceptional, evaluated cases with transparency measures.
- • Based on international data, notably an OECD study, indicating public system efficiency over privatization.
- • Establishes legal framework for health consortia, transparency, and evaluation of prior private management.
Key details
On February 10, 2026, the Spanish Council of Ministers approved a draft law aimed at reinforcing public management, transparency, and the integrity of the National Health System (SNS). This legislation prioritizes public management in the organization and delivery of health services and seeks to ensure universal, equitable, and quality healthcare accessible to all citizens.
The draft law addresses concerns raised by the rising privatization of health services in recent decades, which has caused fragmentation and reduced transparency. Grounded on international data including an OECD study of 38 countries, it asserts no efficiency gains from privatization while highlighting evidence from Spain where indirect management models like the Alzira model have shown poorer health outcomes such as higher avoidable hospitalizations and mortality rates compared to public hospitals.
Key principles enshrined include universality, accessibility, quality, sustainability, equity, and good governance. The law limits indirect management to exceptional cases that require prior evaluation and justification, including expert committee assessments and public disclosure of evaluations and resolutions. It abolishes mixed contractual formulas linking infrastructure and service provision.
The legislation also establishes a legal framework for health consortia, mandates transparency in contract details and health service quality, and calls for evaluations of private management experiences since 1997. Existing contracts under prior laws remain valid until expiration, with the new rules applying moving forward.
This comprehensive legal reform aims to enhance institutional control, ensure accountability, and reinforce the SNS as a public, non-profit cornerstone of Spain’s healthcare system.
This article was translated and synthesized from Spanish sources, providing English-speaking readers with local perspectives.
