The privatisation of health service provision is gathering pace and as the industry readjusts the demand for innovate, cost-saving products will increase and alternative pathways into the market are likely to appear.
Spain has an excellent universal health system that has fostered the development of thousands of highly-skilled healthcare professionals. With over 180 hospitals and more than 160,000 hospital beds, Spain is the fifth largest market for health care in Europe. Budget cuts in recent years should not deflect from the fact that healthcare expenditure in Spain has more than doubled over the last 15 years to €100 Billion and an ageing population will ensure that in the medium to long-term healthcare spending is likely to continue to rise.
Primary care and Hospitals
Although financed nationally, responsibility for administration of the public health system lies with the 17 autonomous regions and, depending on the political persuasion of governing parties, some have proceeded down a Public Private Partnership for hospital management. Over 1 million people in Valencia are now attended in hospitals under private management and Madrid recently confirmed that it would transfer the management of 6 hospitals to the private sector. Castille La-Mancha is also expected to privatise the management of four hospitals over the coming year.
Publicly-funded primary healthcare is also being opened to private sector provision in some regions, opening up opportunities for British firms in this sector. Valencia was the first region to tender some of its local health areas and many are now managed under the PPP. Catalonia has also already tendered some of its primary health care centres, encouraging professional associations to bid in the tender process. Madrid expects to open the management of part of its primary health care network to private initiative during 2013.
Private Health Sector
It may seem counter-intuitive, but since the beginning of the economic crisis private health insurance affiliation has increased by 29% and private clinics have grown by 16%. Although 20% of Spaniards are now covered by private health insurance, this is still below comparable countries such as France and Germany, indicating room for further growth. Furthermore, the cuts in funding to the public sector are likely to increase waiting times for surgery, indirectly increasing the attractiveness of private health insurance.
Spain has one of the highest concentrations of pharmacies in Europe. Pharmaceuticals remain heavily subsidised by the central government, although cost-saving measures have bought a shift in purchasing to generic products. The government has also recently launched a centralised purchasing body for pharmaceuticals, although some regions such as Andalusia have opted to continue their own bulk purchasing. Over-the-Counter products are best distributed through a distributor with extensive links in the individual pharmacies and pharmacy co-operatives
Changes on the horizon include the possible liberalisation of the sector. Currently, pharmacy owners must be certified pharmacists and there are limitations regarding their location. The Ministry for Competitiveness and Economy are pushing for liberalisation while the Health Ministry defends the status quo.
Budget pressures have meant that cost-saving innovative products are in particular demand.
The privatisation of hospital and primary care management brings new opportunities for UK companies who sell healthcare products and services. Public hospitals conduct tender processes for products and the transfer of management to the private sector opens opportunities for UK companies to build relationships with the new procurement managers of now privately-managed hospitals.
There are also opportunities for suppliers of other non-health services to hospitals such as catering, cleaning or IT services. Outsourcing in these areas is increasingly widespread throughout the country and will be even more common after privatisation initiatives.
The Valencia region has outsourced entire health areas to private companies, paying the service provider a fixed amount per inhabitant for a pre-agreed catalogue of services. Firms that provide goods and services that assist in reducing numbers of expensive hospital admissions in these areas, or those who can provide solutions for more-efficient management of chronic illnesses will be especially well received. The Madrid and Castilla-La Mancha regions are also following the Valencia model of outsourced health service management.
Telehealth and E-Health are gaining a foothold in the Spanish market. Andalusia and The Basque Country are leaders in the adoption of these technologies and with Spain’s ageing population the demand for related goods and services is likely to increase.
Spain has important historic and commercial links with Latin America. Using Spain as a springboard into Latin America’s 600 million consumer market is a strategy that has been successfully adopted by other UK firms.
Getting into the market
Official certification and/or CE-marking is necessary, together with marketing authorization where required.
Packaging must be in Spanish.
Key elements of product information and presentation of specific advantages should be translated into Spanish.
English is not widely spoken but larger companies usually have members of staff who are reasonably fluent.
Partnering with Spanish local companies is usually essential in helping to navigate Spanish supply chains, various tendering processes, and regulatory barriers.
Market intelligence is critical when doing business overseas, and UKTI can provide bespoke market research and support during overseas visits though our chargeable Overseas Market Introduction Service (OMIS).
To commission research or for general advice about the market, get in touch with our specialists in country – or contact your local international trade team.
Keiran Bowtell, UKTI- British Embassy, Madrid Tel. +34 917 146 334 firstname.lastname@example.org
Jessica Griffiths, UKTI- British Consulate General, Barcelona Tel: +34 933 666 204 email@example.com
Derek Doyle, UKTI – British Consulate General, Bilbao Tel: +34 944 157 711// firstname.lastname@example.org
UKTI runs a range of events for exporters, including seminars in the UK, trade missions to overseas markets and support for attendance at overseas trade shows.
Biodevices 2012. 11-14 February, 2013. Barcelona, Spain
Infarma. 05 – 07 March 2013. Barcelona, Spain
XVI Congreso Nacional de Informática de la Salud (National Congress of IT in Health).12-13th March 2013. Madrid, Spain