Following a recent visit to the Santa Ana hospital in Motril, the main hospital for the towns and villages of Spain’s Costa Tropical, I was surprised to see the release of the newly revised Health charter (reproduced below) being available not only in Spanish but in various other European languages too. With this in mind, it occurred to me just how little information is available to foreigners living in Spain in respect of the rights and access to state Health facilities in this area.
Most people who plan to move to Spain will already have researched with the appropriate government authority to ensue that they receive at the least a basic level of state health benefits; and may even have looked also to private health insurance schemes to cover any particular issues they may have. The main document required will be the European Health Insurance Card (EHIC) that replaced the E111 from Jan 1 2006, and gives the carrier admission to state-provided medical treatment in the European country they are visiting. Thus you will be entitled to treatment in the same way as a resident  of the country you are visiting. However, even with an EHIC you may be asked to contribute to particular costs of your care that are not covered in the agreement between the UK and Spain for particular treatments and conditions.
If you are retiring to Spain, or have specific medical conditions like diabetes, or receive disability entitlement then you will also need the form E121 and will normally obtain the document once you advise them of when you plan to move abroad. The E121 is only valid once it has been registered with the sickness insurance scheme in Spain; and also you will need to have documents that show proof of your Spanish address, and residence (empadronamiento) in the local authority. Thereafter you will be assigned a GP in the nearest health centre.
What should not be forgotten is that here in Spain there is no discrimination between the private and public sectors in regards to health options. Consequently, it is possible to fast track certain procedures to obtain privately the appropriate tests, scans and results that you can then present to your assigned consultant in the state health sector. It is frequently the case here in Spain that private specialist clinics can offer services such as x-ray, MRI scans, ECG tests, liver function tests, specific blood or urine tests, endoscopy and many others. Thus allowing you the patient the choice to, either stay on the state waiting list until such procedures as recommended by your consultant are available, or to have such tests done privately within a few days without prejudicing the doctors advice at the next appointment. In this way there is a comfortable relationship between both the state and private sector; and with private costs often much less than in the UK then for many expats this gives greater peace of mind.
For more details and advice see
http://www.direct.gov.uk/en/Over50s/TravelAndLeisure/TravellingAtHomeAndAbroad/DG_10026843 . And also
http://www.nhs.uk/healthcarespain/Pages/healthcarespain.aspx

Spain Rights & Obligations of citizens in the Public Health Services of Andalusia, Spain
In accordance with the Andalucian Health Act 2/1998, published in the Official Gazette of the Government of Andalucia number 74 of 4th July. Revised June 2008.

Your RIGHTS AS A USER of the Healthcare system are as follows –

To receive health care under conditions of equality, without discrimination for any reason, respecting your personality, human dignity and privacy.

To be offered the available healthcare, benefits and services deemed necessary to care for your health.

For you, your relatives or companions to receive information in comprehensible language on everything related to your process, including diagnosis, treatment, prognosis, expected stay in hospital and alternative treatments.

To receive information on the health services and benefits to which you may have access and the necessary requisites in each case.

To be offered information on health prevention and promotion programmes carried out in your primary healthcare centre.

To be informed on collective health aspects of special interest, incidence or risk.

To be received personally on arrival at a health centre, and especially in hospital, to be informed of all matters that can make your stay more comfortable.

To receive clear and comprehensible information on treatment, surgical procedures and diagnostic tests that involve risks, before your written consent is obtained.

To know about and give prior written authorisation to procedures used  in a teaching or research project which under no circumstances may entail an additional risk for your health.

To choose from the options submitted by your doctor, and to refuse any health intervention, except in the cases established by law (risk to public health, incapacity and urgent intervention in cases of risk of irreversible injury or danger to life).

To be accompanied by a relative or person you trust at all times during the healthcare process , provided that clinical circumstances so permit.

To have all the information concerning your care in any health centre kept confidential, and to have access to the personal data obtained during your care.

To have a written record, or record on technical support  (ie storage information disk, chip, etc), of your process kept in your medical record. The information, which must be in one record for each health institution, will include your state of health and evolution, as well as the tests and treatment you receive.

To have access to your medical records, using the established procedures.

To receive a report on discharge from hospital, on completion of a specialist consultation, and on discharge from emergency.

To be issued a certificate attesting to the state of your health.

To be assigned a doctor and a primary healthcare centre to treat you, although you may opt to choose another doctor and health centre.

To choose your general practitioner and pediatrician from among those practicing in your village, town or city, and also from among the other doctors in the health district corresponding to your address.

To choose a specialist for consultations, when in the opinion of your GP or pediatrician, you need to treated by such a specialist, and to receive care from the same specialist during your process.

To choose a hospital within the Public Healthcare System of Andalusia if you are waiting for an operation.

To have a second medical opinion on your process, in the terms established.

To know the name and function of the professionals who treat you.

To be operated on within the term established in ruling legislation for each of the procedures of the Public Health System.

To receive healthcare in an acceptable time depending on the process, and to be offered information on waiting times for consultations, tests and operations for the various processes.

To have the Charter of Rights and Obligations available in all health centres. You are also entitled to make complaints and suggestions and to receive a reply within the established periods.

To participate in the public healthcare system through the Area Health Boards, represented by Consumer and Users Associations and to express your opinion through different social research models, and to receive information on the resulting measures for improvement.

To have all appropriate actions taken that, together with the care for your process  and aimed at reducing and relieving suffering and pain both in critical situations and in the process of death, in accordance with maximum respect for autonomy, Integrity and human dignity.

To have your living will, declared using the established procedure, taken into account.

To have the information on your genome kept confidential and not used for any kind of discrimination. You are also entitled to obtain the advantages deriving from available new genetic technology in accordance with the ruling legislative framework.

To use information and communication technologies, in accordance with the development of such technologies in health services, with criteria of accessibility, security and continuity.

Your OBLIGATIONS AS A USER of the Healthcare system

To comply with the general instructions on health common to the entire population, and those of the health services, in accordance with the established provisions.

To respect the rules established in the centre, and to respect the personnel providing services in it.

To be responsible for the use of the resources and benefits offered by the Public Health Service of Andalusia, basically as regards the use of services, pharmaceutical benefits, orthoprosthetic benefits procedures and disability (unfitness to work) procedures.

To take care of facilities and collaborate in their maintenance.

To comply with the administrative rules and requisites for use of and access to healthcare benefits.

To sign, if you refuse treatment, the pertinent document in which it will be clearly stated that the patient has been sufficiently informed and refuses the treatment suggested.

http://www.juntadeandalucia.es/salud/principal/