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The 18-Month Wait Exposing Spain’s Hidden Hospital Queues

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Cases like these rarely make it into Spain’s official waiting list figures. Credit: Shootdiem / Shutterstock.

A colonoscopy in February 2025 was meant to lead to a routine follow-up. Eighteen months on, a patient in Cádiz says that appointment still doesn’t exist, and neither does any record of the procedure that was supposed to trigger it. 

A colonoscopy, then months of silence

In November 2024, a patient at Hospital Universitario de Puerto Real in Cádiz was referred to the Digestivo (digestive medicine) department, and a colonoscopy was prescribed. It was carried out on February 5, 2025, according to consumer group FACUA Cádiz. The patient then asked for the follow-up review about a week later, but more than a month passed with no callback, and when they chased it up, staff reportedly said there were no appointments available. 

A formal complaint followed in December 2025. FACUA says the hospital took almost two months to reply, confirming in February 2026 that the request was logged but still unallocated. Now, more than eighteen months after the colonoscopy: still no appointment.

The record that has also gone missing

FACUA says the gap goes beyond a missing appointment. Neither the pending follow-up nor the report from the colonoscopy itself appears on ClicSalud, the online portal Andalucía’s public patients use to check appointments and test results. The consumer group argues this follow-up is part of the care the colonoscopy started and not a separate request, and that a wait this long risks the patient’s health. FACUA has directly asked the Junta de Andalucía to guarantee timely care and reliable access to patients’ own records.

A two-year wait, and an appointment nobody told her about

Puerto Real is not an isolated case. Molly Grace, who lives in the Bahía de Cádiz-La Janda health district covering Barbate, Vejer de la Frontera, Conil and Chiclana, has been waiting even longer, for a different reason. She injured her hip in June 2024 carrying 50kg of animal feed up two flights of stairs, and was placed on a waiting list for rehabilitation, a step patients there must complete before a traumatólogo (orthopaedic specialist) will see them. 

Molly said she called for an update every six months for two years and was told each time only that the list was long. It was not until she called again this June that a receptionist, surprised by how long she had waited, checked the system and found her appointment had been cancelled by the doctor months earlier. She should have been told to request a new one by phone, Grace said, but never was.

The mix-ups didn’t stop there. At a later appointment in August, Grace was asked whether she had attended one in July. She had never been told it existed, and it had gone ahead without her. Her medical report also understated how long she had been in pain, recording months rather than the roughly two years that had actually passed. A traumatólogo has since said she needs a resonancia (MRI scan), but given her no appointment for one, leaving her to chase the hospital again just to find out how to book it.

Molly said one doctor told her that the rehabilitation department doesn’t really have a long waiting list at all, and that staff there would rather pass referrals on than manage them. Several other doctors have also urged her to file a formal queja (complaint) or reclamación (claim) over the delay. Grace said she is now considering doing so herself, worried about what the continued delay could mean for her mobility.

The wait has also made other appointments awkward: doctors treating unrelated problems have suggested exercises for her knee, only for Grace to explain that her hip is still on a waiting list and she cannot do them.

Spain’s hospital queues, in numbers

Both cases sit inside a much bigger backlog. Ministry of Health figures for December 2025 show more than four million people nationally were waiting for a first specialist appointment, with an average wait of 102 days. Around three in five had already waited more than 60 days.

Andalucía’s own list is longer. Close to 900,000 people were waiting for a first specialist consultation at the end of last year, with an average wait of 136 days. Within that, more than 46,000 people were waiting specifically for a first Digestivo appointment, with an average wait of 117 days, and just over half had already waited more than 60 days.

How patients disappear from the queue

Neither of our cases are actually covered by those figures. The Ministry’s statistics measure only first specialist consultations, referrals a GP sends for someone to see a specialist for the very first time. Andalucía’s own 60-day guarantee works the same way: it explicitly excludes anything classed as a revisión, a follow-up review rather than a first visit, which is exactly what the Puerto Real patient has been waiting for. That gap matters: without a deadline, there is nothing forcing the hospital to act, and no rule is broken no matter how long the wait runs.

Grace’s case shows a second way to vanish from the figures. Hers was straight-up cancelled and never properly rebooked, with nobody telling her either time. A gap like that leaves no mark in any waiting list statistic, because the clock only measures the appointment currently on the books, not the ones that quietly disappeared before it. 

What patients in Andalucía can do 

Anyone facing a similar delay can raise it with the hospital’s Unidad de Atención a la Ciudadanía (citizen care unit), in person using the official complaints book, or online through the Junta de Andalucía’s electronic system.

Neither hospital, nor the Servicio Andaluz de Salud (SAS), has commented publicly on either case beyond February’s acknowledgement to the Puerto Real patient that the request exists.

The average wait just to see a specialist for the first time has climbed from 65 days in 2014 to around 102 days now, an increase of more than half in a decade. That trend only makes cases like these two harder to spot: the figure still only counts first consultations, so for a review appointment with no deadline attached, there is no equivalent number at all, and no way of knowing how many people are waiting in exactly the same silence as Puerto Real’s patient and Molly Grace.

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From One Prescription To Five: The Medication Trap Patients In Spain Need To Know

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Older people are more likely to live with several chronic conditions. Photo credit: PeopleImages/Shutterstock

How many times have you gone to the doctor and left with several boxes of medication, one to treat the original problem, and another because you were told, “If you get this symptom, take this”? For older people taking several medicines every day, that extra prescription could sometimes be treating a side effect of another drug rather than a new illness.

New research has identified 24 potentially harmful prescribing cascades that could leave older adults taking additional medicines they may not have needed in the first place. For British and other international residents living in Spain, the findings are a reminder to look at the whole medication list when a new symptom appears, rather than assuming every new problem needs another prescription. 

When one medicine leads to another

A prescribing cascade happens when a side effect from one medication is mistaken for a new medical condition. Instead of stopping, changing or reviewing the first medicine, another drug is prescribed to deal with the new symptom. That medicine can then produce another side effect, potentially leading to yet another prescription. The result can be a growing list of medicines without the connection between them being recognised.

The new study, published in the BMJ, examined prescription data covering 2,297,942 community-dwelling adults aged 66 and over in Ontario. Researchers started with 65 potentially inappropriate prescribing cascades previously identified by an international panel of experts, then assessed how frequently the medicines were prescribed and how closely the prescriptions followed one another. Twenty-four met all three criteria used to identify the highest-priority cascades. 

Some of the combinations may look completely unrelated

One of the problems is that the original medicine and the later prescription can appear to have nothing to do with each other. Among the cascades identified as having the highest incidence was iron supplements followed by laxatives, occurring in 11.9 per cent of the relevant prescribing sequences studied. Another involved cholesterol-lowering statins followed by pain medication, while another involved cholinesterase inhibitors followed by sleep medication. 

The researchers also found particularly strong temporal associations between some medicines and subsequent prescriptions. These included corticosteroids followed by antipsychotic medication, laxatives followed by anti-diarrhoeal drugs, and cholinesterase inhibitors followed by anti-nausea medication. 

That does not mean these combinations are always wrong. Some prescribing cascades are deliberate and medically appropriate, particularly where a known side effect is being prevented or treated. The concern is when a drug-related symptom is mistaken for a separate condition and another medicine is added unnecessarily.

When in Spain…

Spain is renowned for not going easy on prescription medication, I for one have come out of consultations with at least 4-5 boxes of medicine just for an allergic reaction or muscle damage. For expats, keeping track of all those medicines can become even more complicated. You may have one prescription from your Spanish GP, another from a private specialist, and medicines that you regularly take from the UK or another country. Add over-the-counter painkillers, antihistamines or supplements and it becomes surprisingly easy for one doctor not to have the complete picture.

That is why it is important to tell every doctor or pharmacist everything you are currently taking, including medicines prescribed by another doctor and products you have brought with you from home. This becomes particularly important if you move between Spain’s public and private healthcare systems, where different doctors may not have access to the same prescribing records.

For those who are not fluent in Spanish, explaining a long medication history can also be difficult, particularly when discussing side effects or explaining when a symptom first appeared. Keeping a current written list of your medicines, their doses and what each one is for can make those conversations much easier, and could help a doctor spot when a new symptom might actually be linked to something you are already taking.

The warning is particularly important for older adults

Older people are more likely to live with several chronic conditions and therefore take multiple medicines at the same time. That increases the possibility that a new symptom will be attributed to another illness rather than a medication side effect. 

The researchers say conversations between patients and healthcare professionals can miss the connection between the first medicine, its side effect and the later prescription. They argue that doctors need to consider why every medication was started and whether it is still necessary when another drug is being considered. 

What should you do if you take several medicines?

Do not stop prescribed medication without speaking to a healthcare professional. Instead, if you develop a new symptom after starting or changing a medicine, ask whether it could be a side effect before simply adding another treatment. Keep an updated list of everything you take and show it to your doctor or pharmacist, including prescription medicines, over-the-counter products and supplements. If you have accumulated several prescriptions over the years, it is also reasonable to ask your doctor or pharmacist to review the complete list with you.

The researchers say better medication reviews and clinical systems that can flag possible prescribing cascades could help prevent unnecessary treatment and reduce medication-related harm.  For anyone living in Spain who has found their medication cupboard gradually filling with more and more boxes, the research offers a simple question worth asking at your next appointment: Could this new medicine be treating a side effect from the last one?

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San Miguel De Salinas Prepares For September

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San Miguel to host paella competition. Credit: Elena Eryomenko / Shutterstock.com.

San Miguel de Salinas will be in fiesta mode throughout September, with live music, family entertainment, food, parades and traditional celebrations leading up to the feast of San Miguel on September 29.

Although festivities began earlier in the month, the main programme gets under way on Saturday, September 12, beginning several weeks of events before celebrations continue into October.

Rocket launch and foam party get the main San Miguel fiestas under way

The main programme begins on Saturday, September 12, with the traditional rocket launch outside the Town Hall at 5:00 PM.

The opening will be followed by a foam party and DJs in Plaza de la Libertad, setting the tone for a busy programme aimed at different ages.

The following weekend brings a neighbourhood dinner and street decoration competition, alongside the official fiesta proclamation and coronation. Bella Donna will provide live music as the celebrations gather pace.

Food will also have its place in the programme, with the town’s 16th Tapas Route giving residents and visitors an opportunity to try dishes prepared by participating local businesses.

Children’s activities, water slide and 80s music fill the fiesta programme

Family entertainment continues throughout the festivities with inflatables, traditional games and children’s activities among the events planned.

A fire and light show will add to the programme before September 24 brings Children’s Day, when reduced-price fairground rides will be available.

The following day, September 25, a giant water slide will take over Calle Torrevieja, providing another attraction for families.

The entertainment will continue into the evening with a celebration of 80s music.

One of the biggest nights arrives on Saturday, September 26, when the grand float and fancy dress parade makes its way through San Miguel de Salinas.

The parade will be followed by free pizza and music as the town heads into the final days before its main fiesta.

San Miguel feast day brings fireworks, Mass and traditional procession

September 29 is the main fiesta day and will begin with a morning street band and hot chocolate.

Children’s and main fireworks displays are planned during the day, while the religious programme will include Mass and the traditional procession in honour of San Miguel.

The feast day forms the centrepiece of a programme combining the municipality’s traditions with entertainment, food and activities for families.

The celebrations will not end with September. A paella competition is planned for October 4, extending the festivities into the following month.

San Miguel de Salinas will finally bring its 2026 fiesta programme to a close on October 7, ending several weeks of celebrations across the town.

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Flamenco Night Bring End-Of-Summer Celebration

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A Las Raices head to Orihuela Costa. Credit: A Las Raices.

Flamenco music will take over Los Cucalos in Orihuela Costa on Friday, September 18, as the restaurant marks the end of summer with a special evening of live entertainment.

The Feria Flamenca begins at 8:00 PM and will feature a live performance by A Las Raices, bringing a full band to the Los Dolses restaurant for a night combining traditional food, music, surprise gifts and a special raffle.

A Las Raices brings a full flamenco band to Los Cucalos in Los Dolses

A Las Raices will provide the evening’s live entertainment with an extensive line-up of musicians and singers.

Ibrahim Cetiner will perform on solo guitar, with Demi on rhythm guitar and vocals and Dani on bass and vocals.

They will be joined by El Kiyo on solo guitar, while Emilio, Jos, Gurhan and Sonero will provide percussion. Miga completes the line-up on rhythm guitar.

The full band will bring flamenco music to the restaurant as Los Cucalos stages what it is billing as its final big summer celebration.

The Feria Flamenca begins at 8:00 PM, giving diners the opportunity to combine an evening meal with live music and entertainment.

New Year’s Eve dinner for two is the top prize in special raffle

Alongside the live performance, Los Cucalos is planning surprise gifts during the evening and a raffle with a substantial prize for one lucky winner.

The top prize is dinner for two at the restaurant on New Year’s Eve, valued at €220.

The raffle adds another element to the end-of-summer party, which will combine the restaurant’s traditional food with a full evening of flamenco and music.

With summer drawing towards a close, the event offers residents and visitors an opportunity to enjoy one more major seasonal celebration in the heart of Orihuela Costa.

Reservations open for September 18 flamenco evening in Orihuela Costa

Los Cucalos is located at Avenida Montezenia 1, Los Dolses, Orihuela Costa, close to the Villamartin road.

The Feria Flamenca takes place on Friday, September 18, with the evening beginning at 8:00 PM.

With a large live band, surprise gifts and the chance to win a €220 New Year’s Eve dinner for two, the restaurant is preparing to give its summer programme a lively flamenco send-off.

Reservations are already open for the event.

To reserve a table or ask for further information, call Los Cucalos on (+34) 965 976 639 or (+34) 665 461 923.

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