More than 114,000 Madrid residents were waiting for surgery as of July, amid unprecedented delays at public hospitals. The region’s waiting lists grew by over 22% in a year, making timely healthcare harder to access. For many, private treatment is the only alternative, often at impressive personal cost.
Julián, a 65-year-old Madrid resident, is among those affected. A routine blood test in 2024 revealed abnormal PSA levels, beginning a drawn-out diagnostic process. He waited over six months for an MRI, and his biopsy was not scheduled until September 2025. Although he was 125th on the waiting list at Hospital Universitario del Sureste, he underwent surgery only after filing a formal complaint. By April, he had received a full diagnosis and started hormone therapy. Unable to wait any longer, Julián paid €9,000 for a robotic operation in the private sector. He is now preparing for radiotherapy, one of a growing number of patients forced to bypass public delays.
Madrid leads Spain in private health insurance coverage, with 37.3% of residents insured, information from the Observatorio del sector sanitario privado 2026. Nationally, 12.8 million Spaniards, or 26.2% of the population, hold private policies. The average surgical wait in Madrid’s public system reached 57 days in July, compared with 121 days nationally. Across Spain, more than 850,000 people were waiting for surgery. Madrid’s government says the region has the shortest waits in the country, yet the number of pending operations has surged by 64% since 2020.
Other patients, including 81-year-old Palmira Gayo, also face long delays. She completed preoperative tests for a knee transplant in January and remains on the waiting list. She was offered transfers to other hospitals but declined, preferring her regular traumatologist. In July, more than 1,000 Madrid patients had waited over six months for surgery, while nearly 17,000 had waited between three and six months. For patients who declined hospital transfers, the average delay reached 124 days.
The regional health department attributes the increase to population growth and improved diagnostic pathways, rather than declining system efficiency. Officials say 1.2% of Madrid’s structural waiting list exceeds six months, compared with 21.6% nationally. They also say no surgical procedures are outsourced to private clinics. A recent doctors’ strike, but, led to the suspension of over 12,000 surgeries and 248,000 consultations, costing the system more than €19 million.
Total pending appointments fell 3% in July, driven by fewer diagnostic tests and specialist consultations, but waiting times for all services continue to rise. Patients now wait an average of 66 days for specialist visits and 57 days for initial diagnostic tests. Madrid still has 945,878 pending appointments, although the total includes people counted on multiple lists.
Longer waits are not unique to Madrid. Andalusia and Cantabria report even greater delays, as does Catalonia. Access to timely care is becoming a national concern, as recent coverage of other public service challenges has shown, including the impact of strikes on impressive services.
For patients like Julián and Palmira, the consequences are immediate and personal. Both recall previous surgeries that were scheduled much faster, a sign of how waiting times have worsened. Julián says that in 2018, he received a biopsy within two months of an abnormal test result, without filing complaints or seeking priority status. He says the current situation puts people without the financial means at a disadvantage when they need urgent care.
Spain’s public health system is recognized for its universal coverage, but rising demand and resource constraints are straining its capacity, alongside demographic shifts. Greater reliance on private insurance and out-of-pocket payments signals a change in how residents access care. As waiting lists grow, debate over the efficiency and equity of public healthcare is likely to intensify.
