The number of illegal immigrants treated by the public health service in the Madrid region has risen more than tenfold in 10 years, according to official data.
The Madrid Health Service (SERMAS) treated 150,726 foreigners without legal residence or health insurance in 2025, up from 14,850 in 2016. The figures, drawn from the service’s annual reports, were published by Spanish newspaper La Gaceta on November 11.
Most of the growth came in the past four years. SERMAS recorded 73,419 such patients in 2022, 96,223 in 2023 and 132,972 in 2024.
According to coverage data from Spain’s National Health System, the Madrid region provides public care to more illegal immigrants than any other autonomous community. It accounts for roughly a third of the national total.
The rise came as pressure on services mounted. The average wait for a first specialist consultation in paediatrics, ophthalmology, traumatology or urology grew from 42 days in 2016 to 68 days in 2025.
The number of public and contracted hospitals in the region stood at 35 in both years. That was despite the opening of the Enfermera Isabel Zendal hospital, built during the Covid-19 pandemic.
The regional health budget rose from €7,446 million to €10,462 million over the same period. It reached €11,009.5 million this year, the largest single item in Madrid’s accounts.
Nearly 40 per cent of Madrid residents hold private health insurance, the highest share in Spain, against a national average of 25 per cent. The figure includes civil servants covered by the Muface scheme.
Free healthcare for illegal immigrants has shifted repeatedly with Spanish politics. In 2012 the People’s Party (PP) government of Mariano Rajoy withdrew their health cards and limited care to emergencies, pregnancy and minors.
The Madrid region restored access in 2015 under PP regional president Cristina Cifuentes. Socialist Prime Minister Pedro Sánchez reinstated universal coverage nationwide in 2018.
In March this year the Spanish Government went further, approving a royal decree that obliged every region to provide full care to illegal immigrants. It also allowed them to prove residence without registering with their local council.
The measure was linked to a mass regularisation of up to 500,000 people living in Spain illegally. Madrid regional president Isabel Díaz Ayuso warned the regularisation would cause serious difficulties for public services and her government challenged it in court.
At a European People’s Party forum in July, Ayuso said mass regularisations would generate insecurity across Europe.
Madrid’s regional health department has previously attributed part of the increase to immigrants already living in Spain bringing elderly relatives to receive medical care, Spanish outlet Vozpópuli reported in October 2025.
