Economic crisis and mental health in Spain.

1 La Secretaría General del Congreso de los Diputado. Presupuesto por programas y memoria de objetivos. http://www.sepg.pap. minhap.gob.es/Presup/PGE2011Ley/ MaestroTomos/PGE-ROM/doc/L_11_E_G16. PDF (accessed Nov 29, 2013). 2 Gobierno de España. Programa Nacional de Reformas de España 2013. http://www. mineco.gob.es/stfl s/mineco/comun/pdf/PNR_ Espana_2013.pdf (accessed Dec 2, 2013). 3 Medicos del Mundo. El impacto de la reforma sanitaria sobre el Derecho a la Salud. http:// www.medicosdelmundo.org/index.php/mod. conts/mem.detalle_cn/relmenu.111/id.3306 (accessed Nov 25, 2013). 4 Kentikelenis A, Karanikolos M, Papanicolas I, Basu S, McKee M, Stuckler D. Health eff ects of fi nancial crisis: omens of a Greek tragedy. Lancet 2011; 378: 1457–58. 5 Boletin Ofi cial del Estado. Resolución de 10 de septiembre de 2013, de la Dirección General de Cartera Básica de Servicios del Sistema Nacional de Salud y Farmacia, por la que se procede a modifi car las condiciones de fi nanciación de medicamentos incluidos en la prestación farmacéutica del Sistema Nacional de Salud mediante la asignación de aportación del usuario. http://www.boe.es/diario_boe/ txt.php?id=BOE-A-2013-9709 (accessed Nov 25, 2013) 6 La Federación de Asociaciones para la Defensa de la Sanidad Pública. Las repercusiones del copago sobre la utilización de medicamentos por los pensionistas. http://imagenes.publicoestaticos.es/resources/archivos/2013/3/14/136 3292203193informe%20fadsp%20copago%20 jubilados.pdf (accessed Nov 25, 2013). 7 The Council of Europe. Report by Nils Muižnieks, Council of Europe Commissioner for Human Rights, following his visit to Spain, from 3 to 7 June 2013. https://wcd.coe.int/ViewDoc. jsp?id=2106465&Site=COE (accessed Nov 25, 2013). for drugs. Pensioners will have to pay an increasing part of the cost of medicines. From October, 2013, patients with hepatitis C, HIV, rheumatoid arthritis, and some cancers will also have to pay 10% of their treatment costs in hospital pharmacies up to €4·20 per prescription. Even small out-of-pocket expenses are a barrier to effective treatment. The Federation of Associations Defending Public Health reports that 17% of pensioners could not complete the course of their treatment because of their high and increasing costs. At the European level, several reports are worth mentioning. According to Eurostat’s At risk of poverty or social exclusion in the EU27, austerity measures could aff ect children in particular—they are disproportionately aff ected by the fi nancial crisis with nearly 30% being at risk of poverty or social exclusion. The Council of Europe has raised concerns regarding the diffi culties some children (ie, undocumented migrants) are facing in accessing health care. In its recent recommendations, the European Council has clearly emphasised the need for an assessment of the eff ects of austerity measures on vulnerable groups in Spain. Austerity measures adopted by Spain and other European countries have failed to heal their economies, and there is growing evidence that these measures threathen the health of their citizens. There is still time to save the Spanish health system and reverse the restrictions limiting universal protection. It is possible to re-establish universal access to quality health-care services, free at the point of delivery, in line with the UN resolution.