Malaga province's private healthcare has more doctors in key specialities such as gynaecology than public care

Data confirms the boom in private healthcare in Malaga province: one in three residents has health insurance.

It is the province with the most doctors in this field in Andalucía (4,219 full-time or working concurrently with the Andalusian public health service) and the most hospital beds (2,021).

Out of the total of 48 medical and surgical specialities, up to 14 have more doctors in private hospitals than in those of the SAS (Andalusian public health). In addition, doctors in nine specialities work in the so-called mixed system, sharing time between private and public healthcare and far outnumbering those who work only in the SAS.

All of this data refers to 2025, as released by the Andalusian medical association (CACM).

Among the key specialities with more doctors in the private sector than in the public sector are medical-surgical dermatology and venereology (31 in the public sector, 62 in the private sector, 42 in the mixed system), ophthalmology (66 versus 77 and 77, respectively), ear, nose and throat (27, 38 and 37) and obstetrics and gynaecology (111 in the public sector versus 174 in the private sector and 95 who practice in both).

This also includes traditional specialities in the private sector such as plastic, aesthetic and reconstructive surgery (eight surgeons in the public sector, 28 in the private sector and ten in both), occupational medicine (45, 96 and eight) or geriatrics (only three in the public sector compared to 12 in the private sector).

Regarding the nine specialities that have the most doctors in the insurance sector, combining private practice and those who practice in both, orthopaedic and trauma surgery stands out (108 in the public sector versus 199 in the private sector).

What explains this data? It stems from several structural factors.

Malaga combines strong population growth, a high number of foreign residents with private insurance and multiple private hospitals. Furthermore, some specialities have very few public hospital beds available, while others experience high demand for care and procedures that the public system rarely performs or that have significant waiting lists.

If private demand increases, staffing levels also increase. Some of these specialities also have waiting lists in the private sector. On the other hand, the primary care system requires a high number of public healthcare doctors.

Representative for private medicine at the Malaga medical association Carlos Bueno Guezala says that there are several factors at play: first, in some specialities, the number of public positions available is very limited.

"For example, in sports medicine, there are very few positions in the public sector, as there are in hydrology or occupational medicine, which is mandatory in companies with more than a certain number of employees," he says. The Costa del Sol, due to its economic dynamism, attracts numerous companies.

Bueno highlights the boom in private healthcare, with a "large number of private positions available in ophthalmology and gynaecology". "The consolidation of high-quality private medicine is causing this, especially in the wake of the pandemic. It's only going to increase," he states.

"In specialities like dermatology and plastic surgery, salaries are very high in the private sector, which leads to a transfer of professionals between the two," Bueno explains.

There are few positions in geriatrics within the SAS, "which is why it's four times more common in the private sector". "It's a fundamental speciality that is naturally growing due to the ageing population and the increasing number of chronic illnesses. In the short term, it will be vital to our healthcare system."

Several of these specialities have significant waiting lists, which ultimately drives patients to private clinics in search of faster service. For example, the wait for an initial ophthalmology appointment at Malaga's Hospital Regional is 96 days. In otolaryngology, the average wait is 117 days for a first appointment and 122 days for a referral from primary care.

Regarding orthopedic and trauma surgery, the average wait for a first consultation is 156 days and 165 days if the patient comes from primary care.

GP Daniel Prados says that specialities involving surgery are "very attractive" in the private sector.

"Refractive surgery isn't performed in the public system. I can't get myopia corrected there and cataract surgeries have such long waiting lists that people, understandably, try to resolve their problems as best they can. The same is true for orthopedic and trauma surgery. Professionals earn a lot of money in the private sector and there are people who seek surgery for pain that the public system cannot resolve, such as rheumatic or arthritic pain," he says.

Prados states that private medicine "is a complement that should exist", but he does not agree that heads of service should work in both healthcare systems simultaneously and demands exclusive dedication to the public system.

Spokesperson for the Malaga medical union (SMM) at the Costa del Sol hospital in Marbella José Luis Prada says that "these are the specialities that have the highest demand, both because of waiting lists and because of the health culture, especially in private pregnancy monitoring".

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