The role of municipal and provincial hospitals in Spain from a historical perspective

Abstract

Municipal and provincial hospitals played a key role in the historical creation of the hospital system in Spain until the second half of the 20th century. Their strategic role in coverage of the poor under the 19th century charity system gradually changed with the creation of the modern hospital, located in new buildings and with innovative management techniques, which had a hierarchical internal structure and implemented advances in the diagnostic and therapeutic field. These helped to provide coverage to an increasingly large segment of the population. With this background, this paper focuses on a historical study of the public hospital structures linked to municipalities and provincial councils with specific objectives. First, it analyses how they were set up and organized, the services they provided, and how they were financed up to the Franco dictatorship. Second, it examines how the functioning and survival of the old municipal and provincial infrastructures were affected by the implementation of compulsory sickness insurance in 1944 and the construction of an accompanying network of hospitals known as «residencias sanitarias», Finally, it analyses their practical disappearance after the transfer of responsibility for health care during the transition to democracy.