ACCESSING INTERNATIONAL MARKETS

HOSPITAL & HEALTHCARE EQUIPMENTMARKET IN SPAIN For companies that want to raise their game

Overview & Demographics 2Healthcare System 4The market for medical equipment & supplies 8Methods of doing business 10Exhibitions 12ANNEX - Useful Addresses 13 - 16

Contents

2SPANISH HEALTHCARE

Overview & Demographics

Since joining the European Community in 1986,Spain has risen to become the United Kingdom’s7th largest export market.

The population of about 46.6 million is spreadover a vast area about 2.5 times the size of theUK. Spain is a markedly urban society.Approximately 20 per cent of the population livein cities of around 500,000 inhabitants or more.The capital, Madrid, with its population of around3 million, is the administrative and businesscentre of the country around which many modernindustries have grown, and where many largecompanies have their headquarters. Barcelonaand Bilbao are also at the heart of major areas of

industry and commerce. There are also importantbusiness centres in other regions, includingValencia, Sevilla, Málaga, Zaragoza, Valladolidand Vigo.

The population of Spain is ageing with about 17per cent (about 7.7 million) of the population agedover 65 years and with a birth rate of 1.4 children.Life expectancy in Spain is 83.4 years for womenand 76.9 for men, higher than the EU average. Thepercentage of the population over 80 years of ageincreases significantly each year as people livelonger and this now represents about 3.8 per centof the total population.Source: INE (Spanish National Statistics Office)

“The population of Spain is ageingwith 7.7 million aged over 65”

3 SPANISH HEALTHCARE

4SPANISH HEALTHCARE

PublicThe Spanish National Health System providesuniversal health care free at the point of deliveryand when it was set up in 1986 it was modelledon the NHS in the UK. The Spanish NationalHealth System is financed almost entirely fromtaxation and represents an allocation of 7.6 percent of GDP. Statistics on public expenditure ofpublic health care can be found at:http://www.msc.es/estadEstudios/estadisticas/inforRecopilaciones/gastoSanitario/home.htm

Until the end of 2001, the central government ranthe Health Service in 10 out of Spain’s 17 regionsor “autonomous communities” via its body, theNational Health Institute called INSALUD. Sixregions had devolved responsibility for delivery,though not financing, of their health services.The money to finance the Health Service in theseregions came from central government in a blocktransfer. The 6 regions were Catalonia,Andalucia, Valencia, Galicia, Navarre and theCanary Islands. The 7th region with responsibilityfor running its own health system was theBasque Country, which for historical reasons,finances its public health service from the taxesit raises within its own region. Althoughrepresenting less than half of the regions in all ofSpain, these regions accounted for over 60 percent of the population. In line with centralgovernment policy, the transfer of responsibilityfor healthcare to the other regions wascompleted, after much debate and delay,legislation was finally passed at the end of 2001.Reorganisation of these Regional HealthServices with new responsibilities is an on-goingprocess. The central government has adepartment (the Instituto Nacional de GestiónSanitaria) to monitor and evaluate thefunctioning of the health services devolved to all

17 regions in Spain. But it should be emphasisedthat each region develops its own healthcareprogramme, which includes their policy forexpansion, hospital development andprocurement, and for example, the introductionand implementation of IT technology in hospitalsand health care centres.

The Government is faced with spiralling costs inthe provision of health services which areincreasing at a higher rate than budget forecasts.Some of the reasons for rising costs are: (i) Aslife expectancy increases, the percentage of thepopulation aged over 65 also rises and thedemands made by this segment on the publichealth system are four times greater than the restof the population, particularly in the area of 100per cent reimbursement for pensioner’sprescription drugs. (ii) The recent wave of a newimmigrant population is now also covered underthis universal health system. (iii) Althoughdecreasing, Spain still has the highest proportionof AIDS cases in Europe and this, together with

Healthcare System

“Health services devolvedto all 17 Regions in Spain”

5 SPANISH HEALTHCARE

drug addiction, presents problems for the publichealth system. (iv) Spain is reported to spendtwice as much treating patients, who come astourists from other countries, as it costs othercountries to treat Spanish patients. (v) Theincorporation of more expensive high technologyequipment to detect and treat illnesses is anotherfactor increasing expenditure.

The Government wants to introduce higher levelsof budgetary discipline and is giving publichospitals and health centres more financialautonomy. An attempt has been made to set uphospitals as “Trusts” or “Foundations” but thishas met with limited success, in cases where anew hospital has been built. So far only a few“Foundations” have been set up as the subject ispolitically very controversial.

PPP (Public Private Partnerships) projects in thehealthcare sector are flourishing in Spain. Forcertain regional governments, where lack ofhospitals is an issue, PPP has proved to be a veryimportant tool for the development of newhospitals. The regional government of Madridused the PPP formula to build and operate 8 newpublic hospitals ranging in size from 120 beds to700 beds. In 2005 these projects were all put outto tender and these smaller hospitals wereopened by March 2008. Some of these hospitalsare managed by the public sector and others aremanaged by private healthcare companies suchas Capio. An announcement in 2008 indicated that

a further 4 PPP public hospitals with privatesector management are planned in the Madridregion. The region of Castilla y Leon wasawarded the tender for the PPP project to build anew hospital in Burgos and a further 5 PPPhospitals are planned for the region. The RegionalGovernment in Valencia also has plans to build 2new PPP hospitals with the medical and non-medical services to be managed by a privatecompany. The concession for financing,construction, operation and maintenance of anew 900 bed hospital in Palma in the BalearicIslands has also been awarded.

There are many other examples of hospitalprojects as PPP is being implemented on anincreasingly larger scale in the healthcare sector.The major Spanish construction and servicecompanies dominate the market and these, alongwith the major Spanish banks, are wellconnected politically and economically with theregional authorities. However, foreign companiesand organisations are forming partnerships withlocal companies to enter into these PPPcontracts.

In addition to large projects, the current emphasisis to continue with improvements and provision ofservices at primary health care centres.Reducing waiting lists is another priority.

PrivateAbout 7.5 million of the Spanish population aresubscribers to private health insurance schemesand this figure has increased in recent years. 2million of these subscribers are civil servantsand, due to agreements negotiated with theiremployer, these subscribers pay reducedpremiums to health insurance companies.Private health insurance in Spain is a complexarea and is not confined to the simplereimbursement principle. The UK firm BUPA hasa significant market share in this area through

“About 7.5 million of theSpanish population aresubscribers to privatehealth insurance”

6SPANISH HEALTHCARE

their Spanish subsidiary, SANITASwww.sanitas.es which, in 2009, stated they had40 hospitals. Some other leading companiesinclude Adeslas, ASISA, Mafre Caja Salud, DKV.These health insurance firms either administertheir own clinics or determine the level of fees tobe paid to doctors on their panel or hospitalsunder their schemes.

60 per cent of the business of “private” hospitalsor clinics comes via the contractualarrangements the health insurance firms havewith these hospitals. The remaining 40 per cent ofthe income of these private hospitals comes fromthe agreements they have with the Public HealthService, they use private hospital services toperform surgical processes in order to reduce thepublic sector waiting lists of patients. The lengthof public sector waiting lists causes concern andcriticism from the public and politicians. It isinteresting to note that subscribers to privatehealth insurance schemes will, more often thannot, turn to the Public Health Sector for majoroperations or treatment. The number of Spanishpeople prepared to pay for purely private healthtreatment is minimal.

Hospital bedsAccording to the Spanish Ministry of Health &Social Policy, as of 31 December 2008 there were804 hospitals in Spain with 160,983 beds. Tablesgiving statistics of hospitals and beds by region,general or specialist centres, public or private,the high tech equipment available, can be seenon the following section of the Ministry’s webpage under “Catálogo de Hospitales”. http://www.msc.es/ciudadanos/prestaciones/centrosServiciosSNS/hospitales/inforEstadistica/home.htm

In summary, 47 per cent of the hospitals havebetween 100 and 500 beds and 9.5 per cent haveover 500 beds. Although on average 70 per cent ofthe hospitals are in the public sector and 30 per

cent in the private sector, this split can varyaccording to regions. The percentage of privatebeds is reported to be higher than that figure inCatalonia and lower in regions as such asAndalucia and Extremadura. Even though the ratioof hospital beds per population is lower than theEU average, the actual number of hospital bedshas reduced in recent years as the emphasis isplaced on day surgery in public health carecentres and out patient sections of hospitals.

Nursing homesHistorically, in Latin countries such as Spain,elderly parents are looked after by the family. Thistradition still exists but is changing slowly as canbe seen by the increased demand for beds innursing homes offering assisted care. The latestfigures published in January 2007 by IMSERSO,the Spanish Institute of Social Services for theElderly, indicate that for the total population of 7.5million aged over 65, there were 4,839 nursinghomes. Only 35 per cent of these were in thepublic sector (either public or contracted fromthe private nursing home sector). The totalnumber of 298,870 beds is low by EU standards.The ratio of beds per 100 people aged over 65 isabout 4 per cent. Reports indicate that well over90,000 elderly people are on the waiting list for abed in a public sector nursing home and for thatreason, long term care elderly patients oftenoccupy beds in public hospitals.

7 SPANISH HEALTHCARE

Real estate developers and constructioncompanies have seen the opportunity that existsfor the development of nursing homes and alsoprivate sheltered housing in flats for theindependent elderly. Growth in this sector israpid. For example, it was reported in the pressin 2008 that Sanitas are currently operating 38nursing homes, with 5 more in different stages ofconstruction (see www.sanitasresidencial.com )Local savings banks and venture capitalcompanies have also provided finance to somenursing home developers.

Ambulance ServicesThere has been a vast improvement in the qualityof ambulance services in Spain in the past 10years. Fully equipped mobile intensive care vanswith trained paramedics on board appear quickly

at the scene of an accident. These intensive careambulances are usually operated by the regionaland local health authorities, the city council ormunicipal services in co-ordination with thepolice. The Red Cross also has its own fleet ofintensive care ambulances as well asambulances for the transfer of patients. It is quitecommon to see that a leading bank, leadingcompany or a private health insurance firm hasacted as a sponsor by providing the finance forthese ambulances. Private ambulance servicesalso exist to transfer patients from their homes tohospitals or to rehabilitation centres for treatment- the public health services reimburses the costof this service.

8SPANISH HEALTHCARE

The Spanish market for medical equipment andsupplies is ranked 5th in the EU-25 and 9th in theworld. The Spanish Ministry of Health & SocialPolicy published an interesting table on theirwebsite showing the high tech equipmentinstalled in hospitals in each region in Spain,equipment such as CAT & MIR, lithotripers andmammography machines.http://www.msc.es/ciudadanos/prestaciones/centrosServiciosSNS/hospitales/inforEstadistica/equiposATecnologia.jsp

Reports indicate that about 85 per cent ofelectro-medical equipment is imported. 51 percent of these imports comes from the EU (mainlyGermany, Italy and France), 26 per cent from theUSA and 15.3 per cent from Japan. 80 per centof the market’s requirements for hospitaldisposable or single use supplies are imported,mainly from the Far East in bulk or from USAparent companies by their Spanish subsidiaries.UK brands of medical equipment and othersupplies, including disposable items, are sold inthe Spanish market. Spain does have someproduct areas where local manufacture issignificant e.g. medical and hospital furniture,textile products (bandages, gauze, uniforms,orthopaedic corsets) and in the assembly ofcertain types of medical apparatus.

Source: FENIN (National Federation of Companies dealingin Scientific Instruments, Medical, Technical & DentalEquipment)

The EU Directive on the CE marking formedical devices has been transposed intoSpanish legislation.

The healthcare supplies market in Spain isbecoming increasingly dominated by thesubsidiaries of the major multinationalcompanies. Nevertheless, experienced localdistribution companies exist both at a nationaland regional level. Importers and distributors, aswell as local manufacturers and the products andbrands they sell, can be identified by accessingthe web site for the “Guia Puntex” tradedirectories in the health care sector.www.puntex.es

The market for medical equipment & supplies

9 SPANISH HEALTHCARE

The Spanish market formedical equipment andsupplies is ranked 5th in theEU-25 and 9th in the world”

“

If a foreign supplier of medical and hospitalequipment, equipment for the disabled or elderlyetc, wishes to do business in Spain, they mustappoint a distributor or agent. It is important tonote that distribution arrangements are differentfor medical equipment requiring after salesservice than for disposable or single use medicalsupplies. For example, a foreign supplier ofelectro-medical equipment usually appoints asingle distributor for all of Spain. This distributorwould have branch offices in other major citiesthroughout Spain or appoint sub-distributors ordealers to cover other areas.

This network is essential in order to sell to theRegional Health Services that like to deal withcompanies that speak their regional languageand that are close to hand to provide prompt aftersales service and repair work. In the case ofhospital disposable or single use items, it iscommon for foreign firms to have several localdistributors/wholesalers throughout the country.

Purchasing for public sector hospitals and healthcare centres is done through calls for tender.These tenders are regulated by the EU Directiveson public procurement which were transposedinto Spanish legislation some years ago. The roleof a local distributor is essential as these locally-based firms find out about the tenders beforethey are drawn up and published, purchase thetender specifications, arrange a bid in Spanish orthe regional language and submit a bid bond inEuros arranged through a local bank to the tenderboard on behalf of the foreign principal. Doctorsand senior medical services staff are keydecision makers when purchasing requirementsare drawn up and the staff from the localdistributor’s office must frequently visit these keycontacts. Sometimes equipment may be left on

trial in a hospital by the local distributor free ofcharge in the hope that a need be created and atender prepared. It may take 12 to 18 months fromthe time the local distributor presents a newproduct until the time that the tender is publishedand awarded, so foreign suppliers should notexpect immediate results.

A “Consortium” was set up by the CatalanRegional Health Service to offer privatemanagement services to the public health servicethere. This service includes organising bulkpurchases of disposable medical supplies toobtain the best price, the preparation of tenderdocuments, the management of tenderprocedures and advice on planning purchasesand equipment. In the Valencia Region a centralpurchasing unit exists.

Payments in the public sector vary widelyaccording to regions. The Basque Region HealthService is renowned for being the best payers i.e.within 60 to 90 days. The Navarre Region payswithin a similar period of time. Improvements in

10SPANISH HEALTHCARE

Methods of doing business

“Key drivers creatingbusiness opportunitiesare: aging population,patient and cliniciandemands, innovative andhigh tech products whichsave time & resources”

11 SPANISH HEALTHCARE

the management systems in public hospitals inother regions have meant that the length of timefor payments to be made has been shortened e.g.in the Madrid Region payment delays vary from90 to 120 to 180 days. In Catalonia and theValencia Region payment delays are from 6months to one year. In Andalucia payment delayscan be slightly longer than this.

Private hospitals and nursing homes buy fromlocal distributors or suppliers and request bestbids from several firms when buying supplies. Aprivate health insurance firm may present the“private” hospital incorporated into their schemewith the names of the hospital disposablesupplies they will reimburse and a set low pricewith the recommendation that the private hospitalpurchase this brand.

Equipment for the disabled and elderly is soldthrough orthopaedic shops selling a variety ofitems and equipment. Orthopaedic corsets andprosthetics are fitted in many of these shops byqualified staff. Reimbursement for the cost of aidsfor the disabled by the government depends onthe degree of disability. It is estimated that thereare 1,700 orthopaedic retail outlets in Spain.Details and web pages of major organisationsinvolved in the sector of equipment and servicesfor the disabled and elderly are given in the Annexof Useful Addresses at the end of this report.

12SPANISH HEALTHCARE

There are numerous small exhibitions forspecialised equipment associated with national andinternational medical congresses held in Spain. Forexample, if a national congress for cardiologists isheld then a small exhibition of equipment/devicesused in this speciality takes place in the space orcorridors outside the conference hall. Sometimesthese “small exhibitions” can have as many as 30exhibitor’s stands.http://www.msc.es/profesionales/socCientificas/especialidades.htm

Orprotec – the International Trade Fair forOrthopaedics and Assisted Living and Technologyfor the Disabled and Elderly is held in Valenciaevery two years. Contacts in the trade say thatthis event is becoming increasingly importantwith exhibitors and visitors coming from all overSpain. It is considered a suitable venue for Britishfirms wanting to see what is available in this areaof the market. The last event took place from 29thNovember to 1st December 2007. An event calledSEPROMA, with exhibits of services and productsfor nursing homes and for the elderly, was held atthe same time. The next event will be held from26th to 28th November 2009. http://orprotec.feriavalencia.com

Orto ProCare is held in Madrid on alternate years.The last event was held at IFEMA trade faircentre, Madrid, from 27th to 29th November 2008to coincide with the National Congress forOrthopaedic Technicians and the Congress forNursing Therapy and Care. This was the 3rd timethis event had been held.www.orto-procare.com

Email: info@hf-spain.com

Avante shows products and services for theelderly to improve the quality of life andindependent living, and was held for the first timein 2008, and the 2nd event will be held in June2010. Further information is available in English onthe organiser’s web site, including a list ofexhibitors:http://www.salonavante.com/en/visitants_llistat.html

Spanish distributors of health care equipment areregular visitors to the important “Medica” trade fairas well as to “Rehacare”, both held in Düsseldorf.

Exhibitions

13 SPANISH HEALTHCARE

14SPANISH HEALTHCARE

MINISTERIO DE SANIDAD Y POLITICA SOCIAL(Ministry of Health & Social Policy)Paseo del Prado 18-2028014 MADRID

Tel: +34 91 596 1000Fax: +34 91 596 4480Email: oiac@msc.esWeb: www.msc.es

Comment: For statistical information on differentaspects of healthcare in Spain - seehttp://www.msc.es/estadEstudios/estadisticas/bancoDatos.htm

IMSERSO – Instituto de Mayores yServicios Sociales Avenida de la Ilustración s/nCon vuelta a Calle Ginzo de Limia 5828029 MADRID

Tel: +34 91 363 8916Web: http://www.seg-social.es/imserso &

http://www.imsersomayores.csic.eswww.saad.mtas.es for information on theDependence Law (Law 39/2006)

CEAPAT – CENTRO ESTATAL DE AUTONOMIAPERSONAL Y AYUDAS TECNICASLos Extremeños 128018 MADRID

Tel: +34 91 363 4800Fax: +34 91 778 4117Email: ceapat@mtsa.esWeb: www.ceapat.org

Comment: Centre belonging to the Ministry ofHealth & Social Policy where information ontechnical help and aids for the disabled andelderly is available. Has an area whereequipment is on display.

CATSALUT - SERVEI CATALÀ DE LA SALUTTravessera de les Corts 131-159Edifici Olímpia08028 BARCELONA

Tel: +34 93 403 85 85Fax: +34 93 403 89 25 Web: http://www10.gencat.net/catsalut/

eng/coneix.htm

Comment: CatSalut is the public body responsiblefor healthcare in Catalonia.

ANNEX - Useful Addresses

15 SPANISH HEALTHCARE

INSTITUT CATALÀ D’ASSISTÈNCIA I SERVEISSOCIALS (ICASS)Generalitat de CatalunyaDepartament de Benestar SocialPlaza de Pau Vila, 1 Palau de Mar08039 BARCELONA

Tel: + 34 93 483 1000 / 1742Fax: +34 93 483 1222Email: bdgicass@correu.gencat.esWeb: www.gencat.es/benestar

Comment: This Institute is part of the Departmentof Social Welfare at the Catalan Government andprovides information and advice on technical helpand aids for the disabled/elderly. They manage aseries of programmes to adapt homes to theneeds of the disabled, assist in their adaptation tothe home and workplace, etc. The Centre forInnovation and Development (SIRIUS) is one ofthe sections of ICASS. They analyse, promote andco-ordinate the introduction of new technologiesto assist in accessibility and independent living.They also provide guidance and training on howto meet the specific needs of the disabled. TheCentre has a display area for products such asmobility aids, living and communication aidswhich local manufacturers or distributors leaveon loan.

FEDERACION NACIONAL DE CLINICAS PRIVADA(National Federation of Private Hospital)Profesor Waksman 5 – 1º 28036 MADRID

Tel: +34 91 458 5765Fax: +34 91 458 5766Email: info@fncp.infoWeb: http://www.fncp.info/

Comment: More than 200 private hospitals and 5regional associations belong to this Federation.

ASOCIACION MADRILEÑA DE RESIDENCIAS DELA TERCERA EDAD Y CENTROS DE DIA(Madrid Association of Private Nursing Homesand Day Centres for the Elderly)Travesía de Pinzón 5, Local28025 MADRID

Tel: +34 902 221 722Fax: +34 91 466 5425Email: amrte@amrteWeb: www.amrte.es

FNM - FEDERACION NACIONAL DE CENTROS YSERVICIOS DE MAYORES(National Federation of Private Nursing Homes &Services for the Elderly)La Rambla 75, Principal08002 BARCELONA

Tel: +34 93 301 8015Fax: +34 93 301 4153Email: fnrpte@fnrpte.comWeb: www.fnrpte.com

AESTE – ASOCIACION ESTATAL DE EMPRESASDE SERVICIOS DE RESIDENCIAS PARA LATERCERA EDAD(Association of companies offering services toNursing Homes)Rodríguez San Pedro 2, 6 Oficina 61228015 MADRID

Tel/Fax: +34 91 448 6130Email: asana@asociacion-aeste.esWeb: www.asociacion-aeste.es

Comment: Association of 13 leading nursing homegroups in Spain with 6 founder members.Member companies listed on web site. Thesemembers manage 344 homes for the elderly,which includes 41,921 beds, as well as 5,344places in day care centres for the elderly.

16SPANISH HEALTHCARE

ACRA - ASOCIACION CATALANADE RECURSOS ASISTENCIATravessera de Gracia 40, principal 208021 BARCELONA

Tel: + 34 93 414 7552Fax: +34 93 414 6526Email: acra@acra.esWeb: www.acra.es

Comment: Non-profit making association whichprovides advice for companies runningresidential homes for the elderly in Catalonia.ACRA can advise on legislation for nursing homesin Catalonia and is apparently used as areference point when other regional governmentswant to draft their legislation.

FENIN – Federación Nacional de Empresas deTecnología Sanitaria(National Federation of Companies dealing inScientific Instruments, Medical, Technical &Dental Equipment)Juan Bravo 10, 328006 MADRID

Tel: +34 91 575 9800Fax: +34 91 435 3478Email: info@fenin.es Web: www.fenin.es Comment: Major trade association.

GUIAS PUNTEX (Puntex guides)Padilla 32308025 BARCELONA

Tel: +34 93 446 2820Fax: +34 93 446 2064Email: puntex@puntex.esWeb: www.puntex.es

Comment: Publish Anuario Hospitalario Español(Spanish Hospital Supplies Directory) as well as anumber of directories covering different areas ofhealth care supplies e.g. Traumatology &Orthopaedics Supplies, Gerontology Supplies,Laboratory & Clinical analysis, etc.

CIDAT – CENTRO DE INVESTIGACION,DESARROLLO Y APLICACION TIFLOTECNICACamino Hormigueras 17228031 MADRID

Tel: +34 91 709 7600Fax: +34 91 709 7777Email: cidat@once.esWeb: www.once.es/cidat

Comment: CIDAT belongs to the ONCE –Organización Nacional de los Ciegos (equivalentto National Institute for the Blind). They carry outresearch, develop and import products for theblind. Sales outlets in 33 ONCE centres in themain towns in Spain. The ONCE’s main objectiveis to provide employment and better livingenvironments for the blind, partially blind or thosepeople with some form of physical or mentaldisability. The ONCE has an extensive websitewith English option.

SEIS -SOCIEDAD ESPAÑOLA DEINFORMATICA DE LA SALUD(Spanish Association for IT in Health)CEFIC - Secretaria Técnica de la SEIS Enrique Larreta 528036 - MADRID

Tel: +34 91 388 94 78 / 79Fax: +34 91 388 94 79Email: cefic@cefic.comWeb: www.seis.es

Whereas every effort has been made to ensure that theinformation given in this document is accurate, neither UKTrade & Investment nor its parent Departments (theDepartment for Business, Innovation and Skills (BIS), and theForeign & Commonwealth Office), accept liability for anyerrors, omissions or misleading statements, and no warranty isgiven or responsibility accepted as to the standing of anyindividual, firm, company or other organisation mentioned.

Published September 2009 by UK Trade & Investment

© Crown Copyright.

A range of UK Government support is available from a portfolio of initiatives calledSolutions for Business. The “solutions” are available to qualifying businesses, and covereverything from investment and grants through to specialist advice, collaborations andpartnerships.

UK Trade & Investment is the government organisation that helps UK-based companiessucceed in the global economy. We also help overseas companies bring their highquality investment to the UK.

UK Trade & Investment offers expertise and contacts through its extensive network ofspecialists in the UK, and in British embassies and other diplomatic offices around theworld. We provide companies with the tools they require to be competitive on theworld stage.

For more information regarding UK Trade & Investment services please visitwww.uktradeinvest.gov.uk or contact:

Kerry Farrell - Senior Trade & Investment Adviser British Embassy Madrid

Tel: +34 917 146 334E-mail: Kerry.Farrell@fco.gov.uk