In Spain, the new ministerial order expands and modernises the services of the public health system to make them more comprehensive and better adapted to patients’ needs.
With this regulation, the Ministry of Health strengthens the system under a “social health model”, recognising that well-being depends not only on medical care, but also on social, economic, and mental health factors.
The order adds nine additional diseases to the newborn screening programme, such as severe combined immunodeficiency and adrenoleukodystrophy, bringing the total to 21 detectable conditions.
It also unifies access to in vitro fertilisation with donated oocytes by removing the previous age restriction of 36 years for people with premature ovarian failure and setting the limit at 40 years, in line with other cases.
In addition, colorectal cancer screening is extended to include people up to 74 years of age.
During pregnancy, protection is strengthened through three key screening programmes:
• Preeclampsia screening: a combined first-trimester test (biochemistry, uterine artery ultrasound, and blood pressure measurement) is introduced to detect risk early.
• Infectious disease screening: universal testing for all pregnant women includes syphilis, HIV, hepatitis B, and group B streptococcus. Additional tests for hepatitis C, Chagas disease, or Zika virus will be carried out depending on risk factors.
• Chromosomal abnormalities: the use of free fetal DNA testing in maternal blood is introduced as a second-line test to detect trisomies 21, 18, and 13 in cases of increased risk.
To strengthen the right to participation, the law also modifies the composition of the Advisory Committee on Genetics by adding two representatives from patient federations, ensuring that affected groups are directly involved in updating the common basket of health services.
The new regulation modernises the National Public Health Surveillance Network, giving it continuous response capacity to outbreaks and health emergencies. For the first time, a coordinated 24/7 system is established between the State and the Autonomous Communities, ensuring immediate response adapted to each region’s demographic and geographical characteristics.
In this context of rapid response, the regulation also prioritises transparency and the fight against misinformation or “infodemics” during crisis situations. Citizens will receive verified official guidance through direct communication channels, allowing timely updates on detected risks and clear instructions for prevention and control during health alerts.
Under the “social model of health” approach, surveillance is expanded beyond communicable diseases. The Ministry of Health and regional authorities will now be responsible for developing specific systems to monitor mental health, environmental impacts, addictions, and social determinants of health. This advanced surveillance framework will enable early detection of risk signals and ensure action on the root causes of health inequalities.
The definition of functional rehabilitation is also harmonised to avoid legal uncertainty. Rehabilitation will no longer be limited to recovery, but will include all procedures aimed at facilitating, maintaining, or restoring the highest possible level of autonomy and quality of life for people with complex or irreversible conditions. This includes physiotherapy, occupational therapy, and speech therapy for musculoskeletal, neurological, cardiovascular, and respiratory disorders.
Autonomous Communities will have one year to implement the new newborn screening measures and two years for preeclampsia screening. The expansion of colorectal cancer screening will be introduced progressively, with full coverage expected within ten years.
22.04.2026.
