Public health provision is the set of initiatives organised by public administrations to preserve, protect and promote the health of the population. It is a combination of sciences, skills and activities aimed at maintaining and improving the health of all people through collective or social actions.

Public health services will be provided in a comprehensive manner, based on the public health structures of the administrations and the primary care infrastructure of the NHS.

Primary health care is the basic and initial level of care, which guarantees the comprehensiveness and continuity of care throughout the patient's life, acting as case manager and coordinator and regulator of flows. It shall comprise health promotion, health education, disease prevention, medical assistance, health maintenance and recovery, as well as physical rehabilitation and social work.

Primary care includes addressing health problems and risk factors and behaviours.

Specialised care comprises healthcare, diagnostic, therapeutic and rehabilitation and care activities, as well as health promotion, health education and disease prevention activities, the nature of which makes it advisable for them to be carried out at this level. Specialised care shall guarantee the continuity of comprehensive care for the patient, once the possibilities of primary care have been exceeded and until the patient can be reintegrated into primary care.

Specialised care is provided, whenever the patient's conditions allow, in outpatient clinics and day hospitals. 

Emergency care is the care provided to patients in cases where their clinical situation requires immediate medical attention. It will be provided both in and out of health care facilities, including in the patient's home and on-site care, 24 hours a day, through medical and nursing care, and with the collaboration of other professionals.

Pharmaceutical provision comprises medicines and health products and the set of actions aimed at ensuring that patients receive them in a form appropriate to their clinical needs, in the doses required by their individual needs, for the appropriate period of time and at the lowest possible cost to them and to the community.

An outpatient pharmacy benefit is one by which the patient receives drug prescriptions or hospital dispensing orders through pharmacy offices or services.

The outpatient pharmacy benefit will be subject to a user contribution. This must be paid at the time the medicine or health care product is dispensed and will be proportional to the level of income, which will be updated at least every year.

In general, the user's contribution percentage will be as follows:

1. 60% of the RRP for users and their beneficiaries, whose income is greater than or equal to 100,000 euros, as entered in the general tax base and savings box on the Personal Income Tax (IRPF) declaration.
2. 50% of the RRP for working people with insured status and their beneficiaries, whose income is greater than or equal to 18,000 and less than 100,000 euros entered in the general payable base and savings box in the IRPF declaration.
3. 40% for working people who have insured status and their beneficiaries, who are not included in the foregoing sections a. or b.
4. 10% of the RRP for working people who have insured status as Social Security pensioners, except for people included in section a.
5. 40 % of the PVP for foreign persons not registered or authorised as residents in Spain as referred to in Article 3 ter of Law 16/2003 of 28 May 2003.
   

In order to guarantee the continuity of treatment for chronic illnesses and ensure a high degree of equality for pensioners receiving long-term treatment, the general percentages will be subject to maximum contribution limits in the following circumstances:

1. 10 % of the RRP for medicines belonging to ATC groups with a reduced contribution (Annex III of Royal Decree 1348/2003 of 31 October, which adapts the anatomical classification of medicines to the ATC classification system), with a maximum contribution of 4.24 euros.

2. For individuals with insured status as Social Security pensioners and their beneficiaries, whose income is less than 18,000 euros, as entered in the general tax base and savings box on the IRPF declaration or who are not included in the following sections c) or d), up to a maximum monthly contribution limit of 8.23 euros.
3. For individuals with insured status as Social Security pensioners and their beneficiaries, whose income is greater than or equal to 18,000 and less than 100,000 euros, as entered in the general tax base and savings box on the IRPF declaration, up to a maximum monthly contribution limit of 18.52 euros.
4. For individuals with insured status as Social Security pensioners and their beneficiaries, whose income is greater than 100,000 euros, as entered in the general tax base and savings box on the IRPF declaration, up to a maximum monthly contribution limit of 61.75 euros.

Any contributions exceeding these amounts will be reimbursed by the corresponding autonomous community at least every half year.

Users and their beneficiaries belonging to one of the following categories shall be exempt from making contributions:

1. People affected by toxic shock syndrome and people with disabilities in the cases provided for in their specific regulations.
2. People receiving social integration income.
3. People receiving non-contributory pensions.
4. Unemployed people who are no longer entitled to receive unemployment benefits, for as long as their situation continues.
5. People undergoing treatment as a result of a work-related injury or occupational disease.
6. Persons benefiting from the minimum vital income.
7. Minors with a recognised degree of disability greater than or equal to 33%.
8. Persons receiving economic benefits from the Social Security for a dependent child or minor in permanent foster care or under pre-adoption guardianship
9. Social Security pensioners whose annual income is less than 5,635 euros entered in the general and savings tax base box of the Personal Income Tax return, and those who, if they are not obliged to file this return, receive an annual income of less than 11,200 euros.
   

The level of contribution for persons covered by the General Mutal Society for State Civil Servants, the Social Institute of the Armed Forces and the General Judicial Mutual Society will be 30% in general, with the exemption foreseen for persons with treatment derived from work-related injury and occupational diseases being applicable to them and, for those who are pensioners, 10% of the RRP for medicines belonging to the ATC groups with reduced contribution, with a maximum contribution of 4.24 euros.

Ortho-prosthetics is the use of implantable or non-implantable medical devices intended to replace all or part of a bodily structure, or to modify, correct or facilitate its function. It will comprise the elements required to improve the patient's quality of life and autonomy.

This benefit will be provided by the health services or shall give rise to financial aid, in the cases and in accordance with the regulations established by the competent health administrations.

The service with dietetic products includes the dispensing of diet therapy treatments for people suffering from certain congenital metabolic disorders and home enteral nutrition for patients whose nutritional needs cannot be met, due to their clinical situation, with food for ordinary consumption.

This benefit will be provided by the health services or will give rise to financial aid, in the cases and in accordance with the rules established by regulation by the competent health administrations.

Medical transport, which must necessarily be accessible to people with disabilities, consists of the movement of patients for exclusively clinical reasons, whose situation prevents them from using ordinary means of transport. 

This benefit shall be provided in accordance with the regulations established by the competent health administrations.

The persons who receive the benefits whose portfolio of common services is established in this regulation shall have the right to health and care information and documentation, in accordance with Law 41/2002, of 14 November, the basic law regulating patient autonomy and the rights and obligations regarding clinical information and documentation, and the regulations in force regarding the protection of data of a personal nature.

Likewise, users of the National Health System shall have the right to:

• Information and, where appropriate, processing of the administrative procedure necessary to guarantee the continuity of health care.

• The issuing of sick leave, confirmation, discharge and other clinical reports or documents for the assessment of disability or other effects.

• Documentation or medical certification of birth, death and other cases for the Civil Registry.