Cerdanya hospital

Access to hospital care has long been difficult in the Spanish-French border region along the Pyrenees. The problem mainly affected patients from France, as the nearest hospital in their country was at least an hour’s drive away. The solution was to build a hospital in the town of Puigcerdà to serve both sides of the border.

The Cerdanya Hospital was built during the 2007-2013 INTERREG program period with support from the governments of Catalonia and France. The new healthcare facility expanded the healthcare services available locally and extended them to French citizens living in France. With 64 beds, 32 rooms, 3 operating theatres and a maternity ward, the hospital not only provides short-term medical and surgical care, but has also become the center of healthcare services in the border region.

In order to maintain the institution, a European Territorial Association called Cerdanya Hospital ETT was set up, as this was the only way to ensure the hospital’s legal and financial independence. This enabled French health insurance companies to finance a healthcare institution established outside their national borders. Both the Catalan and French health ministries contribute to the running of the hospital, which means that hospital care is available in three languages (Spanish, Catalan and French).

The hospital was handed over in 2014, but this required the harmonization of different public health care systems and institutional competences, as well as the removal of legal obstacles. In order to ensure the care of French patients and the reimbursement of costs, representatives of the two countries signed a cooperation agreement. This enabled French service providers to conclude separate agreements with their Spanish partners.

A major challenge was the harmonization of healthcare protocols, the implementation and acceptance of bilingual registration, and the employment of cross-border workers. Although most of the institution’s employees come from the Spanish side of the border, the number of workers commuting from France is also significant. They are employed by the French institution (Centre Hospitalier de Perpignan), but in practice they work at the Cerdanya hospital.

The establishment of the institution has solved the problem of hospital care for the 32,000 people living in the border region, a number that can quadruple during the main tourist season. Thanks to its innovative character, the Cerdanya hospital has become a model for cross-border healthcare in Europe.