Thousands of demonstrators rallied in Madrid on Sunday in defense of the local public health system, accusing the right-wing regional government of trying to destroy it with spending cuts.
On a sunny afternoon, huge crowds turned out at four points across the capital. They marched on city hall in a mass protest under the slogan: "Madrid rallies in support of public healthcare and against the plan to destroy primary care services."
The government said some 18,000 people participated in the demonstration, while organizers put the turnout at about 200,000.
Demonstrators filled the central Plaza Cibeles area, chanting and waving flags. Many carried homemade signs with messages such as, "The right to health is a human right. Defend the health service."
One demonstrator sported a huge model of Isabel Diaz Ayuso, the right-wing leader of the Madrid regional government and a fierce critic of Socialist Prime Minister Pedro Sanchez's government, with a Pinocchio-like nose attached.
"We are once again defending our public health as the heart of our welfare state and our society. What is being defended here today is democracy and the health of our citizens," Health Minister Monica Garcia, a former hospital anesthesiologist, told reporters.
Unions and left-wing parties complain about long waiting lists and a shortage of staff in health centres, forcing patients to overwhelm hospital emergency departments.
Diaz Ayuso's opponents say her administration spends the least amount per capita on primary health care of any Spanish region even though it has the highest per capita income.
Many government critics believe the conservatives are dismantling the system. Madrid's regional government denies the accusation.
Spain has a hybrid healthcare system but the public sector is larger than the private one and is considered a basic pillar of the state.
The governments of the regional autonomous communities are responsible for a major part of the health budget as part of Spain's devolved political system.