Internal coordination of social security in Spain

DOI10.1177/1388262719848983
AuthorBorja Suárez Corujo
Date01 June 2019
Publication Date01 June 2019
SubjectArticles
Article
Internal coordination
of social security in Spain
Borja Su´
arez Corujo
Department of Private, Social and Economic Law, Universidad Aut ´
onoma de Madrid, Madrid, Spain; Spanish Ministry of
Labour, Migrations and Social Security, Madrid, Spain
Abstract
This paper introduces the topic of the internal coordination of regional and local social security
schemes in Spain. In the field of social security, the constitutional framework imposes different
solutions in terms of the division of competences between State and Autonomous Communities,
depending on the branch of (public) social protection. In the provision of long-term social care, for
instance, both the State and the Autonomous Communities participate. Healthcare services are
mainly provided by the Autonomous Communities without prejudice to certain aspects of the role
played by the State. Social assistance through cash benefits or social services are exclusively
provided by the Autonomous Communities, with the deep participation of local entities, especially
in the case of social services. The paper outlines the extent of devolution and decentralisation, and
the adjudication of competence and financial arrangements. The final section addresses some
specific questions in healthcare, long-term social care and social assistance.
Keywords
Spain, autonomous communities, healthcare, long-term social care, social assistance, internal
coordination
The extent of devolution and decentralisation
Whether it is a federal State or not, it is undisputed that the degree of political decentralisation in
Spain is very high. As a cornerstone of the territorial organisation, Article 2 of the current 1978
Constitution declares ‘the indissoluble unity of the Spanish nation, the common and indivisible
country of all Spaniard’. Nevertheless, such a clear statement is balanced by the recognition and
guarantee of ...the right to autonomy of the nationalities and regions of which it is composed,
and the solidarity amongst them all’. This ambiguous constitutional provision – which enshrines
Corresponding author:
Dr. Borja Su´
arez Corujo, Associate Professor, Department of Private, Social and Economic Law, Universidad Aut ´
onoma de
Madrid, Spain.
E-mail: borja.suarez@uam.es
European Journal of Social Security
2019, Vol. 21(2) 119–140
ªThe Author(s) 2019
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DOI: 10.1177/1388262719848983
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two antagonistic concepts, unity and autonomy – is later developed by the polemical and ambig-
uous Part VIII of the Spanish Constitution (SC), under the title ‘Territorial Organisation of the
State’.
Not surprisingly, one of the most delicate and tricky issues concerning the interpretation and
application of the Constitution is the distribution of competences between the State and Autono-
mous Communities. As a general framework, competences on specific matters reserved for the
State are listed in Article 149.1 SC, whereas the rest may be considered by the Autonomous
Communities through their Statute of Autonomy – the law that fixes ‘the basic institutional rules
of each Autonomous Community’ (Article 147 SC) within the terms of the Constitution. These
basic provisions are completed through two additional rules. First, matters that are not expressly
assigned to the State may fall under the jurisdiction of the Autonomous Communities by virtue of
their Statutes of Autonomy. This means that the list of Autonomous Communities’ items men-
tioned in Article 148 SC is merely illustrative, as any other may also be assumed – always through
the Statute – as long as it is not conferred on the State. Second, matters that are not provided by the
Statutes of Autonomy, fall within the jurisdiction of the State (Article 149.3 SC).
Focusing on the field of Social Security, the constitutional framework provides four different
solutions in terms of the division of competences between the State and Autonomous Commu-
nities, depending on which branch of (public) social protection is in question. From a more
prominent to a more limited role of the State and vice versa from the perspective of the Auton-
omous Communities, it can be summarised as follows.
First, cash benefits granted by the Social Security system (in its strictest sense) are essentially
fully attributed to the State. Second, both the State and the Autonomous Communities participate
in the provision of long-term social care services (often as an alternative to cash benefits). Third,
healthcare services are mainly provided by the Autonomous Communities without prejudice to the
role played by the State in certain aspects. Additionally, social assistance through cash benefits or
social services are exclusively provided by the Autonomous Communities, with a deep participa-
tion of local entities, particularly in the case of social services.
1
To project this legal design on the
object of this research (healthcare schemes, long-term care social schemes, family allowances and
social assistance schemes), some introductory considerations should be made on the extent of
devolution and decentralization in Spain.
Healthcare
The right to health protection is recognised by paragraph 1 of Article 43 SC. Paragraph 2 remarks
that ‘(i)t is incumbent upon the public authorities to organise and safeguard public health by means
of preventive measures and the neces sary benefits and services’, adding that ‘ (t)he law shall
establish the rights and duties of all concerned in this respect’. The identification of those ‘public
authorities’ is a key aspect regulated in Title VIII SC.
Under Article 149.1.16 SC, the State holds exclusive competence over different aspects related
to healthcare. The most relevant example here refers to the ‘bases and general coordination of
health matters’. This is a broad attribution that limits its scope to determine the common frame-
work and to guarantee that the State exercises the coordination function: it entails the
1. See Articles 149.1.1, .16 and .17 SC, as well as Article 148.20 and .21 SC.
120 European Journal of Social Security 21(2)

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