The Independent Authority for Fiscal Responsibility (AIReF) asserts that temporary disability leave in Spain has grown by 60% since 2017. Furthermore, the average duration of medical leave has increased from 40 to 46 days. In cases regarding mental health, the extension is even more pronounced, jumping from 67 to 99 days.
These are some of the conclusions from its Spending Review 2022-2026 report, which analyzes the Social Security’s second-largest expenditure item: €16.5 billion in 2024, double the amount recorded in 2017.
AIReF (the Independent Authority for Fiscal Responsibility) warns that the issue stems from a “structural deficiency” caused by the separation between “clinical authority—the primary care physicians—and financial responsibility—the INSS (Social Security).” This framework is further “aggravated” by the “decentralized organization of the Spanish healthcare system,” which is effectively 17 distinct regional systems. This leads to an “unnecessary prolongation of processes (medical leave) in the absence of reinforced supervision and coordination.”
Business associations believe that fraud plays a crucial role, suggesting that many employees are absent without justification. On the other hand, labor representatives argue that the key reason many leaves are extended is the deteriorating response times of public healthcare and the aging of the working population.
AIReF provides a much more precise diagnosis: it believes the five main factors driving the increase in Temporary Disability (sick leave) are the ‘lack of supervision and monitoring of processes’; legislative developments, which are ‘more protective of rights’; ‘improvements in collective bargaining agreements’ (employees on leave experience little to no reduction in pay); the ‘expansive economic cycle’; the ‘increase in demand for primary care’; and ‘growing waiting lists’.
