The situation in the Spanish care system is dramatically escalating. A recent report by the State Observatory on Dependency, compiled by the State Association of Directors and Managers of Social Services, paints an alarming picture. In the first half of the year, the number of people on the waiting list increased by a significant 16,536 to 286,861. This is based on preliminary official data from the Ministry of Social Rights.
The waiting list includes not only those awaiting an initial assessment (136,009) but also individuals waiting for the creation of their Personal Intervention Plan (PIA) (123,857), as well as those who already have a PIA but have not yet received a benefit or service (26,995). The average waiting time for a response from the administration has also increased – from 334 to 342 days in the last six months. The report’s authors issue a stark warning: at the current pace, the care system would need a staggering 94 years to achieve full coverage.
More People Cared for, But a “Low-Cost” System
Although the State Association of Directors and Managers in Social Services notes record numbers of people supported in their report – 1,689,695 individuals in the first six months of the year, an increase of 44,532 – they simultaneously warn that the current model is still classified as “low-cost.” This development is leading to a slowdown in the increase of people receiving care.
“Bureaucratic procedures, low benefit amounts, low intensity of services, and the impossibility of reconciliation create a low-cost system that is not very effective in meeting the needs of people in a situation of dependency,” the report states. Lack of funding and significant territorial inequalities further exacerbate the situation.
The stagnation of the additional 600 million euros provided by the shock plan between 2021 and 2023 is denounced as the main reason for a “significant decline in system funding” in 2024. This is reflected less in a decrease in beneficiary numbers, which follow an increasing trend, but rather in a restriction of the services and benefits offered.
Inequalities Between Autonomous Communities
The data reveals clear differences between Spain’s autonomous communities. The regions with the largest “dependency limbo,” i.e., people waiting to receive benefits, are the Canary Islands (35.4%), the Basque Country (16%), Catalonia (14.5%), and Extremadura (11.8%). In contrast, Aragon (1.5%), Navarre (2.1%), and Cantabria (2.6%) show the shortest waiting times.
Seven communities (as well as Ceuta and Melilla) have seen an increase in the number of people in this “purgatory of dependency,” with the Canary Islands (+44.2%), Castile-La Mancha (+40%), and Madrid (+31.6%) leading this increase. More than half (51.7%) of the affected individuals live in Catalonia (39,755), Andalusia (18,749), and the Canary Islands (15,171).
Last year, the largest increases in supported individuals were in Galicia (10%), the Canary Islands (6.7%), and Asturias (5.9%). Conversely, a decrease in supported individuals was observed in Cantabria (0.8%), Extremadura (0.5%), and La Rioja (0.2%). Nationwide, the number of beneficiaries increased by 3.2%. The Canary Islands (17.5%), Galicia (8.6%), and Asturias (5.6%) saw the largest increases in beneficiaries in 2025, while Cantabria experienced a decrease of 0.2%.
The maximum period for processing a procedure is six months (180 days). Only Ceuta and Melilla (163 days), Castile and León (113 days), the Basque Country (129 days), Aragon (163 days), and Castile-La Mancha (176 days) are on average below this value. Navarre (202 days) and Cantabria (210 days) are close to the limit, while Andalusia (574 days), Murcia (564 days), and the Canary Islands (521 days) have the longest waiting times.
Murcia and Madrid significantly extended their processing times in the first half of the year (by 44 and 30 days respectively), while the Canary Islands (40 days), Andalusia (28 days), and Aragon (26 days) managed to reduce them.
An Underfunded System with Deadly Consequences
The report by the Observatory on Dependency warns that despite the gradual increase in the number of people receiving care, the pace is still insufficient to manage waiting lists. Two main reasons are cited: successive cuts in the funding of the Dependency Law, which have created “huge niches of neglect,” and a “crazy and stormy” bureaucratic framework that turns access to benefits and services into a “death trap.”
Although the Dependency Shock Plan brought an improvement in reducing waiting lists, the expected goals were not met due to stagnant investments. The consequence is tragic: people continue to die while waiting for benefits or services to which they were entitled. In the first five months of 2025, 8,004 people died in this situation – every 15 minutes, one person on these waiting lists dies.
Two out of three people on the waiting list live in Catalonia (77,745 people), Andalusia (50,303 people), the Valencian Community (33,115 people), and the Canary Islands (28,867). The largest increases on these lists were in Catalonia (7,972), the Valencian Community (5,930), and Madrid (3,597). The Canary Islands (-2,803) and Castile and León (-2,424) led the decline in numbers.
Regarding funding, the association warns that the Spanish government’s percentage of dependency spending, according to the latest official data, is only 28.6%, far from the desirable 50%. While the shock plan led to annual increases of 600 million euros between 2021 and 2023, there was no significant budget increase in 2024 – only 5%, justified by the increase in people receiving care. This indicates that expenditures were increased due to a legal imperative, not through political commitment.
According to the association, the budget increases in recent years do not compensate for the cuts suffered in 2012. The cumulative increase since 2021 has been 3,793 million euros, whereas the austerity measures of Royal Decree-Law 20/2012 amounted to 6,322 million euros until December 2020.
At the end of the report, it is emphatically stressed: “Without an increase in funding, the rights of the Dependency Law remain a dead letter, which will only serve to create false expectations for people in a situation of dependency and their families.”
