Value for money

I just had three or four days in hospital, sort of related to the cancer but not directly. 

On Monday I went to the local hospital to speak to a nutritionist and to get a dressing changed, and one of the nurses thought I looked so rough that she marched me down to Urgencias (A&E), where they did a few tests, kept an eye on me in observation for a while, and then admitted me onto the cancer ward. I spent the next three nights there. Basically, I was just a bit feverish and a bit dehydrated, but at one point the doctor used the words insuficiencia renal, which obviously translates as renal insufficiency—something kidney-related, though I didn’t know quite what. It certainly rattled a Spanish friend when I repeated the phrase to him. I'm not surprised. I looked up the translation, and “kidney failure” sounded quite bad. Apparently, there are stages, though, and dictionaries can be a little binary at times. It was just that my kidneys were a bit overstretched because I was vomiting repeatedly after the radiotherapy and chemotherapy, which, of course, doesn’t help with staying hydrated. Still, it made me think about the people who currently have my back.

When we first moved here, I had some hare-brained scheme for making a living. We'd realised though, even before the glaring holes and the daftness of the scheme didn't seem so glaring or so daft, that we’d need time for it to start producing money. Fortunately, Maggie is a properly trained and qualified teacher, and she was able to find work in a private school - in fact where she found the job is why we ended up in Alicante province and later why we moved to near the Portuguese border and down to Cartagena all the while maintaining the house here in Culebrón. In the first few months her wages kept us afloat as we very quickly used up all the money we’d brought with us from the UK on buying houses, re-registering cars, eating and whatnot. I was incredibly lucky, and I’ll be forever grateful for a couple of circumstances that led to me working for a business here in Pinoso called RusticOriginal.

Like all immigrants needing work, I was at the mercy of unscrupulous employers. Fortunately, my first employers were both mean and generous at the same time. I’d said, and it was my only condition for working for them, that I needed a legal contract. It has always been my one and only stipulation when taking on any work in Spain. Without fail, the employers have twisted the contract situation to suit their ends, but I have never worked without a contract, and that first job was no exception. Sometimes, always, the conditions haven’t been what they should be; usually, the pay rate has been altered, and the terms and conditions—the convenio—have never been adhered to, but there has always been a contract across the six different employers I worked for in Spain.

The reason I was so insistent on contracts was to guarantee healthcare. I’ve never been young in Spain, and I’ve always been aware of the frailty of the flesh, even when I seemed reasonably fit. Pay your Social Security on that contract, and you’re covered. Actually, I was lucky too. Some judges decided, just before I reached pensionable age, that a working day was a working day. If your contract was for three hours and you worked three hours, then you’d worked a day. Before that, a day was, say, eight hours, so if you worked four hours per day, you needed to work two days to clock up one full day. Changing the calculation to days instead of hours made a massive difference—not to my healthcare but to my Spanish pension.

Always working with a contract gave me enough recorded working years to be entitled to a portion of a full Spanish pension. I also receive a UK pension for the years I worked there. My “old age” pension is a combination of the UK one and the Spanish one, but the fact that I am a Spanish pensioner gives me certain rights that have proved very handy over the years for all sorts of bureaucratic reasons—from registering my income with the banks to prove I’m not laundering money to buying a car on finance to getting the subsidised IMSERSO holidays.

I reckon I’ve been in hospital six times in my life: three times in the UK and three times here. Like everyone else, I’ve had lots of other medical “interventions”—from peritonitis and a bleeding stomach to various cancer scares before this current, real, one. As I lay there, awake at 4 a.m. in a hospital bed, I thought of the effort and the cost that has gone into trying to stop me dying of throat cancer: the original referral and diagnosis, the radiotherapy and chemotherapy sessions, the ambulance rides to and from various hospitals, the plethora of drugs, the stuff that’s taken over from food, the clean pyjamas, and all sorts of health professionals talking to me and looking after me—all for nothing more than the requirement that I paid my contributions as part of that legal contract. Donnie Trump may think state healthcare makes us communists and, if  he's right, and I've never heard him say anything that is truthful or right, then all I can say is: "Comrade: Let me hear them balalaikas ringing out".

He loved Big Brother

I didn't sleep particularly well last night. I kept waking up with some half formed Spanish phrase rolling around the empty quarters of my mind before lapsing back into semi unconsciousness. It wasn't the thought of what the Catalans might do after the sentencing of their pro independence politicians today, it was because I was off to the Social Security office.

When I was last in that office, just before Christmas, I was told that my old age pension would include a little from Spain and a lot more from Britain. I started to get money from the UK, on time, in May. I expected a top up from Spain last month.  But it didn't come. Worse than that, trying to find out why not, I found, online, that my health care had been downgraded from a constitutional right as a worker to a bit of a dispensation for foreigners. Given that the UK has been a hotbed of political idiocy for a few years the less I have to depend on anything coming from there and the more I can rely on things directly from here the better.

I was worried about my appointment on two scores. The first, the perennial, is simply being able to present my case in Spanish. The second is that if my Spanish work history, dodgy and short as it is, was going to be disregarded then all those times I had stood out for a legal contract were going to be wasted. I also know that challenging a wrong, unfair or unreasonable bureaucratic decision is a hard and thankless slog.

My appointment was on the dot, no waiting at all. I told the bloke behind the desk that all I wanted to know was where I stood with Social Security - did I have Spanish rights or just foreign ones? We talked for a while, he looked at paperwork and then he said the magic words "If you've paid in to the system here then you have the right to health care". That was all I needed to hear. I was as happy as Larry; anything else was largely irrelevant. By the way apparently the phrase comes from the state of mind of an undefeated Australian 19th century boxer, Larry Foley, on retirement. But then  he made me happier. I was asked why I hadn't claimed the Spanish part of my pension. It seems that going in December hadn't been enough. I should have gone back when I finished working in April. We filled in the paperwork. All I have to do now is wait.

The handshake, as I left , was as warm as a manly, cisgender, handshake can be.

Doctor, doctor

I know that the NHS, the British healthcare system, is a politically hot topic nowadays and I suspect there have been several changes to it since I left but, for someone who lived in the UK till 2004, the Spanish healthcare system and the British ones are basically similar.

The main difference is that you have to have paid into the Social Security system, or be the dependant of someone who has, if you are to get anything out of the Spanish system. Emergencies are always treated - though I'm not sure whether there might be a corresponding bill afterwards if you haven't contributed. Pensioners from any EU country are covered by the system here but the payment actually comes from the home country.

Dentistry is not included in the Social Security cover and there is a system of charging for prescriptions with various discounts which take account of your age, any disabilities and income but, in general, get sick and paramedics, nurses, doctors and an impressive array of medical hardware will come to your aid.

I've not been a big user of the system. An infection here and an injury there but the last time I spent any time at a doctor was in Cartagena four or five years ago. I have this idea that I can tell when it's something serious and when it isn't so, most times, I just wait for the malady to disappear and, touch wood, up to now there has been nothing serious.

Pinoso, as you know, is a really a village, rather than a town. A few souls short of 8,000. Nonetheless, it has 24 hour emergency medical cover. Our health centre is modern and operates at full swing on weekday mornings and early afternoons and then has a quieter afternoon/evening session. I don't actually know the opening hours but I know the principle well enough.

The last time I went to the doctor was on a Saturday afternoon when there is a just a skeleton, out of hours, staff on call. My stomach had been painful for a long time and the pain didn't seem to be going away and I didn't like it. Finally I was persuaded to go to the doctor in "emergency" hours. The doctor laughed, gave me something akin to imodium and sent me on my way. I felt suitably foolish.

Regular readers will know we have a couple of newish house cats and a visiting street cat  - a big white job. Having tried to scare him away we have now taken to trying to feed him so much that he leaves our two alone. A risky strategy I know. He is grateful for the food though. He goes into a frenzy as the food approaches and chows down in a noisy and very animated way. Tonight as I gave him a handful of the dried food he bit me. Nothing serious, he just mistook me for chicken flavoured biscuits, but he got a clout on his backside in retaliation.

An hour later and my hand was feeling very strange, A sort of pins and needles. I've heard about cat bites. A friend was very close to losing his finger after a bite from the family pet. Once again I rang on the out of hours bell at the health centre. Once again I was treated as a sort of idiotic time waster. They gave me a tetanus jab and told me to go back tomorrow if my hand swells up but basically they were miffed that I'd interrupted whatever it was that they were watching on the telly.

It's excellent that we have the emergency service though. Even if they do laugh at me.

Nothing in particular

It's raining. It's rained quite a lot in the last couple of weeks. We've forgotten all about the drought which lasted from last winter through to a few weeks ago. Usually, though not today, it rains overnight which is very civilised. I can't pretend that it's warm but it isn't cold either - at least not outside. Generally we're into the mid to high teens during the day but with sun and blue skies so it feels pleasantly warm. Overnight we're down at 7ºC or 8ºC maybe. I expect it will turn cold in December, it usually does. The pile of leaves that have just started to clog our drive suggest that Autumn has finally arrived. And its getting dark just after six in the afternoon. Considering it will start to get lighter again just before Christmas that's not too bad. So outside, in the fresh air everything is as it should be. Inside the house of course it's miserable. On the front page of today's Alicante paper there's a headline which says that nearly half of the houses in Alicante province lack any form of insulation against sound, heat or cold. This statistical information is tied in to the introduction of energy efficiency certificates for dwellings a while ago. In our house the little windows, designed to keep out the beating sun of summer make our rooms dismal in winter and the uninsulated house with tiled floors, painted walls and badly fitting doors make it exactly the opposite of cosy. With the log burner alight the living room has been lovely and warm but all the adjoining rooms have a cold, musty feel. Getting into bed is quite unpleasant until you stop shivering.

In the news, corruption stories are everywhere. The health minister resigned this week. She was mentioned by a judge as being the direct recipient of goods bought with her husband's dodgy money. I heard lots of comments that it was like making the poor thing resign for having eaten poached game when she didn't know it was poached. Hmm. The same judge said the ruling PP or Conservative party had benefitted directly from dodgy funding but the health minister's boss, the national president, forgot about that when he stood up in parliament and said that corruption was not endemic. The last three PP party treasurers have all been in court, one is on remand and that one has accused the current president of taking illegal payments. I wouldn't like to give the idea that only the PP have their fingers in the till. Certainly on percentages they come out top but, down in Andalucia, there's a huge corruption deal about suspect redundancy notices which implicates two past PSOE or Socialist party presidents. And the independents don't want to miss out either. In Cataluña an almost mythical ex leader turns out to have a stash in Andorra and there was a case of illegal party funding a while ago that another key political figure somehow seemed to sidestep.

Back to our national president; he's a very strange president. Earlier this month a couple of million Catalans turned out for an illegal referendum on independence - the national president generally ignored that and sent something akin to the Crown Prosecution Service (if it's still called that) after the regional president for running an illegal poll. So much easier than arranging to talk about it. He's behaving the way I do when I need to talk to someone in Spanish on the phone. Anything to avoid a difficult conversation.

There are close on 2000 politicians currently charged with some level of corruption yet none of the promised anti corruption legislation has got past the committee stage. The politicians don't go easily either. None of them behave like people convicted of crimes. No sackcloth and ashes. Most of them spin out the process for ever with iffy legal arguments and expensive lawyers. The few who have been locked up argue about which prison they'd like. An ex president of one of the regions was in the sort of prison regime where you go home for the weekends and only put on your stripey suit every now and again. When people found out they got a bit indignant so a judge decided to withdraw those privileges. The ex politician appealed the decision. Another ex regional president who has been sentenced to four years in chokey still has body guards and an official looking car and has been asking the Central Government for a pardon - a real live get out of gaol for free card.

Yesterday I got a text message from the General Treasury of the Social Security on my phone to tell me that my petition to become a self employed person had been approved. In the past I've complained about the difficulties that people face who want to set up their own business here. People needed to have a hefty amount of cash behind them in the bank or at least some heavyweight backers willing to cough up if the business went pear shaped. Social security payments were high too with even the smallest business subject to a 260€ minimum payment from the first day of trading and before any tax committment. Anyway, for my new job, my new boss suggested that I should be self employed. This only made sense because now there is a sort of reduced charge sliding scale social security payment scheme starting at around 53€ for the first 6 months and then going 130€, 180€ and finally 260€ after two years. I thought it sounded like a good scheme. An incentive to get people to register and run legal businesses from the start rather than to start illegally and register only when the profits justified it. Nonetheless in my case I thought it sounded a bit flaky and there were plenty of disadvantages as well as advantages but the accountant told me that at least it was all legit. He did all the work. All I had to do was to sign on the dole and hand over some basic ID documentation and he did the rest. Then a text message. Nearly as strange as our president.