Madrid (AFP) - Hundreds of thousands of demonstrators rallied in Madrid on Sunday in defence of the region’s primary care services, warning that plans to overhaul the system would “destroy” local healthcare.

On a sunny afternoon, huge crowds rallied at four points across the capital and 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”.

Primary care services in the Madrid area have been under huge pressure for years due to a lack of resources and staff, with the situation worsened by poor regional management, unions say.

A regional government spokesman said there were 200,000 people out on the streets, but organisers gave a figure three times higher, saying 650,000 demonstrators had joined the protest.

Aerial shots over the main boulevards leading to City Hall showed a vast sea of protesters surging in from all directions, among them many doctors and healthcare professionals, union members and politicians.

“Your health should never depend on your wallet,” read one huge green banner, while others read: “Health care is not for sale, it must be defended” as thousands of voices demanded the resignation of the region’s right-wing leader Isabel Diaz Ayuso.

The protest, called by local associations and municipalities, took aim at the health policies of Ayuso’s regional government, its push for public-private healthcare partnerships and its restructuring of the primary care system.

- Doctors sick with stress -

One doctor working at an emergency unit in the region told AFP the cutbacks, staff shortages and mismanagement of the health services were putting an impossible strain on medical staff.

“I haven’t slept properly for six weeks. I’m barely surviving. I keep having anxiety attacks which I can only control with breathing exercises or sometimes medication. And all my colleagues are the same,” said Isabel de Barrio, 59.

“We have to put up with it the best we can.”

The protest comes ahead of a planned strike by nearly 5,000 regional family doctors and paediatricians scheduled to begin on November 21, due to “the overload of work, endless appointments and lack of time with patients”.

They will join an earlier strike by medical staff over the new model for non-hospital emergency centres, which have seen some offering only video consultations due to a lack of staff.

Spain’s left-wing government threw its weight behind the protesters, with cabinet minister Felix Bolanos saying the crisis was due to the “disastrous management” of public healthcare by the regional government which is run by the right-wing opposition Popular Party.

“Madrid is the region that invests least in health per inhabitant. The national average is 1,700 euros per inhabitant, and in Madrid it is 1,300 euros,” he said.

“It’s the region with the least doctors and nurses per inhabitant.”

- ‘An unprecedented disaster’ -

Speaking to reporters at the rally, Monica Garcia of the hard-left Mas Madrid party said the regional government was destroying the public health system.

“What they are doing is an unprecedented disaster,” she said.

“Ayuso needs to step up, listen to this demonstration and take political responsibility: either her health minister goes or she goes, or the whole Popular Party government goes” she said.

But few had hope Ayuso or her government would listen or make any meaningful changes.

“I don’t think so. They have so many business interests that even if they wanted to change their policies, they couldn’t,” said Jose Luis Yuguero, 66, a self-employed energy expert.

“We are going to have to do three or four more demonstrations like this for it to have any effect.”