The Government will inform migrants on the street in Ceuta about how to protect their eyes during the eclipse.

In Spain, health protection policies for migrants in street situations are mainly being shaped through the recovery of universal healthcare for migrants in irregular situations and some specific strategies (vaccination, mental health, self-care campaigns), rather than through a specific state regulation on “migrant homelessness.” The legal core is already in force (Royal Decree 180/2026 and development of Law 16/2003), while the major structural reform — the National Health System Universality Bill — remains stalled in Congress. Practically, implementation depends on autonomous communities and municipalities, where political conflicts and territorial inequalities are concentrated.

State framework: from exclusion to universal healthcare

The major recent change is Royal Decree 180/2026, which regulates the recognition of the right to health protection and healthcare for foreigners without legal residence, published in the Official State Gazette (BOE) on March 12, 2026 (Royal Decree 180/2026). It develops Royal Decree-Law 7/2018 and seeks to correct exclusions derived from RDL 16/2012.

According to parliamentary and media coverage, the decree:

• Allows access under the same conditions as the Spanish population if effective residence is proven (preferably registration in the municipal register, but also bills, school certificates, or social reports) and absence of other health coverage (Demócrata article and analysis on “health tourism”).
• Introduces a responsible declaration and a provisional document that grants immediate access while the application is processed, with positive administrative silence after three months (prior public consultation and subsequent approval).
• Strengthens protection for minors, pregnant women, victims of gender-based violence and trafficking, and applicants for international protection (RD preview).

All this is key for migrants in street situations: although the regulation does not specifically mention homelessness, it eliminates registration as the only route and accepts other documents, which is decisive for those living on the street and having difficulties registering.

In parallel, the National Health System Universality Bill (file 121/000021) is still under processing, with the amendment deadline extended until September 2, 2026 (Congress file; Health Ministry note at Universality Bill). This bill “enshrines” in law what the decree already applies: access to healthcare for any person residing in Spain regardless of their administrative status.

Specific health measures for vulnerable migrant populations

On this universalist base, more concrete policies relevant to homeless migrants have been added:

• Common vaccination strategy for migrants and refugees arriving irregularly, approved by the Public Health Commission, with accelerated schedules for measles-mumps-rubella, polio, tetanus, and diphtheria in the first weeks of stay, coordinated with the Humanitarian Care Program and regional health services (Moncloa note and coverage in Demócrata).
• Outpatient psychosocial units for migrant children in the Canary Islands, funded by the Ministry of Health, working at arrival points, emergency centers, and community networks (UPAIM initiative).
• Self-care and access to health resources campaigns aimed at homeless people, such as those by Solidaridad Enfermera and the Red Cross, with materials on hygiene, vaccination, and system use (“Your well-being matters” campaign).

Official studies show that migrant populations use the health system less and arrive later, facing legal, administrative, and cultural barriers (Health Ministry report; Infosalus analysis). This worsens when there is residential exclusion.

Competences, conflicts, and territorial inequalities

Healthcare is the competence of the autonomous communities, and municipalities manage social services, shelters, and street teams. The State sets the rights framework, but implementation is uneven:

• The Ministry itself acknowledges that some autonomous communities had been placing barriers to access despite the 2018 framework; the new RD seeks to homogenize criteria (statements by the Secretary of State and responses on “health tourism”).
• PP and Vox regional governments link universality and migrant regularization with a “collapse” of services and announce appeals against extraordinary regularization or the health decree itself (threat of regional appeals).
• In the Community of Madrid and Madrid City Council, Christian organizations denounce “exclusive and aporophobic” policies towards homeless and migrant people, including removal of belongings on the street and decisions that hinder mobility of unregistered persons (criticisms of Ayuso and Almeida). Registration is key both for healthcare access and other benefits.
• Other municipalities, such as Bilbao, commit to issuing social reports to guarantee healthcare access for foreigners with few resources (agreement in Bilbao), and Barcelona emphasizes its investment against homelessness, although mainly focused on housing and not on a differentiated health policy (reference to resources against homelessness).

Ongoing reforms and specific gaps for “street situation”

Besides the Universality Bill, parliamentary debates and motions continue to restrict or support universal healthcare and extraordinary migrant regularization (Vox motion in Congress; GeSIDA position).

However, in the sources consulted, there is no specific state health policy for migrants in street situations. Their protection rests on three pillars:

• The universal healthcare framework (RD 180/2026 and future Universality Law).
• Municipal and regional homelessness policies and social services, which determine if they can register, access shelters, or receive social-health follow-up.
• The action of NGOs and street outreach services (Red Cross, Solidaridad Enfermera, etc.) that act as a bridge to the health system.

In summary, as of August 2026, the formal right to healthcare for undocumented migrants — including those living on the street — is much more guaranteed than a few years ago, but the real effectiveness depends on local policies on registration, housing, and social support, as well as the evolution of the political conflict between the central government and several autonomous communities.

The Ministry of Inclusion, Social Security and Migrations (MISSM) assumes, regarding migrants, the planning and management of the state reception system, financial coordination with autonomous communities and social entities, and much of the policy on international protection and labor mobility. Its general framework derives from the basic organic structure of ministerial departments (Royal Decree 139/2020 and its amendments) and is specifically developed, among others, through Royal Decree 497/2020 (cited in Royal Decree 1152/2021). Subsequent regulations show that MISSM directs the reception system for asylum seekers, distributes direct subsidies to autonomous communities and entities for basic needs care, and regulates international cooperation instruments in resettlement, return, and labor mobility. Additionally, in crisis situations, it directly assumes the provision of basic services in reception facilities.

1. Reception system and international protection

The Ministry's central role in receiving asylum seekers is reflected in Royal Decree 220/2022, which approves the regulation of the reception system in international protection matters. Based on this regulation, the reception structure (places, phases, types of resources, referrals) is organized under MISSM's direction, through the State Secretariat for Migrations and its management bodies.

Complementarily, Royal Decree 590/2022 regulates the direct granting of subsidies to certain entities to finance the International Protection Reception System, showing that the Ministry not only designs but also finances and supervises the management of reception resources operated by NGOs and other collaborating entities.

2. Basic needs care and coordination with autonomous communities

In temporary protection contexts, MISSM coordinates and finances coverage of basic needs for displaced persons. This is shown by Royal Decree 672/2022 and Royal Decree 673/2022, which regulate direct subsidies to autonomous communities to:

• Improve basic needs care for beneficiaries of temporary protection affected by the war in Ukraine without sufficient resources.
• Finance direct economic aid to these persons, thus articulating a co-governance scheme where the State (MISSM) provides funds and sets criteria, and communities execute care close to the territory.

In saturation or crisis situations, MISSM can even directly assume management competences. The Resolution of December 20, 2020 by the State Secretariat for Migrations assumes competences “to ensure the provision of basic services in reception facilities for immigrants in vulnerable situations,” reinforcing the idea that the Ministry is ultimately responsible for guaranteeing accommodation, sustenance, and basic care.

3. International cooperation and labor mobility

MISSM also leads the international aspect of migration policy linked to inclusion and legal mobility. The MISSM–IOM agreement of 2024 is signed for projects of resettlement, assisted voluntary return and reintegration, labor mobility, and social inclusion, evidencing that the Ministry designs and finances programs of:

• Resettlement and relocation of refugees.
• Assisted voluntary return and support for reintegration in origin countries.
• International labor mobility and inclusion projects.

Similarly, the Ministry signs bilateral agreements to regulate labor migration flows, such as the agreement with Honduras (2021, published in 2023) and the agreement with Guatemala (2023, published in 2024). In both cases, MISSM is assigned the function of regulating and managing migrant worker contingents, in coordination with the country of origin, with the explicit goal of ordering and protecting labor migration.

4. Management of centers and other instruments

Although the specific basic regulation (Royal Decree 497/2020) is not fully available in the references, the fact that it “develops the basic organic structure” of the Ministry, as stated in Royal Decree 1152/2021, implies that functions such as the following are distributed among the State Secretariat for Migrations and its general directorates:

• Planning and management of reception devices and centers.
• Relations with social entities and international organizations in migration matters.
• Supervision and monitoring of inclusion and integration programs linked to migration.

Additionally, other instruments linked to MISSM complete this framework: regulation of the reception system (international protection), subsidies to entities and communities, and agreements with IOM, Guatemala, and Honduras allow concluding that the Ministry's competences in migrant care range from emergency material reception to social and labor integration and management of legal and safe migration pathways.

5. Other related texts

There are numerous more general or internal management regulations of MISSM (expenditure orders, committees, information security policies, etc.) that configure the institutional framework, such as Order ISM/813/2024, Order ISM/614/2024, Order ISM/1245/2024, Order ISM/55/2024, or Resolution of September 14, 2021, among many others, but they do not add specific material content on rights or services for migrants beyond strengthening the Ministry's operational capacity.

In Ceuta, as in the rest of Spain, the common rule is that all mandatory safety information and usage instructions for emergency devices must be at least in Spanish. The state regulations on medical devices, consumer protection, and safety signage set this minimum, and the Autonomous City does not have (according to available state regulations) additional linguistic requirements. Including other languages (for example Arabic/Dariya, English, or French) is voluntary and compatible, provided it does not obscure the information in Spanish and standardized safety symbols are respected. Therefore, multilingual material is allowed and may be recommended for accessibility, but the only legally required language in Ceuta is Spanish.

1. General obligation to use Spanish in user information

The key piece is the consolidated text of the General Law for the Defense of Consumers and Users (TRLGDCU), approved by Royal Legislative Decree 1/2007. It establishes that:

• All essential information about goods and services (nature, purpose, usage instructions, warnings, risks, etc.) must be clear, understandable, and accessible to consumers.
• Mandatory labeling and presentation indications of goods and services marketed in Spain must appear at least in Spanish (article amended in 2022).

This applies to fire extinguishers, emergency signage, equipment manuals, self-protection brochures, and generally any informational material the user receives as part of using an emergency device.

2. Medical devices: external defibrillators (DEA/DESA)

External defibrillators are medical devices and are regulated by Royal Decree 192/2023 on medical devices, which develops Regulation (EU) 2017/745. Three key points stand out from this royal decree:

• When placed on the market in Spain, products must include the data and information of Annex I of Regulation (EU) 2017/745 at least in Spanish, both on labeling and instructions for use.
• Economic operators (manufacturers, importers, distributors) must be able to provide the health authority with documentation in Spanish, although the authority may accept another language.
• Labeling and instructions with which the product is marketed in Spain must be submitted to the AEMPS for registration, which in practice consolidates the Spanish requirement.

Royal Decree 365/2009, which sets safety and quality conditions for the use of automatic and semi-automatic external defibrillators outside the healthcare field, does not detail linguistic aspects but refers to the manufacturer's instructions and applies over the general framework above. Consequently, a DEA installed in Ceuta must mandatorily have instructions and basic signage in Spanish; other languages may be added complementarily.

3. Signage, fire extinguishers, and other emergency equipment

3.1. Safety signage and pictograms

Emergency exit signage, fire-fighting equipment, evacuation routes, etc., are governed by Royal Decree 485/1997, on minimum provisions regarding safety and health signage at work. This royal decree:

• Defines rescue or aid signals, prohibition, obligation, warning, etc., and sets their shape, colors, and use.
• Emphasizes that pictograms must be as simple as possible, without unnecessary details, and their meaning must be clearly perceived.

It does not establish a specific language for sign text, but since these are centers providing services to users and workers, the combination of this regulation with the TRLGDCU leads to any mandatory text (e.g., “Emergency exit,” “Fire extinguisher”) must, at minimum, appear in Spanish. Adding translations into other languages is lawful as long as it does not reduce legibility of the standardized sign.

3.2. Other industrial safety equipment

Certain emergency equipment is regulated by sectoral industrial safety regulations. For example, Royal Decree 212/2002 (machines for outdoor use) requires that the CE declaration of conformity be written or translated at least into the official language of the Spanish State at the time of market placement. Although this text refers to technical documentation, it illustrates the general pattern: essential documentation must be at least in Spanish.

4. Civil protection, self-protection plans, and Ceuta's scope

The Basic Civil Protection Standard, approved by Royal Decree 524/2023, regulates minimum contents of civil protection and self-protection plans but does not introduce specific linguistic requirements. It only requires defining information, alert, and self-protection measures systems, leaving the concrete communication form to plans and basic guidelines.

Regarding Ceuta, the Statute of Autonomy (Organic Law 1/1995) assigns the city competences in civil protection and consumer and user defense, but it also contains no language rules. No reference has been identified in state regulations to Autonomous City provisions imposing the use of languages other than Spanish in emergencies.

Therefore, in Ceuta the state framework applies: obligation that mandatory safety information be at least in Spanish; full possibility for administrations, companies, or facility owners to add versions in other languages to improve population comprehension, always respecting standardized signage formats and information clarity.