Hundreds of thousands of demonstrators rallied in Madrid on Sunday in defence of the region's public healthcare system which they say is at risk from the conservative regional government.

Well-known artists, whole families with children and grandparents, politicians, trade unionists and health sector workers joined the march.

A regional government spokesman said 200,000 people took part, but organizers put the total at more than three times higher.

Aerial shots over the main boulevards leading to City Hall showed a vast sea of protesters surging in from all directions.

Why are Madrid residents protesting?

Unions say primary care services in the Madrid area have been under huge pressure for years due to a lack of resources and staff as a result of austerity measures imposed during the country's financial crisis a decade ago.

Union reps say that healthcare has been worsened by poor management and that the regional government wants to restructure the system further to allow for more public-private healthcare partnerships.

Authorities also want to increase online emergency care due to staff shortages in public health centres.

"What they are doing is an unprecedented disaster," Monica Garcia of the hard-left Mas Madrid party told reporters.

"There is a very simple way to retain professionals and that is to treat them well: give them contracts that are not just for a month, a week, a weekend. When a government is incapable of doing this, it is because there are political interests at work," Garcia added.

Regional leader Ayuso singled out

In addition to more investment in healthcare, protesters also demanded the resignation of Madrid's right-wing regional head of government, Isabel Díaz Ayuso.

The Iron Lady of Madrid has drawn support and opposition with her populist rhetoric, accusing left-wing politicians of being communists and nurses of being lazy.

The left-wing national government threw its weight behind Saturday's protest, saying regional authorities under Ayuso's leadership were responsible for the "disastrous management" of public healthcare in Madrid.

"Madrid is the region that invests least in health per inhabitant," cabinet minister Felix Bolanos said. "The national average is €1,700 ($1,759) per inhabitant, and in Madrid, it is €1,300." 

Bolanos added that Madrid was also the region with the least doctors and nurses per inhabitant.

Strike action widens to family doctors

The protest comes ahead of a planned strike by nearly 5,000 regional family doctors and paediatricians scheduled for November 21, due to what they say is the overload of work, endless appointments and lack of time with patients.

"The cuts that have already been made since 2010 are devastating for public health. The situation is now untenable," a doctor at the Hospital de la Princesa told the Spanish news agency Europa Press.

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.

mm/aw (AFP, AP dpa)