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@Bee Eater

My father had similar experience in the UK with the NHS. It's certainly not unusual for public health systems to apply some kind of age criterion when the "cost-benefit" of expensive ops might be debatable. I don't think these things are set in stone, so it's likely that the squeaky wheel will get the oil. :-) I think you can try again with your GP, and explain that you're really in a lot of pain and want to be referred for x-rays and a consultant. It probably won't hurt to point out that you have an S1, so your treatment would actually be paid for by the UK. (Also it's not clear from your post whether the advice came from your GP directly, or was broad guidance from your medical centre receptionist. In which case, get an appointment with your GP and see what he says when you discuss it directly with him.)

Alternatively, have a (private) consultation with another doctor (or specialist orthopedist), and tell them your problem and ask for their advice on how to navigate the Spanish system, given the feedback from your GP.

I don't know what connections you still have with the UK, but perhaps there's a way to get the NHS to do something for you.

If you want to go private, it's usually very easy, and you can have pretty much whatever treatment you want, when you want, regardless of your age. But it's typically very expensive, and costs vary widely. Hip and knee replacements are very popular ops, so there are plenty of options in the 10-15k euros range, and maybe a few coming in just below 10k. And lots who will charge 20k, 30k, and up (especially in the USA).

Usually, you start off by picking a private hospital (by recommendation/reviews/cost/convenience) and paying for the appropriate scan (e.g. x-rays of your knee) and a consultation/review with the appropriate specialist (e.g. orthopedic surgeon). A lot of folks will do ops internationally to save money. Turkey, in particular, is a very popular spot for European health tourism as it's very cheap and quite quick/easy to fly to Istanbul. For Brits, going back to the UK is also a very popular option as there are lots of very high quality private hospitals, no language issues, and the cost is not outrageous (maybe 15-20k euros for hips/knees).

Many of the international options specialize and behave like "focused factories" doing lots of hip replacements, or dental veneers, or boob jobs, or whatever. In my own hip research I spotted Nordorthopaedics who have good pricing (sub-10) and excellent reviews, and might be worth investigating. Dr. Google will find you a ton of options when you search for "hip replacement" or "knee replacement".

@gwynj

Thank you for your insightful and helpful comments and recommendations.

Regarding my recent experience; our health centre is very small and often over subscribed. I had had two appointments cancelled and when I saw a doctor two weeks ago, he did send me for x-rays at the local hospital the next day. So far, so good. The subsequent appointment was when I was told I would receive no further treatment due to my age, and my enquiries re the x-ray results were completely dismissed. Unfortunately, it is rare to see the same doctor twice so continuity can be problematic.

I have the utmost respect for the great majority of healthcare professionals and think I was just unlucky. I will certainly check out the terms of my S1 and engage the services of Dr Google.

@Bee Eater

It does sound like your GP is not overly cooperative. As he's the gatekeeper, it sounds like a challenge!

In the UK, I don't think I was ever given my x-rays. I'd guess the Spain public system is the same.

If that's the case, my preferred next step would be to get new x-rays at a private hospital... with a CD with the scans (plus a written report, usually). I'd expect that, for a small cost, they can give you additional CD copies.

As mentioned, I suggest a specialist consultation at the same hospital. Typically, they'll do a physical examination and look at your scans. They'll make a recommendation (e.g. rehab. conservative treatment, partial/full knee replacement) and. probably give you an idea of cost.

If you find some international specialist clinics (e.g. in Istanbul, UK, or Lithuania), you'll find that many (most? all?) will review your scans and give you an opinion/recommendation. You might be able to put your scans online, or send them by email, but I find the easiest is just to send one of my CDs to them by courier.

Armed with this info, you're in a better position to decide if you want to simply pay for the operation privately, or if you want to pressure the public system to provide you with equivalent treatment.