The Spanish National Health System (, SNS) is the agglomeration of public healthcare services that has existed in Spain since it was established through and structured by the Ley General de Sanidad (the "Health General Law") of 1986. Management of these services has been progressively transferred to the distinct autonomous communities of Spain, while some continue to be operated by the National Institute of Health Management (Instituto Nacional de Gestión Sanitaria, INGESA), part of the Ministry of Health and Social Policy (which superseded the Ministry of Health and Consumer Affairs—Ministerio de Sanidad y Consumo—in 2009). The activity of these services is harmonized by the Interterritorial Council of the Spanish National Health Service (Consejo Interterritorial del Servicio Nacional de Salud de España, CISNS) in order to give cohesion to the system and to guarantee the rights of citizens throughout Spain. Article 46 of the Ley General de Sanidad establishes the fundamental characteristics of the SNS: a. Extension of services to the entire population. b. Adequate organization to provide comprehensive health care, including promotion of health, prevention of disease, treatment and rehabilitation. c. Coordination and, as needed, integration of all public health resources into a single system. d. Financing of the obligations derived from this law will be met by resources of public administration, contributions and fees for the provision of certain services. e. The provision of a comprehensive health care, seeking high standards, properly evaluated and controlled. Antecedents to the SNS in Spain Public intervention in collective health problems has always been of interest to governments and societies, especially in the control of epidemics through the establishment of naval quarantines, the closing of city walls and prohibitions on travel in times of plague, but also in terms of hygienic and palliative measures. Al-Andalus—Muslim-ruled medieval Spain—was distinguished by its level of medical knowledge relative to the rest of Europe, particularly among the physicians of the Golden age of Jewish culture in Spain. In the years after the Reconquista, the Real Tribunal del Protomedicato regulated the practice of medicine in Spain and in its colonies. However, the system of medical faculties at the various universities was very decentralized. Surgery and pharmacy were quite separate from medicine and were considerably less prestigious; the systems of Galen and Hippocrates dominated medical practice during most of the era of the Antiguo Régimen. Medicine was one of the principal fields of activity for the novatores of the