Hundreds of thousands of Spain’s health workers protested in Madrid on Sunday over what they say is the destruction of the public health system by the conservative regional government.

The Madrid government has been the target of criticism in recent years, especially since the COVID-19 pandemic started in 2020, over poor staffing in hospitals and primary healthcare centres. Protesters say it is dismantling public health services and favouring private health providers.

“They have cut our wages instead of raising them. We are overwhelmed with work and do not have any support. We are in danger of extinction,” Lilian Ramis, 61, a matron at the El Molar health centre in Madrid, told Reuters.

Demonstrators filled the Plaza Cibeles area in the city centre, chanting and waving flags. One demonstrator sported a huge model of Isabel Diaz Ayuso, the right-wing leader of the Madrid regional government, with a Pinocchio-like nose attached.

Regional governments in Spain are responsible for a large part of the health budget as part of the country’s devolved political system.

A regional government spokesman put the number of people who marched through the streets of central Madrid at 250,000 while organisers put it at closer to 1 million.

Ayuso denies the accusation that her administration is dismantling public health services in favour of the private sector.

“We all believe in public health,” she wrote on Twitter on Saturday.

Thousands of health workers also demonstrated in Santiago de Compostela, in northwestern Spain on Sunday, calling for the preservation of the public health system. Police said 20,000 took to the streets.

In November, tens of thousands of people marched through Madrid in support of health workers calling for better working conditions.