Whilst the waiting time for inpatient care on a number of procedures, such as cataract surgery has been reduced substantially over the past year, outpatient waiting times are “long and have been increasing”, a report published by the European Social Policy Network states.
The report, which focuses on inequalities in access to healthcare in Malta, notes that the waiting lists for inpatient care had substantially decreased and that only 0.1% of respondents reported unmet needs for medical examination due to long waiting lists.
However, in contrast, the report found that the waiting times in outpatients have continued to increase; as at March 2018, on average patients across 18 departments at the Mater Dei Hospital had to wait for 40 weeks before being granted a first outpatient appointment, the network wrote in its findings.
Similarly, data on pending unscheduled and scheduled interventions in the different specialities suggest long waits, especially in the orthopaedics department where it ran up to 220 days, while long and increasing waiting lists for some radiological investigations were also observed at the medical imaging department, the report said.
The report states that Malta’s challenges concerning healthcare access arise primarily because the same health consultants and specialists are allowed to provide services in both the public and privately run hospitals and clinics. “This systemic feature severely limits the ability of health authorities to extend outpatient opening hours, and this situation is partially responsible for long outpatient waiting times”, the report reads.
As a result, the report found that many believe that inpatient care in public hospitals is best secured by consulting specialists in the private sector first. This helps patients who can afford to pay for private consultations to by-pass, or at least minimise, their waiting times for inpatient care.
Waiting times, unlisted prescribed medication putting pressure on pensioners, low income families, third-country nationals
The waiting times and the resultant priority given towards consultation of specialists in the private sector create pressure for pensioners and low income families who require specialist care, the report read.
Furthermore, when persons in these categories are prescribed medicines that are not listed in the government formulary their challenges become harder, the report read. While it’s difficult to accurately assess the size of this group of people is, the report noted that out-of-pocket (OOP) expenses are quite high, accounting for 28% of total health spending, and are nearly double the EU average, at 15.3%. This puts Malta amongst the top third of countries with the highest rate of OOP spending, the report said.
Similar problems are also faced by third-country nationals who enter Malta legally – normally through Italy or Spain – but who are barred from working, the report noted. The report says that they face more problems in accessing adequate health and follow-up care whilst there is no specific legislation which covers this group. Similarly, there seems to be a legal limbo in relation to how such people can access mental health services or expensive treatment for HIV. Such migrants may also face barriers to using health services due to lack of information, language problems and fear of being deported, the report read.
Overall, the population coverage of the public healthcare system is high, comparing very favourably with other EU countries – the study used EU statistics on income and living conditions (EU-SILC) as a means of comparison in this regard. The variability in reported unmet medical needs between those in the highest and the lowest quintiles of income meanwhile suggests a not quite equitable access to services across all income groups, the report noted.