A spokesperson for the Ministry of Health has confirmed that the Mater Dei Hospital management is not aware of any cases when emergency patients were not helped because of payment issues.
This comes about after a couple filed a claim in court that a baby died in the mother’s womb because the staff at the hospital were more concerned about dealing with payment issues for the non-EU father.
“Mater Dei’s position and internal policies on the subject are clear on this. In cases of emergency, patients are first treated and then the paperwork is dealt with afterwards. In cases of electives/scheduled appointments the entitlement status of the individual is clarified before an appointment is processed,” the spokesperson said.
She explained that EU nationals treated in NHS entities require the EHIC card, those working in Malta require proof of NI contributions, individuals married to Maltese require a marriage certificate, whilst British nationals living in Malta need either proof of NI contributions or a reciprocal health agreement card or a certificate of entitlement.
The Malta Independent, however, reported that the law detailing who should be paying for healthcare in Malta and the fees that apply for patients who are not entitled to free healthcare is not clear and is being interpreted differently by those applying it, according to NAO audit reports.
Also according to law, and with respect to a reply to a parliamentary question asked by PD MP Godfrey Farrugia to Health Minister Chris Fearne, there are a number of provisos which entitle foreign patients to free healthcare.
System knowing whether patients entitled to free healthcare ready by end of year
As things stand, those without a Maltese ID card have to present documentation to prove their entitlement because so far there is no electronic system in place that checks the NI contributions of patients.
A system will be rolled out across the health entities that will facilitate the entitlement process is in the pipeline and should ready by end of the year, the spokesperson noted.
How the current system for foreign patients works
At the moment, applied from 2017, a Standard Operation Procedure (SOP) is set out for all departments at Mater Dei Hospital, except for the accident and emergency department.
The purpose of the SOP is to ensure that only persons entitled to free medical care use the service for free.
The SOP identifies that only persons holding a Maltese ID card ending with letters M, G, L, H, P or C are automatically entitled to immediate free medical care. All other persons are considered as foreign patients.
These foreign patients may be liable for the payment of hospital fees in accordance with the law.
The way it works is that upon receipt of the referral ticket by the booking office or any clinic, the ID card number is checked. If the ID card does not end in the letters mentioned, for example ending in A or a passport number is written, the referral ticket is sent to the billing office for verification of entitlement.
The billing office then performs checks on the patient’s status: he will either be entitled to free medical care or will be asked to pay.
If the patient is entitled to free medical care an administrative process is carried out and an appointment can be made.
If the patient is a paying one, he will be informed of the fee (the first visit is always a new consultation and he is charged for that) and asked to pay before an appointment is given. When the patient pays for this and is given a receipt, an administrative process follows.
If after the first consultation at the Outpatients Department the consultant orders further investigations or treatment, the department receiving the request must repeat the above process is a similar manner.