Malta ranks among the "poor performers" in Europe when it comes to patients' rights to healthcare services, despite the building of a state-of-the-art hospital.

Maltese patients still do not have proper rights when it comes to their health, according to the results of the 2009 Euro Health Consumer Index, compiled by the Swedish-based research agency Health Consumer Powerhouse.

The results published yesterday placed Malta 23rd out of 31 European countries analysed. In view of this, the agency called on Maltese authorities to introduce, without further delay, a proper patient's rights law that would ensure patients needing care had access to their own medical records.

The study shows Malta has not moved positions compared to last year's index. Denmark topped the league table, although it still received a rap on the knuckles for its lack of cross-border care. Germany ranked second, followed by Switzerland.

The report groups 18 indicators of patient's empowerment into four categories: patients' rights, information, health technology assessment and financial incentives.

Each sub-discipline is weighted for importance to provide the overall score of a maximum 1,000 points. In this year's report, Malta scored 539 points. The best performer, Denmark scored 777 points while the worst, Bulgaria, scored 473.

Among the few good points highlighted in Malta's favour was the right to choose among health providers and the right to a second opinion.

However, Malta was given a poor grade in 11 out of the 18 rated indicators, including that of patients not having a right to view their own medical records, a lack of healthcare law based on patients' rights, no direct access to specialists and no fault malpractice insurance.

According to the agency, Malta needs to step up the participation of patients or patients' organisations in healthcare decision-making. It pointed out that policy makers in the top-ranked countries seemed to have realised that the healthcare system was for patients.

"Good healthcare is dependent on the active participation of the patients and the systems adopted in the top-ranking countries work to involve patients, offering financial incentives, power over information and patient rights leading to active choices," it said.

The report found that the right to a second opinion was non-existent in several European countries, while the right of a patient to access his own medical record was limited in many countries.

On waiting lists, a headache for Maltese authorities, the report said access to services within a reasonable time was still far from guaranteed, despite investments by many countries.

Agency president Johan Hjertqvist said choice within healthcare was still far from what citizens and users expected.