Health ministry clarifies position on medical treatment abroad

The Health Ministry this afternoon explained the implications of a recent  judgement by the Appeals Court in relation to cross border health care and the perception that people who have been waiting for an operation can have the procedure abroad, billing the government.

"A clear distinction must be made between the Court judgement and the issue of waiting times. It is important to note that the Court judgement itself was primarily concerned with an EU Member State’s application of publicly funded health care services," the ministry said.

"The judgement specified that the Maltese Government had the duty to inform the public of its publicly funded health care package; the Department of Health has addressed this issue and the package of health care services offered by
government has been available on its website since October 2010. This package is being updated on a regular basis to keep the public informed on the introduction of new services."

In the meantime, the Ministry said, it is also working on the transposition of a new directive on cross border health care which will come into force by no later than October 2013.

This directive provides a new mechanism for patients to access cross border health care. It stipulates that patients will pay for the full cost of treatment conducted abroad and be reimbursed the amount it would cost government to carry out the procedure in Malta.

"In doing so, the patient will fork out the difference between the cost of treatment abroad and the cost of the same procedure in Malta," the ministry pointed out.

"To make use of this service, prior authorisation will still be necessary for specialised investigations and interventions and for care involving an overnight stay in a hospital. Additionally, procedures will only be rendered eligible for reimbursement if they form part of Malta’s publicly funded package of health care services. This will provide a clear legal framework to deal with requests for treatment overseas."

Malta, it said, is working closely with the European Commission through the committee that has been set up specifically to oversee the implementation of this directive across all Member States.

Until the Directive forms part of Maltese legislation, the Health Department will continue to process requests for treatment abroad in line with current EU regulations and local administrative procedures through the EU Health Care Entitlement Unit and the National Programme for Highly Specialised Overseas Referrals.

EU law (under regulation 883/04) grants patients the right to seek authorisation for treatment outside their country where such treatment cannot be provided within a time limit that is medically justifiable, taking into account the patient’s current state of health and the probable course of the illness in question. The final decision on these requests is made by a panel of clinical experts who decide upon each case on its clinical merits, in line with EU law.

"The notion of “undue delay” requires assessment and confirmation by a board referred to as the Treatment Abroad Committee. Therefore, the Court judgement itself is not directly linked to the issue of waiting lists," the ministry said.

"Nevertheless, the government is determined to continue tackling waiting times across the full spectrum of services it offers."

It noted that last year,  41,795 operations were conducted at Mater Dei, an increase of 28% (9,000 operations) over the final year of St Luke’s Hospital.

Initiatives including the outsourcing of public health services services to private and NGO sectors were also developing steadily.