High infant mortality, long hospital waiting times and the weak decline in the number of stroke deaths are some of Malta’s greatest failings, highlighted in a damning study aimed at measuring healthcare provision from a consumer viewpoint.
According to the Euro Health Consumer Index Report 2014, which was presented to the European Health Commissioner yesterday, Malta ranked 27th out of 36 European states, lagging behind countries such as Hungary, Slovakia and Latvia.
Health Consumer Powerhouse (HCP), which drew up the index, lambasted Malta’s infant mortality rate, which stood at over six deaths per 1,000 live births.
“Infant deaths, a very revealing indicator, are still alarmingly high at a level otherwise known only in poor South Eastern Europe,” the HCP said in its comments on Malta.
It described infant mortality as the best single indicator, which could be used to judge the overall quality of a healthcare system.
Increased infant mortality occurs primarily among very low birth weight infants, many of whom are born prematurely; low birth weight infants probably account for more than half of all infant deaths.
In Europe, with infant deaths generally dipping below six per 1,000 live births, good check-ups during pregnancy and access to state-of-the-art delivery care are probably the key factors in attaining low figures.
Iceland has the lowest infant death rate in the world, with less than two per 1,000 live births.
In terms of hospital waiting times, Malta fared badly by not having direct access to a specialist without referral from a family doctor. Additionally, over 50 per cent of major elective surgery cases (such as coronary bypass, angioplasty and hip/knee joint) have to wait over 90 days.
While the best performing countries had non-acute CT scans performed in under seven days, Maltese patients have to wait for over three weeks. Waiting times at the Accident and Emergency Department frequently took more than three hours.
Malta registered a weak decline in the number of stroke deaths while MRSA infections remained a major problem, with 47 per cent of hospital-acquired infections being resistant.
Malta also had a high Caesarean section rate, with over 300 per 1,000 births. High C-section rates are an indication of poor prenatal support and poor baby delivery services.
Malta also fared badly in the ‘patient rights and information’ section. In 2013, only two countries out of 34 had not introduced healthcare legislation explicitly expressed in terms of patients’ rights: Malta and Sweden.
Sweden, the HCP noted, would hopefully be rectifying this shortcoming this year.
Malta also lacked a ‘no-fault malpractice insurance’, where patients could get compensation without the judicial system’s assistance in proving the errors committed by the medical staff. Maltese patients also lack access to the online booking of appointments.
A Health Ministry spokesman said the side-effects of one major success of the Maltese healthcare system – namely, a high life expectancy – meant a higher demand for certain types of services that created waiting lists.
The waiting list problem was being addressed at a “steady and consistent pace” with a number of waiting lists already having been significantly reduced.
Referring to the infant mortality rate, the spokesman said that, under Maltese law, abortion was illegal. As such, foetuses diagnosed with potentially-fatal congenital anomalies were born alive but some passed away after birth, rather than being terminated earlier. This greatly influenced and increased the infant and childhood mortality rates in Malta when compared to other countries where screening for congenital anomalies was practised routinely and termination of pregnancy offered.
Regarding hospital-acquired infections, he noted that MRSA infections at Mater Dei Hospital dropped by 50 per cent in 2014 alone.
The report, the spokesman continued, also acknowledged the efforts being made in prevention.
It recognised the exceptionally high rate of peritoneal dialysis which allowed the patient to undergo the procedure in relative comfort at home rather than having to attend for dialysis in hospital up to three times a week.
This year’s report also recognised the effort to increase the rate of cataract procedures every year.