Lengthy waiting times for outpatient appointments have been singled out by the European Commission, with a new report saying the Maltese were waiting an average of 40 weeks for a first appointment at the national hospital.
According to the European Social Policy Network – a Brussels body that provides the Commission with independent research – outpatient waiting times in Malta were “long and have been increasing”.
Just over a year ago, the National Audit Office had found that the average patient waited more than eight months for their first outpatient appointment at Mater Dei.
On average, patients across 18 departments at Mater Dei Hospital had to wait 10 months before being granted a first outpatient appointment. Similarly, data on pending unscheduled and scheduled interventions in the different specialities also suggested long waits, especially in the orthopaedics department, where patients waited an average of 220 days for treatment.
Long and increasing waiting lists for some radiological investigations were also highlighted at the hospital’s medical imaging department. On the other hand, the report on inequalities in access to healthcare concludes that waiting lists for inpatient care for a number of procedures, such as cataract surgery, had reduced substantially in recent years.
Inpatient care is best secured by consulting specialists in the private sector first
Only 0.1 per cent of respondents reported unmet needs for medical examination due to long waiting lists.
Overall, the population coverage of the public healthcare system was ranked as “high”, comparing very favourably with other EU countries as documented through the EU statistics on income and living conditions.
Between 2005 and 2015, the public share of health expenditure increased by more than a third.
Despite this, in 2015 health expenditure in Malta remained below the EU average – both in per capita terms and as a share of the island’s GDP.
Challenges arise primarily because the same health consultants and specialists are allowed to provide services in both the island’s public and privately run hospitals and clinics
The island’s small size meant that citizens enjoyed a good distribution of health services with regional healthcare centres and other smaller clinics scattered around the country.
And just as there was no incidence of inability to access free healthcare as a result of geographical limitations – a serious concern in some other member states, unmet needs for dental examination were also considered “very low”.
Malta’s challenges concerning healthcare access arise primarily because the same health consultants and specialists are allowed to provide services in both the island’s public and privately run hospitals and clinics.
This “severely limited” the ability of health authorities to extend outpatient opening hours and is partially responsible for long outpatient waiting times, the report concludes.
“As a result, 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,” the report authors conclude.
This, however, also created pressures for pensioners and families on low incomes who were in need of specialist care and were often unable to afford a private fee-paying consultation.
When these vulnerable people were prescribed medicines that are not listed in the government formulary, their challenges become harder.
A lack of research into this field meant it was “very difficult” to assess how big this group was: although out-of-pocket expenses were reported to be on the high side, taking up 28 per cent of total health spending, nearly double the EU average of 15.3 per cent.
This put Malta among the top third of countries with the highest rate of out-of-pocket spending on healthcare.