The State System
Healthcare is free for everyone in and Malta and therefore, there is no mandatory system of contribution. Employees and employers pay weekly national insurance contributions, which fund the healthcare service as well as other social services like pensions. Dependant family members are covered by the contributions paid by employed family members. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave do not have to pay healthcare contributions. Foreigners immigrating to Malta from the European Economic Area (EEA) also qualify for free healthcare.
If you are self-employed, you need to get additional insurance to cover members of your family. The Department of Social Security means tests low-income citizens to determine whether they qualify for assistance. Those that do, receive a card entitling them to free prescription medicine. Citizens who suffer from a chronic illness listed on the government list of chronic disease also qualify for free prescription medicine regardless of their financial status.
The state fund covers most medical services including treatment by specialists, hospitalisation, prescriptions, pregnancy and childbirth and rehabilitation.
An increasing number of citizens take out private healthcare insurance and some choose to use private GP and Consultants’ services on a ‘pay as you go’ scheme. Large employers often contract private doctors to tend to the needs of their employees. Most state employed GPs also work in private practice, which is considered more lucrative and prestigious.
Maltese citizens have to pay for their prescription medicine unless they belong to one of the vulnerable groups of society e.g. low-income earners, pregnant women, people with chronic illness and the unemployed.
Doctors and Health Centres
Most GPs work from Health Centres and primary healthcare is available year round, all day and night. Doctors are the first point of contact with the state health system. Citizens do not register with the doctor of their choice as they are treated by the doctor on duty at the time of their visit. People seeking state medical care must make sure that their doctor is contracted into the state scheme. If you are treated by anyone other than a state funded doctor, you will have to pay the fees yourself.
There is a high turnover of doctors in Malta and they receive little training in general practice. They are paid salaries by the Ministry of Health.
GPs prescribe drugs, give referrals, treat acute and chronic illnesses, and provide preventive care and health education.
There are seven Health Centres across the country and one on the island of Gozo. They are staffed by GPs, Consultants, dentists, paramedics and nurses and they provide a variety of specialist healthcare services including immunisation, paediatrics, speech therapy, dental treatment, maternity care, Well Baby Clinics and diabetes clinics. They also carry out home visits, but after 8pm, these are limited to urgent cases only.
There is no need to make an appointment as doctors see people on a first come first served basis.
The Malta Memorial District Nursing Association (MMDNA) provide midwifery and community nursing care on a contract basis with the state health fund.
The older towns and villages in Malta and Gozo have local clinics to serve the population. There are 47 local clinics and they are staffed by an administrative that provides prescription medicine, which has been prescribed by the Health centre. A GP attends the clinic on a set time each week to write prescriptions and to carry out routine health checks.
CommCare Assessment Unit (CAU)
The CAU is staffed by nurses and ensures that people in need of community-based care receive appropriate treatment. It also aims to increase a patient’s independence and to ensure their well-being. The CAU’s assessment group endeavours to increase community care and to improve the provision of care as well as decrease inequalities in health care.
Consultants are senior doctors who have completed a higher level of specialised training. GP's refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis. There are numerous specialist fields of medicine in Malta like gynaecology, obstetrics. Consultants are based in the hospitals but also conduct clinics from the Health Centres.
Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. The conditions in hospitals are good. State hospitals provide a wide range of treatment and care for both in- and out-patients. The main general hospital is St Luke's Hospital based in Sliema and it provides a full range of services, which include psychiatric treatment, transplant and open-heart surgery. Many hospitals have been modernised and now provide a pleasant care environment.
Some patients are referred abroad for treatment - usually to the UK, where Malta has a bilateral agreement.
Emergency care is available free for everyone including those without state health insurance. However, once your condition is stabilised they will want proof of your insurance status. Emergency treatment is provided at the emergency room of all hospitals. Emergency departments are open non-stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.
There are three private practices in Malta provided by independent office-based doctors and specialists. The premises, equipment and personnel are funded by the doctors themselves and through private insurance contributions. Other private doctors operate from offices based in community retail pharmacies. In these cases, the doctors have set times when they visit. The private sector is better equipped than the state sector and treats both in- and out-patients.
Dispensing chemists sell medicines in Malta. Only doctors and consultants can prescribe medicine. Non-prescription drugs are priced higher than prescription drugs. Under this system, you may pay less for a packet of aspirin if it has been prescribed by your doctor. Costs for prescription drugs are reimbursed through the national health system.