Malta’s Healthcare System: A Short Guide For Expats
Malta’s history of providing publicly funded health care dates all the way back to 1372, when its first hospital was already functioning. When the Knights of St. John first arrived in Malta in the 16th century, one of their first projects was the building of hospitals. Malta today has a public healthcare system, called the government healthcare service, where medical services are free at the point of delivery; and a also private healthcare system. The country has a strong base of general practitioner-delivered primary care. Secondary and tertiary care are provided by the country’s public hospitals. The Maltese Ministry of Health urges overseas residents to obtain private medical insurance.In the 2000 World Health Organization’s ranking of the best healthcare systems around the globe, Malta ranked number five. Other countries such as the United States and United Kingdom ranked 37 and 18 respectively. Malta’s healthcare system is similar to the British system, with healthcare being free at the point of delivery. In the Euro health consumer index, Malta’s healthcare system ranked 24 in 2014, and climbed up to 23 in 2015.
Malta has a well-respected healthcare system and residents can choose between the public and private systems.
Public healthcare in Malta
The Mater Dei Hospital (MDH), known popularly as simply Mater Dei, is the primary hospital in Malta, located in Msida. It is an acute general and teaching hospital, and offers hospital and specialist services. It is one of the largest medical buildings in Europe. Patients are admitted to the hospital through a referral by a doctor or through the emergency department.
Malta’s public healthcare system receives funds through taxation and covers any type of treatment, such as hospitalization, surgeries, pregnancy, childbirth and rehabilitation. There are eight health centers across the Maltese Islands through which the government provides primary healthcare. There are seven public medical centers in Malta and one in Gozo. Apart from general practitioners and nursing services, Malta’s health centers also provide a variety of preventive, curative and rehabilitative services, in the form of antenatal and postnatal clinics, gynecology clinics, ophthalmic clinics, diabetes clinics, psychiatric clinics, podiatric clinics, and even physiotherapy, and speech therapy and language pathology clinics. Secondary and tertiary care is offered by many different public hospitals in the country.
Private healthcare in Malta
With an increasing number of residents opting for private healthcare insurance, there has been an increase in the number of private healthcare clinics and hospitals in Malta. Those under the private healthcare system pay every time they visit a doctor. But most doctors working in the private medical care system also work as general practitioners in the state-run hospitals and clinics. The Ministry of Health, Elderly and Community Care governs both, the public and private healthcare systems.
Many local residents choose private healthcare insurance, while some prefer to avail themselves of general practitioner and consultants’ services on a ‘pay as you go’ basis. The major employers in the country usually hire private doctors on contract to attend to the medical needs of their employees. The majority of the GPs that work in the public healthcare system, also have their private practice, which has a better reputation and is also more lucrative. In the islands of Malta and Gozo, nearly all pharmacies offer GP services during certain hours. Some pharmacies also provide specialized doctors. This is considered as private healthcare and costs around 10 euros. Patients are advised to call in advance to check the consultation hours and if an appointment is required.
Healthcare for foreigners in Malta
Expats moving to Malta pay national insurance contributions to the social security fund. This is approximately ten percent of the gross salary for employers and employees. The self-employed also make contributions. EU nationals on temporary visits to Malta can use the European Health Insurance Card (EHIC) and receive free medical treatment from public hospitals and clinics. The EHIC can be obtained without any charge from your home country. It provides coverage for necessary and emergency treatments. However, this card serves as a complement to healthcare insurance and does not substitute it, as it does not cover traveling costs in case of serious conditions, injuries and deaths. It is advisable to figure out what exactly is included in your insurance policy, and remember to bring your EHIC card with you to Malta. Since the UK and Australia have a bilateral agreement with Malta, residents of these two countries qualify for free medical and hospital care for stays up to one month.
Expats staying in Malta for more than three months qualify for free healthcare from the government-run hospitals and clinics if they have the E121 form, which needs to be obtained in your home country. Once the form is issued, it is registered with the Malta Health Department Entitlement Unit, where you will be issued a Certificate of Entitlement.
Non-EU nationals are advised to obtain travel insurance that can cover medical costs overseas, including medical evacuation.
It is advisable to check which geographical areas your existing insurance policy covers, if you have one. A Maltese health insurance policy will most likely not work outside of Malta, unless you specifically applied for international cover. If you have a foreign policy that does not have international insurance cover customized for expats, it may not work even in Malta. You will need to inform your insurance company that you will be moving to Malta and hence need to switch to an international cover. There is likely to be an extra charge for this. A comprehensive international policy should insure you against medical costs in Malta, medical costs in your home country and medical evacuation costs.
Malta’s primary hospital is the Mater Dei Hospital founded in 2007. It replaced St. Luke’s Hospital as the main public general hospital. St. Luke’s Hospital in Pietà has now become the second most important hospital in Malta, offering a full range of medical services, such as open-heart surgery, psychiatric treatment and transplant surgery. Other public hospitals in Malta include the Paul Boffa Hospital, an oncology hospital located in Floriana; St Vincent De Paule Hospital, a geriatrics hospital; and the Gozo General Hospital, which is the only hospital on Gozo.
Malta also has some highly regarded private hospitals that are equipped with the latest technology. In addition to providing healthcare for Maltese residents, these also cater to foreign patients from across the globe. St. Philip’s Hospital, an independent private hospital, specializes in knee and hip replacements, and also in a comprehensive range of plastic and re-constructive surgery. It is known to use the latest implant methods and the joint prosthesis of the highest quality.
The St. James Hospital has the distinction of being the longest running private medical center in Malta. It offers a wide range of medical services, from simple pathological tests to cosmetic surgical treatment. The hospital group, to which this hospital belongs, also owns four modern clinics in Malta, including an 80-bed hospital in the town of Sliema, which also has a dedicated eye clinic. Cosmetica, another private hospital in Malta, specializes mainly in plastic and re-onstructive surgery. Any specialist or non-emergency hospital treatment requires a GP referral.
The older towns and villages in Malta have local clinics to provide medical care for the population. There are 47 local clinics that are staffed by an administrative that provides prescription medicine, which are prescribed by the health center. A GP visits the clinic at a particular time every week to write prescriptions and also to perform routine health checks.
The CommCare Assessment Unit (CAU) in Malta is staffed by nurses and exists so that those in need of community-based care get the treatment they require, and also to improve the independence and well-being of patients. The assessment group of the CAU attempts to increase community care and provision of care, along with reducing any inequalities in healthcare.
Although Malta’s public healthcare facilities are good, there may be waiting times for non-urgent hospital treatment. Expats who are not happy with the waiting times can opt for private healthcare. This, of course, requires you to pay extra, but you will be assured of quick treatment.
Waiting times for major elective surgery are known to be among the highest in Malta. Patients may have to wait as long as three weeks for a CT scan. Waiting times in the emergency departments can last as long as three hours.
Most GPs work at health centers providing primary healthcare all year round, including nights. Doctors are the first point of contact within the public healthcare system. Residents do not have to register with the doctor of their choice, since the doctor on duty will treat them at the time of their visit. Expats who wish to avail themselves of state medical care must ensure that their doctor is part of the state scheme. If someone other than the public-funded doctor treats you, you are required to pay the fees. GPs in Malta treat acute and chronic illnesses, give referrals and prescribe medication. They also offer health education and preventive care. Usually, there is no requirement to make an appointment, as the system works on a first come first served basis. Doctors also carry out home visits, but only after 8pm, and these visits are for urgent cases. The Malta Memorial District Nursing Association offers midwifery and community nursing care and is registered on a contract basis with the government health fund.
In the case of private healthcare, you should register with a GP of your choice in your area of residence. If you require any further treatment, your GP may refer you to a specialist. In the state-run system, you need your GP’s referral before you can see a specialist.
Consultants are the senior doctors who have gained a higher level of specialized training. GPs usually give referrals to patients who may require specialist diagnosis and help. Consultants are based at hospitals, but can also be present at clinics form the health centers.
Acute emergency dental treatment is provided without any charge, provided you seek treatment at a public hospital or health center. This is not a widely available service. Most dentists have a private practice. Keep in mind that the costs for private healthcare are not refundable with the EHIC.
Medication that is prescribed during inpatient treatment or for the initial three days after a patient’s discharge is free of cost, provided you show your EHIC. Any drugs that are prescribed after this duration will carry a charge, and the charges are not refundable under EHIC arrangements.
If you need to bring your own medicines to Malta, for a particular condition you have, you are required to furnish a letter from your GP stating the type of medicine and the reason for taking them. For medicines that come under the controlled drugs category, you are required to comply with regulations on drug exports.
Pharmacies in Malta are open during normal working hours, except for Sundays, when they are open from 9am-12.30pm in Malta and from 7.30-11am in Gozo. Only doctors and consultants are allowed to write prescriptions. Non-prescription drugs are often priced higher than prescription drugs. So, you may end up paying less for a strip of aspirin if it has been prescribed by your GP. The national health system reimburses the costs for prescription drugs. There is at least one pharmacy present in each village of the archipelago.
Emergency medical care
Emergency care is provided free of cost to everyone, even those without public health insurance. But once a patient’s condition is stabilized, proof of insurance status must be furnished. Emergency treatment is offered at the emergency ward of all hospitals in Malta, and these are open throughout the year. You can avail of emergency services if you require immediate medical attention, or if your doctor has given you a referral, or if there is no GP available to treat you. The emergency number for ambulance is 112, and calling is free of charge. Calls are answered in Maltese and English.