Malta: health system review

ABSTRACT

Maltese life expectancy is high and people spend on average close to 90% of their lifespan in good health. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private part of that remains higher than in many EU countries. The total number of doctors and GPs per capita is at the EU average, but the number of specialists remains relatively low. The health system offers universal coverage to a comprehensive set of services, free at the point of use for people entitled to statutory provision. The historical pattern of integrated financing and provision is shifting towards a more pluralist approach; people often choose to visit private primary care providers and in 2016 a new public–private partnership contract for three existing hospitals was agreed. Important priorities for the coming years include further strengthening of primary and mental health sectors, and strengthening the health information system to support improved monitoring and evaluation. The priorities during the Presidency of the Council of the EU in 2017 include childhood obesity, and Structured Cooperation to enhance access to highly specialized and innovative services, medicines and technologies. Overall, the Maltese health system has made remarkable progress. The main challenges include adapting the health system to an increasingly diverse population; increasing capacity to cope with a growing population; redistributing resources and activity from hospitals to primary care; ensuring access to expensive new medicines whilst making efficiency improvements; and addressing medium-term financial sustainability challenges from demographic ageing.