Editorial: Health tourism raises questions

There have been around 100 cases in two years of – mostly – third-country ‘tourists’ coming to Malta to be treated for infectious diseases.

At first glance, this does not appear worrying: after all, Mater Dei Hospital had around 105,000 patient admissions in 2024.

Perhaps when reading the introduction, though, the focus should be on two points: that the diseases they carry are infectious; and that these are ‘tourists’ specifically coming to Malta for treatment.

Take the nature of the disease: the Infectious Disease Prevention and Control Unit annual report gives a breakdown of all the diseases it deals with, which run into a few thousand each year. Admittedly, not all those infected end up in hospital – which is just as well, since the Mater Dei unit has only 20 beds.

So those 100 cases represent a worrying figure.

The head of the unit, Tanya Melillo, was not reported as having given any breakdowns as to what the diseases were. However, it would be unlikely that they came to Malta to be treated for a gastric complaint: the implication is that these diseases require a little bit more than antibiotics.

Infectious diseases, as their name implies, can spread to other people, and, even though not all of them are airborne, this poses a risk to all those they come into contact with.

The possibility that they might be carrying diseases that are as yet rare in Malta adds to the level of concern.

Indeed, one of the untold stories is increased vulnerability to illness.

Family doctors report multiple cases of diseases originating from overcrowded, unsanitary conditions, not to mention low vaccination rates at the point of origin.

The important aspect of this story is not that the patients are infected but that they come to Malta for treatment, even though it is not free.

The information on who can get what treatment in Malta – and indeed in the EU – is not kept secret: it is widely available online.

Is this a new form of exploitation? Are unprincipled agents targeting people with diseases?

So why would anyone come all the way here for treatment, especially since they end up faced with a hefty bill? Is this a genuine mistake or is someone maliciously hinting to them that they can come to Malta for free treatment?

Melillo said the tourists in question were mainly from Latin American countries. Malta is hardly a main tourist route for people across the Atlantic.

Speaking at a conference which touched on migration, she also mentioned that some of these ‘tourists’ are forced to “take low-paying jobs so that they can pay national insurance that would eventually make them eligible for free healthcare” – which raises the suspicion level even higher.

Is this a new form of exploitation? Are unprincipled agents targeting people with diseases? Surely that would be a new low, even by the shady human trafficking standards of some!

The statistics do not come in a vacuum: her speech also touched on the growing number of non-EU nationals seeking treatment at Mater Dei, with non-EU attendance at the emergency department rising from 7% to 14% between 2014 and 2024.

This is not about blaming or stigmatising people who are ill, nor about questioning Malta’s duty to provide urgent care to anyone who needs it.

It is about safeguarding a public health system that is already under strain, and ensuring that it is not being misused or manipulated through opaque practices. If people are being misled into travelling to Malta for treatment, or worse, exploited in the process, that demands scrutiny.